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Changes in treatment status of patients with severe mental illness in rural China, 1994–2015

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Mao-Sheng Ran, Xue Weng, Yu-Jun Liu, Tian-Ming Zhang, Shi-Hui Hu, Xin-She Yang, Ting Zhang, Graham John Thornicroft, Cecilia Lai-Wan Chan, Meng-Ze Xiang

Original languageEnglish
Pages (from-to)e31
JournalBritish Journal of Psychiatry
Volume5
Issue number2
Early online date18 Mar 2019
DOIs
Publication statusPublished - 18 Mar 2019

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Abstract

Background
Although it is crucial to improve the treatment status of people with severe mental illness (SMI), it is still unknown whether and how socioeconomic development influences their treatment status.

Aims
To explore the change in treatment status in people with SMI from 1994 to 2015 in rural China and to examine the factors influencing treatment status in those with SMI.

Method
Two mental health surveys using identical methods and ICD-10 were conducted in 1994 and 2015 (population ≥15 years old, n = 152 776) in the same six townships of Xinjin County, Chengdu, China.

Results
Compared with 1994, individuals with SMI in 2015 had significantly higher rates of poor family economic status, fewer family caregivers, longer duration of illness, later age at first onset and poor mental status. Participants in 2015 had significantly higher rates of never being treated, taking antipsychotic drugs and ever being admitted to hospital, and lower rates of using traditional Chinese medicine or being treated by traditional/spiritual healers. The factors strongly associated with never being treated included worse mental status (symptoms/social functioning), older age, having no family caregivers and poor family economic status.

Conclusions
Socioeconomic development influences the treatment status of people with SMI in contemporary rural China. Relative poverty, having no family caregivers and older age are important factors associated with a worse treatment status. Culture-specific, community-based interventions and targeted poverty-alleviation programmes should be developed to improve the early identification, treatment and recovery of individuals with SMI in rural China.

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