Grant: Team Grant: GACD Mental Health - Canada-China

Depression is a common mental disorder affecting approximately 350 million people worldwide and representing the third leading contributor to the global disease burden (World Health Organization [WHO], 2012). However, much of the literature on the depression derives from studies conducted in Western Europe and North America. Consequently, there is a need for novel depression research in low- and middle-income countries, including China. In China, depression is highly prevalent but is not treated in existing community mental health programs, limiting many residents’ access to mental health care and contributing to the large treatment gap. Currently, mental health care for depression exists at urban mental health centres; additionally, there is a lack of integration between primary and mental health care and the absence of mental health training for primary care physicians. Collectively, these factors hinder access to mental health care in rural and urban areas, and across communities of various socioeconomic backgrounds, languages and dialects. Thus, the development of community mental health prevention and treatment programs for depression would increase access to mental health care for residents of China in both rural and urban areas. Additional barriers that contribute to the treatment gap include culturally ingrained negativistic attitudes towards mental disorders that contribute to social- and self-stigma, and lack of education about mental disorders and their treatment. Consequently, our research endeavors, involving coordination between Canada and China, are as follows: (1) to help develop community-based mental health services for the early identification of individuals with depressive symptoms and prevention of clinical depression, (2) to improve access to mental health care and the management of patients with depression in community- and hospital-based settings, and (3) to establish international psychosocial networks or systems to monitor the quality of care. In addition, we aim to implement prevention and intervention strategies that address the aforementioned barriers to improve the quality of depression management and increase willingness to seek mental health care. Studies have reported that screening individuals with depressive symptoms and the subsequent provision of psychological therapy to prevent the onset of clinical depression is a cost-effective intervention, compared to treatment after depression onset. If depression prevention strategies become a standard part of mental health services, unnecessary suffering due to depression will be greatly reduced.