China – Mental Health

How is mental health generally viewed and discussed in China?

For many decades, mental health has received little public attention in China, shaped in large part by deeply embedded cultural stigma. Conversations about psychological wellbeing remain taboo in many communities across the country. Someone arriving from a background where therapy is a routine and accepted part of life — such as countries where public health systems actively fund psychological services — may find this cultural contrast striking and, at times, disorienting.

The Confucian emphasis on personal and social harmony means that individuals experiencing mental disorders are frequently seen as falling short of this valued ideal. Families of those affected often fear that any disclosure of mental illness will damage their reputation, and the prospect of being labelled or excluded from social life deters many people from reaching out for professional help.

In Chinese culture, great weight is placed on how a family is perceived collectively by others. Having a relative with a mental illness may be viewed as bringing dishonour to the household — a concept inextricably linked to the notion of “face” (mianzi). The fear of losing one’s standing within a community can result in social exclusion, and patients may be deliberately kept away from social circles to spare the family from embarrassment.

Research has consistently shown that Chinese patients with mental illness tend to present with more physical complaints than their counterparts in Western clinical settings, who are more likely to describe emotional difficulties directly. For example, individuals experiencing depression in China may describe persistent fatigue or bodily aches rather than low mood. This tendency to express psychological distress through the body — a process known as somatisation — means that mental health conditions may manifest in ways that differ considerably from what expats are accustomed to.

Those who fear the social consequences of being identified as having a mental health problem are less likely to pursue help promptly. Community-level research in China has found that a significant proportion of the general population believes that deeply negative attitudes toward people with mental illness are widespread — perceptions that intensify the experience of stigma and delay help-seeking even further.

That said, the situation is evolving. The mental health of children and young people in particular has received growing attention in recent years, and government-backed awareness efforts, school-based programmes, and an expanding range of services are slowly reshaping the public conversation. Younger generations in urban areas tend to hold considerably more open attitudes, and expats in major cities will generally encounter a more understanding climate than in rural or smaller regional settings.

What publicly available mental health services exist in China, and how does the system function?

China’s approach to mental health professional regulation operates on two tracks, underpinned by the Mental Health Law enacted in 2013. At the heart of the public system is the Serious Mental Illness Management System (SMIMS), a national programme designed to support people with severe psychiatric conditions living in the community. In practical terms, this means that state-funded mental health care is oriented primarily toward managing serious disorders rather than offering the kind of counselling or talking therapies that many expats might be familiar with from their home countries.

Unlike models found in some other nations — such as Germany’s statutory health insurance framework or the UK’s Improving Access to Psychological Therapies (IAPT) scheme — China’s public system does not offer a straightforward funded route to counselling or psychotherapy for common conditions like anxiety or mild depression. It is nonetheless possible to see a psychiatrist at a public hospital, and these appointments generally do not require a prior referral, though navigating a busy outpatient system can be time-consuming.

As of 2024, 40% of public hospitals at city level and above have dedicated mental health outpatient departments, and meaningful progress has also been made in community and school-based psychological support services. However, national policy ambitions and local delivery capacity can diverge substantially, meaning that the quality and availability of services differ considerably from one location to the next.

As part of a significant expansion initiative by the National Health Commission, sleep and mental health clinics are expected to be operational in every prefecture-level city throughout China by the close of 2025. The NHC has also designated 2025–2027 as the “Years of Pediatric and Mental Health Services,” signalling a commitment to addressing gaps in both paediatric and psychiatric care.

Mental health resources remain heavily concentrated in urban centres and provincial capitals. Expats stationed in first-tier cities such as Beijing, Shanghai, Guangzhou, or Shenzhen will have access to a far broader range of options than those living in smaller cities or posted to rural areas. By the end of 2019, China had 40,850 licensed psychiatrists and psychiatric registrars, representing approximately 2.9 per 100,000 people — well below the average of 6.6 per 100,000 recorded in developed countries at that time.

For the most up-to-date information on public services, consult the National Health Commission (NHC) website, which serves as the primary regulatory authority for all healthcare in China, including mental health.

