Academic journal article Shanghai Archives of Psychiatry

Number and Characteristics of Medical Professionals Working in Chinese Mental Health Facilities

Academic journal article Shanghai Archives of Psychiatry

Number and Characteristics of Medical Professionals Working in Chinese Mental Health Facilities

Article excerpt

1. Introduction

Findings from the Global Burden of Disease Project indicate that mental disorders account for 11% of overall disease burden in low- and middle-income countries, but only 35 to 50% of individuals with mental illnesses ever received treatment. [1-4] In China, mental disorders have become a major cause of disease burden; [5] based on current projections, by 2020 they will account for over 15% of the total burden of disease and injury in the country. [6] The largest mental health epidemiological study conducted in China to date (with a sample of 63,000 and a sampling frame of 113 million adults) [7] estimated that there are 173 million individuals with current mental disorders in the country but only 8% of them have ever received any type of mental health treatment. It is unknown whether or not the current mental health services and the currently available numbers of mental health professionals can meet this large and growing need for services. To help understand the current situation, this study describes the number and characteristics of health professionals working in mental health institutions throughout China.

2. Methods

2.1 Data

The steps used to identify the data used in this analysis are shown in Figure 1. For the purpose of this study, a 'mental health facility' refers to any specialty mental health facility including psychiatric hospitals, freestanding outpatient clinics (that are not administered by psychiatric hospitals), and mental health surveillance centers (that monitor mental health conditions in the community and, in some locations, provide follow-up care to mentally ill individuals). Most of these facilities are administered by the Ministry of Health, but the Ministry of Civil Affairs (the ministry responsible for public welfare services) also administers many chronic-care psychiatric hospitals, the Ministry of Public Security administers the forensic psychiatric hospitals, and there are a growing number of mental health facilities administered by local communities or by private individuals or organizations.

All medical facilities in China provide monthly updates to the Ministry of Health Statistics Information Center, where data is archived annually. The authors searched this database (updated to 2010) using the keywords 'mental health' and 'medical facility' and identified 757 different specialized mental health facilities. The characteristics of the facilities and the number and characteristics of the medical professionals working at these facilities in 2010 were abstracted from the database and used in the current analysis. According to the definition in the Provisional Regulations of Medical Professionals}*8 'medical professionals' refers to physicians, nurses, pharmacists, and medical technicians; in the current analysis these professionals were categorized as 'licensed physicians' (i.e., psychiatrists and other physicians working in mental health institutions), 'registered nurses', and 'other medical professionals' (i.e., pharmacists and medical technicians). Physicians and nurses in China are classified into six groups based on their professional rank: senior clinician, associate-level clinician, intermediate-level clinician, assistant-level clinician, entry-level clinician, and clinicians who are not yet classified. Seven geographical regions of China employed in the analysis were defined as follows: 'North China' included Beijing, Tianjin, Hebei, Shanxi, and Inner Mongolia; 'North-East China' included Liaoning, Jilin, and Heilongjiang; 'East China' included Shanghai, Jiangsu, Zhejiang, Anhui, Fujian, Jiangxi, and Shandong; 'Central China' included Henan, Hubei, and Hunan; 'South China' included Guangdong, Guangxi, and Hainan; 'South-West China' included Chongqing, Sichuan, Guizhou, and Yunnan; and 'North-West China' included Shaanxi, Gansu, Qinghai, Ningxia, and Xinjiang. The 2010 population of each region was obtained from the 2010 national census published by the National Statistical Bureau. …

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