Mental health of Chinese students

Last updated

According to the World Health Organization (WHO), Mental health is essential for individuals' well-being and functioning, encompassing cognitive abilities, emotional understanding, and interpersonal interactions. [1] Students worldwide consider psychological well-being, happiness, and contentment as essential life values. Research indicates that students' well-being is greatly influenced by specific needs, including the ability to make choices, express oneself freely, pursue passions and interests, achieve success, and feel psychologically and socially secure.[ citation needed ] Moreover, global studies suggest that an increased sense of well-being is associated with enhanced academic achievement, interpersonal relationships, and overall health. [2]

Contents

Research indicates that despite scoring higher on international tests, Chinese students report lower levels of well-being compared to their counterparts in other countries. [2] [3]

Current situation

Primary and high school students

Adolescence is a critical phase for establishing psychological well-being. Adolescents facing mental health issues may encounter challenges in adulthood and are more likely to continue experiencing mental health difficulties as they mature. [4]

Recent social reforms and rapid economic development in China have significantly impacted the mental health of children and adolescents. This includes heightened social stress, increased labor migration, and shifts in family planning, which have altered traditional family structures and social support systems. [5] Numerous studies have suggested that academic stressors, including academic workload, exam failures, interpersonal conflicts, and family financial issues, are the primary sources of stress in the daily lives of Chinese adolescents. [6]

Students encounter various academic demands in school, including exams, competition with peers, and meeting the expectations of teachers and parents, all of which contribute to academic stress. [7] An empirical study using the Middle School Students’ Academic Stressors Questionnaire (SSA) to explore academic stress among junior high school students in northwestern China's Gansu province (seventh to ninth grade). Their findings revealed that stress often stems from parental and teacher expectations and peer competition. Similar results have been observed among Chinese students in other regions such as Ürümqi. [8]

Besides, financial stress and interpersonal stress were found to have association with Chinese adolescents' wellbeings. [9] However, academic stress seems to be the predominant stressor. [9]

Colleges and universities students

The significance of college and university students extends beyond individual development, as their physical and mental health affect both personal growth and the nation's future. Consequently, their mental well-being has garnered attention from families, educational institutions, and society as a whole. [10] [11]

A meta-analysis investigated the prevalence of the most common mental health issues among college students in mainland China from 2010 to 2020 via consideration about various moderating factors. Two categories of mental health problems were selected: internalizing disorders encompass anxiety, depression, sleep issues, somatization, and suicidal ideation; externalizing issues include non-suicidal self-harm and suicide attempts. [12] The result suggested that:

International students

The influx of Chinese students to the United States surged in the 1980s due to the implementation of the "open-door policy." Since then, China has consistently ranked among the top sources of international students in the United States. As of 2011–2012, Chinese students constituted the largest group of international students in the United States, numbering 194,029. [15]

However, as a result of cultural adjustments and transitions, international students have distinct support requirements that increase their vulnerability to various psychological issues. [16] Moreover, Chinese education system prioritizes effort and excellence while demonstrating less tolerance for underperformance. [17] Chinese students are accustomed to early academic competition and internalize these cultural values, potentially influencing their behavior, interactions in class, and responses to academic stressors. [17] [18]

A survey among Chinese international students at Yale University showed that 45% percent experienced signs of depression, while 29% displayed symptoms of anxiety. Additionally, 27% of respondents were unaware of the mental health and counseling services offered on campus. An studies indicated that Chinese students are less inclined to seek formal mental health support compared to local students, preferring instead to rely on informal support from friends. [19] Factors such as self-perceived poor health, a strained relationship with one's advisor, and low physical activity levels were linked to higher rates of depression and anxiety symptoms. [20]

Other Contributing factors

Academic stress

Chinese adolescents navigate a cultural and educational system distinct from that of Western countries. Students in China contend with rigorous academic competitions, such as the national college entrance examination, which begins in childhood. In Chinese society, there is a widespread belief that attending prestigious schools can lead to lucrative careers and long-term happiness for children. [21] However, many Chinese families currently face the challenge of educational anxiety as they pursue these goals. [22] [23] Despite Chinese students' high global rankings in academics, including reading, mathematics, and science, their life satisfaction scores, which are crucial for mental health assessment, are notably low. [24] This trend reflects increasing academic competition, resulting in heightened financial and time investments in education, as well as an upsurge in extracurricular tutoring and a heavy academic workload for students. [21] [9]