Is private therapy or counselling available in China, and what are the costs?

Private therapy and counselling is obtainable in China, particularly across the major cities, and it is the route most expats follow when looking for support with non-crisis mental health concerns. The private sector encompasses everything from psychology departments within international hospitals to independent practitioners — both Chinese and foreign — running standalone counselling practices.

Psychiatrists practising in China are medically licensed by the state, while psychologists and counsellors register through a professional body. Since 2007, the Chinese Psychological Society (CPS) has operated the national professional registration system for psychologists, with registration requiring a university degree alongside supervised clinical experience. It is advisable to verify a practitioner’s credentials before beginning sessions — registration status with the CPS can be confirmed through the society, and medical qualifications can be checked with the National Health Commission.

Importantly, the national psychological counsellor certification was abolished in 2017, which has resulted in a fragmented and inconsistent landscape of training and certification for private practitioners. The quality of private therapists can therefore vary considerably, and credential-checking is particularly vital in this context. Seeking out practitioners who hold internationally recognised qualifications from a regulated profession in their country of training — alongside any applicable local registration — offers an additional layer of assurance.

Fees at independent practices in major cities typically range from approximately RMB 300 to RMB 800 or more per session, with rates at international medical centres often considerably higher (as of 2024–2025). These are indicative figures only — actual costs depend on the city, the practitioner’s experience, and the type of service involved. Always confirm current pricing directly with the provider or by consulting the Chinese Psychological Society.

Because private mental health professionals in China essentially operate as independent service providers, pricing can be highly variable and sessions are not always reimbursable under insurance policies. Some international clinics are able to bill insurers directly, but many private counsellors require upfront payment and leave patients to submit their own claims. It is worth clarifying billing and reimbursement arrangements before attending a first appointment.

Are English-speaking therapists or counselling services available in China?

China has a notable community of foreign mental health professionals, and one effective approach to finding a qualified practitioner is to seek out professional networks and alliances of such specialists. The highest concentration of therapists offering sessions in English is found in Shanghai, Beijing, Shenzhen, and Guangzhou. Outside these major centres, in-person options can be sparse, making remote therapy particularly valuable for expats based elsewhere.

The following directories and organisations are useful starting points when searching for English-language mental health support:

• International Therapist Directory — internationaltherapistdirectory.com: A searchable database of professional counsellors and therapists in more than 60 countries who specialise in working with internationally mobile and expat clients. China-specific listings include practitioners based in Beijing, Shanghai, and Shenzhen.
• Shanghai International Mental Health Association (SIMHA): In Shanghai, a range of therapists offering support with issues such as relationship difficulties, LGBTQ+ concerns, eating disorders, and more are affiliated with the Shanghai International Mental Health Association. Check their website for current member listings and contact information.
• Parkway Health — parkwaychina.com: Parkway Health’s internationally trained team of psychiatrists and psychologists delivers evidence-based cognitive behavioural therapy for conditions including depression, anxiety, stress, substance dependence, and eating disorders, and is experienced in supporting expat families adjusting to life in China.
• TherapyRoute China listings — therapyroute.com: An international directory featuring China-specific listings along with guidance on assessing practitioner credentials.
• LifeLine Shanghai: For those who need to talk confidentially and anonymously, LifeLine Shanghai operates an English-language telephone listening service staffed by trained volunteers. Current operating hours and contact details are available at lifeline-shanghai.com.

A directory of English-speaking therapists based in China is also available at therapistsinchina.com. Some Chinese therapists additionally offer services in English. Embassies and consulates can serve as a valuable first port of call — many maintain lists of local healthcare providers and can offer emergency assistance to their citizens, including guidance on mental health resources.

What support organisations or mental health charities are active in China?

