Understanding and Addressing the Treatment Gap in Mental Healthcare: Economic Perspectives and Evidence From China

Abstract

A common challenge faced by the healthcare systems in many low- and middle-income countries is the substantial unmet mental healthcare needs, or the large gap between the need for and the provision of mental healthcare treatment. This paper investigates the potential causes of this treatment gap from the perspective of economics. Specifically, we hypothesize that people with mental illness face 4 major hurdles in obtaining appropriate healthcare, namely the high nonmonetary cost due to stigma, the high out-of-pocket payment due to insufficient public funds devoted to mental health, the high time costs due to low mental healthcare resource availability, and the low treatment benefit due to slow technology diffusion. We use China as a study setting to show country-specific evidence. Our analysis supports the above theoretical argument on the 4 barriers to access, which in turn sheds light on the effective approaches to mitigate the treatment gap. Four policy options are then discussed, including an information campaign for mental health awareness, increasing public investment in primary mental healthcare resources, transforming the healthcare system towards an integrated people-centered system and capitalizing on e-health technologies.

Investigating the Association between Streetscapes and Mental Health in Zhanjiang, China: Using Baidu Street View Images and Deep Learning

“…With rapid economic development and population growth, Zhanjiang has experienced rapid urban expansion and large areas of agricultural land have been converted to nonagricultural and urban land [ 39 ]. At the same time, the Zhanjiang government has added mental diseases into their health insurance coverage to support the development of local mental health services since 2015 [ 40 ]. The study mainly covers four municipal districts of Zhanjiang, namely Chikan District, Xiashan District, Potou District, and Mazhang District ( Figure 1 ).…”

The power of knowledge: How mental health literacy can overcome barriers to seeking help.

“…Failure and delays in seeking treatment are generally greater in developing countries than in developed countries (Qin & Hsieh, 2020; P. S. Wang et al, 2007).…”

“…Failure and delays in seeking treatment are generally greater in developing countries than in developed countries (Qin & Hsieh, 2020; P. S. Wang et al, 2007). The World Health Organization has reported that the treatment gap (i.e., the proportion of people who receive care among those who need care) for serious mental disorders is 76%-90% in low-and middle-income countries (i.e., developing countries; cited from Mascayano et al, 2015).…”

“I'm stressed!”: The work effect of process innovation on mental health

“…To combat the rapid rise in labour costs, many manufacturing firms have been motivated by giant subsidies and support policies and have implemented industrial upgrades by introducing more advanced automated systems and facilities into their workplaces. In contrast to the rapid deployment of automation in the manufacturing sector, the insufficient and maldistributed mental healthcare resources and capacity 1 in China ( Liang et al, 2018 ; Liu et al, 2011 ; Shang et al, 2019 ), together with other barriers, cannot satisfy the pressing service needs for mental health-related inquiries (in particular, stress and anxiety), leading to a large gap between the high prevalence of mental disorders and the low counselling rate ( Lin, 2018 ; Qin & Hsieh, 2020 ; Que et al, 2019 ). In fact, this mental health burden may be worsened in the new era of automation.…”