COVID-19

According to several review studies, the prevalence of psychological distress including stress, anxiety, depression and PTSD symptoms has been notably heightened in correlation with the COVID-19 pandemic. [25] [26] The likelihood of experiencing increased depressive symptoms was notably higher among Chinese students when compared to individuals in other occupational situations such as employment or retirement. [27] The emotional distress stemming from school closures, social event cancellations, difficulties in adapting to remote learning, and exam postponements has been noted to impact students significantly. [28] [29] According to an meta-analysis, approximately 24.9% of Chinese college students experienced symptoms of anxiety during the COVID-19 outbreak. [25] The shift to online learning was reported to bring the challenges, fostering feelings of loneliness, disconnection, and difficulty adapting to new environments. Residing in urban areas, living with parents, and maintaining a stable family income were protective factors against anxiety among college students. [30] Conversely, having a family member or acquaintance infected with COVID-19 significantly increased anxiety risk. Economic impacts also be found to added financial stress for students and families. [26] [25]

Rural Area

The majority of research indicates that rural children and adolescents experience poorer mental health compared to their urban counterparts. Studies found a higher prevalence of depressive symptoms among adolescents from rural areas compared to those from urban areas. However, some studies produced inconclusive or contradictory results which observed no significant difference in the mental health of college students between rural and urban areas. [31] [32]

A research comparing the general well-being of children left behind versus those not left behind revealed that, on average, left-behind children scored lower on the Pediatric Quality of Life Inventory. [33] Although there were no notable variations in mean scores related to physical health, left-behind children exhibited significantly lower scores in areas concerning psychosocial summary, emotional and social functioning, as well as school performance. [33] [34] A meta-analysis encompassing 1465 left-behind children and 1401 children from intact family environments, indicates a consistent trend that left-behind children tend to exhibit notably elevated levels of anxiety, loneliness, fear, and self-attribution. [35]

Initiatives and policies

In China, the focus on children and adolescents' mental well-being is emphasized through three interconnected policy frameworks: inclusion in national policies, integration into maternal and child health initiatives, and dedicated policies for this demographic. [36] Mental health promotion programs within schools are recognized as effective initiatives. [22] Recent efforts aim to reduce academic stress, notably through the introduction of the "Double Reduction Policy" in July 2021, mandating schools to decrease excessive homework and off-campus training. [37] [38] [39] Primary schools, under China's nine-year compulsory education program, play a significant role in promoting child mental health, with initiatives aimed at achieving widespread mental health education coverage. [22] Provisions introduced in the revised 'Mental Health Law of the People's Republic of China' emphasize the availability of psychologists and counselors in schools at all levels, alongside the requirement for preschools to conduct mental health education. [40] Additionally, schools are obliged to provide psychological counseling and support to students in need. [40] In 2016, various ministries jointly released the 'Guiding Opinions on Strengthening Mental Health Services,' emphasizing the need for improved mental health services across educational institutions. [41] [5]

See also

Related Research Articles

<span class="mw-page-title-main">Anxiety</span> Unpleasant state of inner turmoil over anticipated events

Anxiety is an emotion which is characterised by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different from fear in that fear is defined as the emotional response to a present threat, whereas anxiety is the anticipation of a future one. It is often accompanied by nervous behavior such as pacing back and forth, somatic complaints, and rumination.

<span class="mw-page-title-main">Anxiety disorder</span> Cognitive disorder with an excessive, irrational dread of everyday situations

Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause physical and cognitive symptoms, such as restlessness, irritability, easy fatigue, difficulty concentrating, increased heart rate, chest pain, abdominal pain, and a variety of other symptoms that may vary based on the individual.

<span class="mw-page-title-main">Postpartum depression</span> Mood disorder experienced after childbirth

Postpartum depression (PPD), also called postnatal depression, is a type of mood disorder experienced after childbirth, which can affect both sexes. Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns. PPD can also negatively affect the newborn child.

Generalized anxiety disorder (GAD) is a mental and behavioral disorder, specifically an anxiety disorder characterized by excessive, uncontrollable and often irrational worry about events or activities. Worry often interferes with daily functioning, and individuals with GAD are often overly concerned about everyday matters such as health, finances, death, family, relationship concerns, or work difficulties. Symptoms may include excessive worry, restlessness, trouble sleeping, exhaustion, irritability, sweating, and trembling.

<span class="mw-page-title-main">Depression (mood)</span> State of low mood and aversion to activity

Depression is a mental state of low mood and aversion to activity. It affects more than 280 million people of all ages. Depression affects a person's thoughts, behavior, feelings, and sense of well-being. Depressed people often experience loss of motivation or interest in, or reduced pleasure or joy from, experiences that would normally bring them pleasure or joy.