A growing number of organisations are engaged in mental health work across China. The key bodies that expats should be aware of are outlined below:

• National Health Commission (NHC) — nhc.gov.cn: The central government authority responsible for all mental health policy and the oversight of public service provision throughout China. The NHC sets national standards and coordinates the ongoing expansion of mental health services across all regions.
• Chinese Psychological Society (CPS) — cps.net.cn: The CPS administers the national professional registration system for psychologists, maintaining professional standards and disciplinary authority. Registration requires a university-level qualification and a period of supervised clinical practice.
• Shanghai Mental Health Center (SMHC): One of China’s foremost psychiatric institutions, the SMHC provides both inpatient and outpatient clinical care and is a leading centre for research and professional training. It has played a central role in shaping national mental health statistics and informing policy development.
• Beijing Suicide Research and Prevention Center / Hope 24 Hotline: This organisation operates a round-the-clock crisis and suicide prevention telephone service at 010-82951332. The service is delivered primarily in Mandarin but remains a key crisis resource in the country.
• LifeLine Shanghai — lifeline-shanghai.com: A volunteer-run confidential emotional support service aimed specifically at the international community in Shanghai, operating in English. Operating hours and contact details are published on their website.
• World Health Organization (WHO) China Office — who.int/china: The WHO collaborates with the Chinese government on mental health policy and research. The China country office publishes materials of relevance to mental health in the Chinese context.

China does not currently have a locally active affiliate of the International Association for Suicide Prevention (IASP) listed as a member organisation, though the Beijing Suicide Research and Prevention Center has contributed to international suicide prevention research in the past. For the most current information on affiliated organisations in China, refer to the IASP crisis centre directory.

What steps should expats take during a mental health crisis in China?

Familiarising yourself with the appropriate steps to take in a mental health emergency — before any crisis arises — is critically important. China’s emergency response framework differs in structure from crisis care approaches in many other countries. For example, unlike some nations where specialist psychiatric crisis teams attend independently or alongside general emergency services, psychiatric emergencies in China are typically handled through hospital emergency departments.

If a life-threatening mental health emergency arises — whether affecting yourself or someone else — the following steps apply:

1. Call 120 — China’s national medical emergency number, comparable to 999 in the UK or 112 across Europe. Request an ambulance and, where possible, indicate that the situation involves a psychiatric emergency.
2. Call 110 — The police emergency number. Police involvement is common in psychiatric emergencies, particularly where there is an immediate risk of harm to the individual or to others.
3. Proceed to the nearest hospital emergency department — Large hospitals in major cities maintain psychiatric on-call staff. Ask specifically for the psychiatric emergency department (精神科急诊, jīngshén kē jízhěn).
4. Contact LifeLine Shanghai for English-language support — If you or someone nearby requires immediate emotional support and is located in Shanghai, LifeLine Shanghai operates a confidential telephone service. Check current operating hours at lifeline-shanghai.com.
5. Dial the national mental health hotline: 12356 — The NHC has promoted 12356 as a unified national mental health hotline. By May 2025, all regional hotlines had been connected to this single service. Note that calls are handled primarily in Mandarin.
6. Contact your embassy or consulate — Many embassies maintain resources for their citizens including emergency assistance and mental health support. Embassy staff can advise on hospitals with international departments and help facilitate communication in difficult situations.
7. Use your international health insurance emergency line — Most international health insurance plans include a 24/7 emergency assistance number. Store this contact in your phone and keep it readily accessible.

Under China’s Mental Health Law, compulsory inpatient treatment is only applicable where a person poses a risk of harm to themselves or others, meaning that voluntary admission and outpatient pathways remain available to those who choose to seek them. If you are supporting someone else in a non-life-threatening crisis, approaching a private psychiatrist or international clinic directly may lead to faster and more accessible care than attending a public emergency department.

For non-emergency crisis support in Mandarin, the Beijing Suicide Research and Prevention Center operates the Hope 24 Hotline at 010-82951332, available at any hour of the day or night.

Are online or remote therapy options accessible from within China?

Online therapy has become an increasingly important resource for expats in China, particularly those living outside major urban centres or those who prefer to work with a therapist in their native language. However, there are some practical realities specific to China that are worth understanding before selecting a platform.

