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

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.