Child psychopathology refers to the scientific study of mental disorders in children and adolescents. Oppositional defiant disorder, attention-deficit hyperactivity disorder, and autism spectrum disorder are examples of psychopathology that are typically first diagnosed during childhood. Mental health providers who work with children and adolescents are informed by research in developmental psychology, clinical child psychology, and family systems. Lists of child and adult mental disorders can be found in the International Statistical Classification of Diseases and Related Health Problems, 10th Edition (ICD-10), published by the World Health Organization (WHO) and in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association (APA). In addition, the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood is used in assessing mental health and developmental disorders in children up to age five.

Mental health in China is a growing issue. Experts have estimated that about 130 million adults living in China are suffering from a mental disorder. The desire to seek treatment is largely hindered by China's strict social norms, as well as religious and cultural beliefs regarding personal reputation and social harmony.

Gender is correlated with the prevalence of certain mental disorders, including depression, anxiety and somatic complaints. For example, women are more likely to be diagnosed with major depression, while men are more likely to be diagnosed with substance abuse and antisocial personality disorder. There are no marked gender differences in the diagnosis rates of disorders like schizophrenia and bipolar disorder. Men are at risk to suffer from post-traumatic stress disorder (PTSD) due to past violent experiences such as accidents, wars and witnessing death, and women are diagnosed with PTSD at higher rates due to experiences with sexual assault, rape and child sexual abuse. Nonbinary or genderqueer identification describes people who do not identify as either male or female. People who identify as nonbinary or gender queer show increased risk for depression, anxiety and post-traumatic stress disorder. People who identify as transgender demonstrate increased risk for depression, anxiety, and post-traumatic stress disorder.

<span class="mw-page-title-main">College health</span> Health of individuals enrolled in college

College health is a desired outcome created by a constellation of services, programs and policies directed at advancing the health and wellbeing of individuals enrolled in an institution of higher education, while also addressing and improving both population health and community health. Many colleges and universities worldwide apply both health promotion and health care as processes to achieve key performance indicators in college health. The variety of healthcare services provided by any one institution range from first aid stations employing a single nurse to large, accredited, multi-specialty ambulatory healthcare clinics with hundreds of employees. These services, programs and policies require a multidisciplinary team, the healthcare services alone include physicians, physician assistants, administrators, nurses, nurse practitioners, mental health professionals, health educators, athletic trainers, dietitians and nutritionists, and pharmacists. Some of the healthcare services extend to include massage therapists and other holistic health care professionals. While currently changing, the vast majority of college health services are set up as cost centers or service units rather than as parts of academic departments or health care delivery enterprises.

Mental distress or psychological distress encompasses the symptoms and experiences of a person's internal life that are commonly held to be troubling, confusing or out of the ordinary. Mental distress can potentially lead to a change of behavior, affect a person's emotions in a negative way, and affect their relationships with the people around them.

<span class="mw-page-title-main">Internet addiction disorder</span> Excessive internet use that causes psychological disorders

Internet addiction disorder (IAD) can otherwise be referred to as problematic internet use or pathological internet use. It is generally defined as problematic, compulsive use of the internet, that results in significant impairment in an individual's function in various aspects of life over a prolonged period of time. Young people are at particular risk of developing internet addiction disorder, with case studies highlighting students whose academic performance plummets as they spend more and more time online. Some also experience health consequences from loss of sleep, as they stay up later and later to chat online, check for social network status updates or to further progress in a game.

<span class="mw-page-title-main">Depression in childhood and adolescence</span> Pediatric depressive disorders

Major depressive disorder, often simply referred to as depression, is a mental disorder characterized by prolonged unhappiness or irritability. It is accompanied by a constellation of somatic and cognitive signs and symptoms such as fatigue, apathy, sleep problems, loss of appetite, loss of engagement, low self-regard/worthlessness, difficulty concentrating or indecisiveness, or recurrent thoughts of death or suicide.

Experts from many different fields have conducted research and held debates about how using social media affects mental health. Research suggests that mental health issues arising from social media use affect women more than men and vary according to the particular social media platform used, although it does affect every age and gender demographic in different ways. Psychological or behavioural dependence on social media platforms can result in significant negative functions in individuals' daily lives. Studies show there are several negative effects that social media can have on individuals' mental health and overall well-being. While researchers have attempted to examine why and how social media is problematic, they still struggle to develop evidence-based recommendations on how they would go about offering potential solutions to this issue. Because social media is constantly evolving, researchers also struggle with whether the disorder of problematic social media use would be considered a separate clinical entity or a manifestation of underlying psychiatric disorders. These disorders can be diagnosed when an individual engages in online content/conversations rather than pursuing other interests.