China operates extensive internet filtering — often referred to as the Great Firewall — which blocks or restricts access to many international websites and applications without the use of a Virtual Private Network (VPN). Platforms such as BetterHelp, along with standard video conferencing tools frequently used by therapists based abroad, may be inaccessible. It is important to check whether your preferred platform can currently be reached from mainland China before signing up.

Online therapy services designed with expats in mind aim to match users with therapists who are both culturally aware and equipped to address the distinct challenges of living abroad. The flexibility of scheduling that these platforms offer can make it easier to maintain consistent therapy while managing the practical demands of expat life.

Relevant platforms and options include:

• Expathy — expathy.org: Expathy connects international expats with licensed psychologists who have a thorough understanding of cross-cultural experience, offering prompt access to affordable counselling without lengthy waiting periods.
• International Therapist Directory (online sessions) — internationaltherapistdirectory.com: Many practitioners listed in this directory offer remote sessions and have experience working with clients who move frequently between countries.
• Talkspace — Talkspace provides therapy via text, audio, or video. Access from mainland China may be affected by internet restrictions; verify current availability before subscribing.
• Local Chinese platforms: Apps such as Jiandanxinli (简单心理) and Yidianling (壹点灵) are Mandarin-language teletherapy platforms that operate within China’s internet environment and are therefore not subject to accessibility difficulties. These may be useful for those with sufficient Mandarin proficiency or for supporting a Chinese-speaking partner or family member.

From a regulatory standpoint, therapists who are licensed in another country and provide remote sessions to clients in China generally do so under the licensing framework of their own jurisdiction. Formal mutual recognition arrangements for mental health professions are rare, with notable gaps covering counselling, social work, and related fields. This means that a therapist holding a licence abroad is not automatically authorised to practise under Chinese law, though practical enforcement in the online therapy setting is uncommon. It is worth discussing this regulatory context openly with any prospective therapist before beginning.

How do expats typically manage health insurance for mental health care in China?

Health insurance is a critical factor for expats seeking mental health support in China. Because the public system offers limited provision for mild-to-moderate conditions, most private therapy costs must be borne by the individual — making adequate insurance cover a practical necessity rather than an optional extra.

Most expats rely on international health insurance products — such as those offered by Cigna Global or Allianz Care — rather than local Chinese insurance plans. International policies tend to be more comprehensive, offering coverage across multiple countries and typically including benefits for therapy sessions, psychiatric consultations, and in some cases, inpatient mental health care.

The specifics of coverage, however, deserve careful scrutiny. Key questions to raise with your insurer include whether there is an annual cap on the number of covered therapy sessions, whether prior authorisation is needed before accessing certain mental health services, and what out-of-pocket costs or deductibles may apply specifically to mental health treatment.

Given the expense of private therapy, it is advisable to review your current policy before assuming mental health services are covered. Pre-existing mental health conditions are frequently excluded, and it may be worthwhile comparing several insurers to find a plan that provides adequate coverage, potentially through a premium upgrade with broader benefits.

China has no domestic legislation equivalent to the United States’ Mental Health Parity and Addiction Equity Act, which requires insurers to treat mental health coverage on an equal basis with physical health coverage. As a result, locally issued Chinese insurance products may explicitly limit or exclude psychological and psychiatric benefits. Always read policy terms carefully before purchasing, and ask any prospective insurer directly about mental health session limits, exclusions for pre-existing conditions, coverage for private practitioners versus hospital-based psychiatrists, and the claims process for overseas providers if you plan to use a therapist located outside China.

For information on insurance regulation in China, the National Financial Regulatory Administration (NFRA) is the body responsible for overseeing the insurance sector. Monitor both the NHC website and the NFRA for any updates to the mental health coverage requirements placed on insurers operating in China.

Frequently asked questions about mental health support in China

Will I be able to see a therapist who speaks my language in China?

