In the past decade, mental health services have developed rapidly in China 1 . The number of psychiatric hospitals increased from 583 in 2002 to 1,026 in 2016 nationwide. The numbers of licensed psychiatrists and psychiatric registrars in psychiatric hospitals increased from 1.27 per 100,000 in 2002 to 2.15 per 100,000 in 2016 2 .
However, due to historical, sociocultural and economic reasons, mental health resources are mostly located in cities, but often less accessible or even lacking in economically underdeveloped areas, such as in Qinghai‐Tibetan Plateau, the “roof of the world”.
Compared to other parts of China, very few studies examined the epidemiology of psychiatric disorders in Qinghai‐Tibetan Plateau. An epidemiological survey using a multi‐stage, random sampling method was conducted in Tibet Autonomous Region (part of the Qinghai‐Tibetan Plateau) in 20033, 4, and found that the lifetime prevalence of mood disorders, schizophrenia, and alcohol dependence was 0.56%, 0.37%, and 3.08%, respectively. The lifetime prevalence of severe psychiatric disorders was 1.14%.
There are around 10.24 million inhabitants in Qinghai‐Tibetan Plateau. According to the above findings, this translates to approximately 116.7 thousand persons suffering from severe psychiatric disorders, and 315 thousand persons suffering from alcohol dependence.
Tibetans suffering from psychiatric disorders usually do not seek professional help. Due to the impact of Tibetan Buddhism, they commonly seek help from living Buddha in temples, rather than health professionals. In addition, sometimes they receive Tibetan medicine, although no solid evidence suggests that this is effective for psychiatric disorders 4 .
Furthermore, mental health services are almost not available in Qinghai‐Tibetan Plateau. For instance, the first and only psychiatric outpatient clinic in Lhasa (the capital city of the Tibet Autonomous Region) was established in 2004, with only one psychiatrist, and was closed in 2008 as the psychiatrist moved elsewhere4, 5.
In the past few years, the importance of mental health services has gained recognition in the Tibetan area. The Chinese Government has taken effective measures to provide regular mental health care. In 2017, the first and currently only available psychiatric hospital in the Tibetan area was established in Nangqian county, Qinghai province, with 32 psychiatrists and psychiatric nurses and 52 psychiatric beds 6 .
Due to insufficient local mental health resources, medical training and continuing education in Qinghai‐Tibetan Plateau, the Chinese government assigns senior psychiatrists and nursing staff from Beijing to this hospital on an annual basis and ensures training for this personnel. However, this hospital can only provide services for local patients and those in neighboring areas. Most Tibetans with psychiatric disorders in Qinghai‐Tibetan Plateau still have no accessible mental health services.
In summary, the endeavors of the Chinese government and health authorities have improved access to mental health services, but further progress is still needed to address the major challenges facing mental health care in Qinghai‐Tibetan Plateau.
The two authors contributed equally to this work.
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