Through conversation, Yuan learned about Gao having trouble sleeping every night – and that he was often in pain during the daytime. His wife and children are actually alive, but do not want to live with him because his family does not think he is normal, and worry that his illness will drag down the whole family. Although his wife would occasionally come over to cook him a meal, her stays were always short.

Gao himself is aware that he does not fit well into society. Additionally, for individuals like him, who lack strong family and financial support, the burden can be overwhelming. “I don’t want anything else,” he said during the visit. “I just hope for discounts on my medication. Most of my family’s money has gone to buying medicine.”

Another family living in the same community has a seven-year-old girl who has been diagnosed with depression. She spends her days locked in her room. Yuan, the volunteer, did not meet the young girl with depression in person, but met her father, Jianle Gu. Her father, mother and their grandparents live in a house of less than 70 square meters. When Yuan entered the house, five people were having lunch around a small table; a pot of water-soaked rice, a pot of green vegetables, and a small bowl of pickles was all the food they had to eat. Her family expressed being overwhelmed by financial stress and frustration.

“We are very short of money, particularly, [insurance] policies have changed, and the monthly financial subsidy [due to the patient having]  no serious illness has been reduced a lot,” Jianle Gu said. “If you can provide financial aid, that would greatly help.”

China has made strides in expanding mental health care, but the financial burdens remain a critical obstacle for families dealing with relatives in need of constant treatment. Medication costs can consume a significant portion of a family’s income, particularly for low-income households without robust social support. As reported in Psychology Today, drug costs can account for 15% to 25% of a low-income family’s annual income in China.

In part to address such issues, the China Disabled Persons’ Federation, a renowned organization that assists people with disabilities, has also promoted a 2023 “jingkang” initiative in recent years, to raise awareness among the public to not neglect those with mental health disabilities.

In addition, many mental rehabilitation service centers have been set up in China under the policy. Despite the government’s push, there are shortages of professionals in the field. According to a comprehensive report in the Lancet published in 2023 on the mental health workforce in China, the country has doubled the number of fully-qualified professional psychiatrists over the last 10 or 15 years – but that still means only roughly 44,000 psychiatrists for the entire nation. Further efforts to assist lie in programs like community rehabilitation, which relies on alternative models, such as “task sharing,” where trained laypersons help deliver services. Moreover, in remote and economically underdeveloped areas, there are still few to no mental health professionals, and nearly 70 percent of county-level districts have no psychiatric medical teams.