Antenatal depression, also known as prenatal or perinatal depression, is a form of clinical depression that can affect a woman during pregnancy, and can be a precursor to postpartum depression if not properly treated. It is estimated that 7% to 20% of pregnant women are affected by this condition. Any form of prenatal stress felt by the mother can have negative effects on various aspects of fetal development, which can cause harm to the mother and child. Even after birth, a child born from a depressed or stressed mother feels the affects. The child is less active and can also experience emotional distress. Antenatal depression can be caused by the stress and worry that pregnancy can bring, but at a more severe level. Other triggers include unplanned pregnancy, difficulty becoming pregnant, history of abuse, and economic or family situations.

Culture defines how people view the world and certain phenomena. Culture also appears to influence the way people experience depression. An individual's experience with depression can vary from country to country. For example, a qualitative study revealed that some countries did not recognize post-natal depression as an illness; rather, it was viewed as a state of unhappiness that did not require any health interventions.

<span class="mw-page-title-main">Mental health in education</span>

Mental health in education is the impact that mental health has on educational performance. Mental health often viewed as an adult issue, but in fact, almost half of adolescents in the United States are affected by mental disorders, and about 20% of these are categorized as “severe.” Mental health issues can pose a huge problem for students in terms of academic and social success in school. Education systems around the world treat this topic differently, both directly through official policies and indirectly through cultural views on mental health and well-being. These curriculums are in place to effectively identify mental health disorders and treat it using therapy, medication, or other tools of alleviation.

In colleges and universities in the United States, suicide is one of the most common causes of death among students. Each year, approximately 24,000 college students attempt suicide while 1,100 students succeed in their attempt, making suicide the second-leading cause of death among U.S. college students. Roughly 12% of college students report the occurrence of suicide ideation during their first four years in college, with 2.6% percent reporting persistent suicide ideation. 65% of college students reported that they knew someone who has either attempted or died by suicide, showing that the majority of students on college campuses are exposed to suicide or suicidal attempts.

<span class="mw-page-title-main">Mental health during the COVID-19 pandemic</span> Psychological aspect of viral outbreak

The COVID-19 pandemic has impacted the mental health of people across the globe. The pandemic has caused widespread anxiety, depression, and post-traumatic stress disorder symptoms. According to the UN health agency WHO, in the first year of the COVID-19 pandemic, prevalence of common mental health conditions, such as depression and anxiety, went up by more than 25 percent. The pandemic has damaged social relationships, trust in institutions and in other people, has caused changes in work and income, and has imposed a substantial burden of anxiety and worry on the population. Women and young people face the greatest risk of depression and anxiety.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on children</span> Overview of the impact of the COVID-19 pandemic on children

A systematic review notes that children with COVID-19 have milder effects and better prognoses than adults. However, children are susceptible to "multisystem inflammatory syndrome in children" (MIS-C), a rare but life-threatening systemic illness involving persistent fever and extreme inflammation following exposure to the SARS-CoV-2 virus.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on neurological, psychological and other mental health outcomes</span> Effects of the COVID-19 pandemic and associated lockdowns on mental health

There is increasing evidence suggesting that COVID-19 causes both acute and chronic neurologicalor psychological symptoms. Caregivers of COVID-19 patients also show a higher than average prevalence of mental health concerns. These symptoms result from multiple different factors.

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  39. ↑ Qian, Zijing (2022), Holl, Augustin; Chen, Jun; Guan, Guiyun (eds.), "The Impact of the "Double Reduction" Policy on the Mental Health of Adolescents", Proceedings of the 2022 5th International Conference on Humanities Education and Social Sciences (ICHESS 2022), Paris: Atlantis Press SARL, pp. 1402–1408, doi: 10.2991/978-2-494069-89-3_161 , ISBN   978-2-494069-88-6
  40. 1 2 Chen, H.; Phillips, M.; Cheng, H.; Chen, Q.; Chen, X.; Fralick, D.; Zhang, Y.; Liu, M.; Huang, J.; Bueber, M. (2012-12-12). "Mental Health Law of the People's Republic of China (English translation with annotations) - Shanghai Carchives of Psychiatry". Shanghai Archives of Psychiatry. 24 (6): 305–321. doi:10.3969/j.issn.1002-0829.2012.06.001. PMC   4198897 . PMID   25324635 . Retrieved 2024-03-27.
  41. ↑ Li, Bin, ed. (2020). Tutorial for Outline of the Healthy China 2030 Plan. doi:10.1007/978-981-32-9603-9. ISBN   978-981-32-9602-2.
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