The Ingredients of Integrated Care in China

On May 8, the Global Master of Social Work Program at NYU Shanghai hosted a cross-disciplinary dialogue that looked into the prospects of developing an integrated care system to support treatment and prevention programs for a growing population afflicted with mental illnesses.

Provost Joanna Waley-Cohen opened the roundtable with a congratulatory message to gMSW Program’s inaugural class, set to complete studies in a few weeks. The two-year gMSW program immerses students in a learning environment in both Shanghai and New York city for reflection on global oriented and culturally appropriate practices.

Following the introduction, four internationally renowned scholars presented their research conducted in either Chinese or US cultural settings. Acknowledging that mental disorders have become a global concern impacting all populations, scholars pointed out that the challenge for patients lies in how to gain access to available treatment and preventions programs.

“As a pioneer in primary care, China has been introduced with the idea of integrated care as a focus of its healthcare reform. It is in a unique position to become a global leader in healthcare innovation, ” said Xu Qingwen, Professor of Social Work and gMSW program coordinator at NYU Shanghai, who moderated the conversation.

In her presentation, Victoria Stanhope, Associate Professor at the NYU Silver School of Social Work, described the development of integrated care in the United States, drawing insight from her own policy background.

“The care models of both the China’s and the United States are geared principally toward acute needs as opposed to prevention,” Stanhope said. “Policymakers should think about reallocating resources to balance the situation and increase investment in prevention.”

Professor Michael R. Phillips analyzed the aspiration-reality gap in China’s practice of providing community mental health services, based on his fieldwork in West China’s Ningxia Hui autonomous region.

“Moving mental health services out of centralized psychiatric hospitals and into the community remains problematic not only because psychiatric hospitals are reluctant to allocate the necessary resources and general health services are unwilling to provide these services, but also there is a lack of trained community-based personnel,” he said.

Phillips, who is the Director of the Suicide Research and Prevention Center of the Shanghai Mental Health Center at Shanghai Jiao Tong University School of Medicine, added that the lack of monitoring framework further undermined the effectiveness of the government initiative.

Addressing the stigma of mental illness in China, Lawrence Yang, Associate Professor of Global Public Health in the Department of Social and Behavioral Sciences at NYU, discussed how patients are negatively implicated.  

“Culture defines capacities by which ‘personhood’ is judged. If mental illness occurs without affecting such capacities, stigma may not affect one’s claim to ‘personhood’,” Yang said. “It’s important that as we examine our healthcare system, we promote such capacities of patients, so that they are free from stigma.”

Professor Douglas Perkins from Vanderbilt University also joined the discussion, talking about his findings in developing an empowering ecological-transdisciplinary care system that surrounds families and children with various services.  

“Such a care system should above all be children-centered, family-driven, community-based and culturally competent,” Professor Perkins said.