In major cities including Shanghai, Beijing, Shenzhen, and Guangzhou, there are professional networks and directories of therapists who offer sessions in English and a range of other languages. China has a substantial community of foreign mental health professionals, and organisations such as the Shanghai International Mental Health Association bring together practitioners offering support with issues from relationship difficulties to LGBTQ+ concerns and eating disorders. In smaller cities, in-person options may be considerably limited, making online therapy an important alternative. The International Therapist Directory at internationaltherapistdirectory.com is a practical starting point.

Is it safe to talk openly about mental health in China — will it affect my visa or employment?

There is no general requirement to disclose personal mental health treatment to Chinese immigration or employment authorities when applying for standard work or residence visas. That said, it is always sensible to review any health-related declarations on visa application forms thoroughly and to seek independent legal advice if you have particular concerns about your situation. In the workplace, the cultural stigma surrounding mental illness leads many expats to keep their treatment private, which is entirely their right to do.

How do I find out if my health insurance covers therapy in China?

The most reliable approach is to contact your insurer directly with specific questions: How many therapy sessions are covered per year? Is pre-authorisation required? Does cover extend to private practitioners as well as hospital-based psychiatrists? Is there an approved provider list for China? International health insurance policies generally offer more comprehensive mental health benefits than locally issued Chinese plans, but verifying the details in advance will help avoid unexpected costs.

What do I do if I am having thoughts of self-harm or suicide?

In an immediate emergency, call 120 for an ambulance or 110 for the police, and make your way to the nearest hospital emergency department. For English-language emotional support in Shanghai, LifeLine Shanghai (lifeline-shanghai.com) provides a confidential telephone service. The national mental health hotline 12356 operates in Mandarin. Your embassy or consulate can also assist with emergency contacts and hospital referrals. If you are located outside Shanghai, the emergency line on your international health insurance policy operates around the clock and can help coordinate access to local care.

Can I use a therapist based in my home country via video call while living in China?

Many expats do use overseas-based therapists via video call successfully, but China’s internet restrictions mean that commonly used video platforms may be blocked or unreliable. While a VPN can sometimes resolve this, the use of VPNs in China occupies a legally uncertain space and their performance is not always consistent. Platforms built specifically to function within mainland China’s internet environment, or locally based Chinese teletherapy applications, may offer a more dependable solution. Discuss the practical arrangements with your prospective therapist before committing to regular sessions.

How does China’s public mental health system compare to publicly funded systems elsewhere?

China’s mental health sector continues to develop, but a substantial proportion of people with mental illness remain untreated or undiagnosed. The combined effects of social stigma, a shortage of qualified professionals, and culturally distinctive expressions of psychological distress all contribute to this treatment gap. In contrast to systems such as Germany’s statutory health insurance or the UK’s NHS — both of which offer funded pathways to talking therapies for common conditions — China’s public provision is largely reserved for managing severe psychiatric illness. For expats experiencing anxiety, depression, or other mild-to-moderate difficulties, private services represent the main avenue for accessing support.

Are there support groups or community resources for expats struggling with mental health in China?

Building a social support network outside of work can be an important part of maintaining wellbeing. Platforms such as Meetup and expat communities including InterNations, Expat Neighbours, and Girl Gone International can help you meet people with shared interests and experiences. Social media groups such as “Expats in Shanghai” or “Beijing Expats” on Facebook provide spaces to connect, exchange advice, and seek recommendations. Many international schools and larger multinational employers also offer Employee Assistance Programmes (EAPs) that include access to confidential counselling sessions — your HR department should be able to tell you whether this benefit is available to you.

What should I look for when choosing a private therapist in China to ensure they are properly qualified?

With the national psychological counsellor certification having been discontinued in 2017, China’s private therapy sector operates within a fragmented and inconsistent credentialling environment, which makes thorough due diligence especially important. Prioritise practitioners who hold internationally recognised qualifications from a regulated profession in their country of training and who maintain registration with a recognised body — such as the Chinese Psychological Society (CPS) or a professional association in their home country. Before booking, ask the therapist directly about their academic and professional background, the licensing framework under which they practise, and what supervision or continuing professional development arrangements they have in place.