Chinese perspectives on primary care for common mental disorders: Barriers and policy implications.
BACKGROUND
The World Health Organization (WHO) has called for integration of mental health into primary care for a decade. In Western countries, around 15% to 25% of patients with common mental disorders including mood and anxiety disorders seek help from primary care physicians (PCPs). The rate is only about 5% in China.


AIMS
This article reviews the Chinese findings on the barriers to primary care for common mental disorders and how they compared with Western findings.


METHODS
A narrative literature review was conducted, focusing on literature published from mid-1990s in English or Chinese. Patient, PCP and health system factors were reviewed.


RESULTS
Although Chinese and Western findings show similar themes of barriers, the Chinese have stronger barriers in most aspects, including under-recognition of the need for treatment, stigma on mental illness, somatization, worries about taking psychiatric drugs, uncertainties in the role, competency and legitimacy of PCPs in mental health care and short consultation time.


CONCLUSION
Current policies in China emphasize enhancement of mental health facilities and workforce in the community. Our review suggests that patients' intention to seek help and PCPs' competency in mental health care are other fundamental factors to be addressed.
['Sun|Kai Sing|KS|0000-0003-0631-9699', 'Lam|Tai Pong|TP|', 'Wu|Dan|D|']
D002681:China D007722:Health Knowledge, Attitudes, Practice D006801:Humans D001523:Mental Disorders D008605:Mental Health Services D016134:Organizational Policy D010342:Patient Acceptance of Health Care D058007:Physicians, Primary Care D011320:Primary Health Care D057545:Social Stigma
Chinese primary care common mental disorder Barriers Western help-seeking