Policies, resources, and interventions for child and adolescent mental health in China: a scoping review

IF 8.1 1区医学 Q1 HEALTH CARE SCIENCES & SERVICES

The Lancet Regional Health: Western Pacific Pub Date : 2025-09-01 DOI:10.1016/j.lanwpc.2025.101635

Yiqun Luan , Yuhe Wang , Lingjun Chu , Stephanie Zhang , Xiwang Fan , Chikyu Tsin , Zihua Yu , Kexin Chen , Xinran Wang , Yijing Zhang , Yizhe Wang , Linyu Gao , Nan Jiang , Juanzhi Zhang , Eteri Machavariani , Yujia Qiu , Na Zhong , Min Zhao , Guohong Li , Jiang Long , Chunling Lu

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Abstract

Child and adolescent mental health (CAMH) disorders have become a public health concern in China, yet evidence on resource allocation remains limited. This scoping review synthesizes English- and Chinese-language peer-reviewed and grey literature to assess four domains related to CAMH: legislation and policy, financing and health insurance coverage, service delivery and utilization, and available interventions. While China has established a comprehensive legislative and policy framework for CAMH, resources remain insufficient to fully implement it. In 2020, per-adolescent (aged 10–19 years) spending on mental health curative care in China was 27.6 RMB (equivalent to $4.6 in 2023 USD), with households covering 58.1% and the government only 14%. Insurance rarely covers psychotherapy or counselling for children and adolescents. CAMH workforce and infrastructure remain limited and concentrated in urban areas. Intervention studies are mostly small-sample and focus on short-term outcomes. Evidence on cost-effectiveness is scarce. Key recommendations include expanding health insurance coverage, improving CAMH workforce and infrastructure, especially in underserved regions, and strengthening evidence-based policymaking through establishing a national-level monitoring system and conducting large-sample, long-term studies.

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中国儿童和青少年心理健康的政策、资源和干预措施：范围综述

儿童和青少年心理健康（CAMH）障碍已成为中国的一个公共卫生问题，但有关资源分配的证据仍然有限。这篇范围综述综合了英文和中文同行评议文献和灰色文献，评估了与CAMH相关的四个领域：立法和政策、融资和健康保险覆盖、服务提供和利用以及可用的干预措施。虽然中国已经建立了全面的社区卫生保健立法和政策框架，但资源仍然不足，无法全面实施。2020年，中国每个青少年（10-19岁）在心理健康治疗方面的支出为27.6元人民币（相当于2023年的4.6美元），其中家庭占58.1%，政府仅占14%。保险很少包括儿童和青少年的心理治疗或咨询。医疗卫生人力资源和基础设施仍然有限，而且集中在城市地区。干预研究大多是小样本的，关注的是短期结果。关于成本效益的证据很少。主要建议包括扩大医疗保险覆盖面，改善医疗卫生人力资源和基础设施，特别是在服务不足的地区，以及通过建立国家级监测系统和开展大样本长期研究，加强循证决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health

CiteScore

8.80

自引率

2.80%

发文量

305

审稿时长

11 weeks

期刊介绍： The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.