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. 2025 Jan 2;25(1):3.
doi: 10.1186/s12913-024-12125-2.

Non-governmental organizations' perceptions of challenges and opportunities for participating in the provision of government-purchased community-based psychiatric rehabilitation services in Shanghai, China: a qualitative study

Hao Yao  1 , Siyuan He  2 , Fei Yan  3 , Wei Wang  3 , Hanyi Lin  3 , Yanli Liu  2   4 , Lili Xue  2 , Jun Cai  5   6   7 , Weibo Zhang  8   9   10   11
Affiliations

Non-governmental organizations' perceptions of challenges and opportunities for participating in the provision of government-purchased community-based psychiatric rehabilitation services in Shanghai, China: a qualitative study

Hao Yao et al. BMC Health Serv Res. .

Abstract

Background: In recent years, the Chinese government has increased its support for the development of community-based psychiatric rehabilitation (CBPR) services and initiated pilot programs for government purchasing of CBPR services from non-governmental organizations (NGOs) in order to address the inadequacy of the government's own supply capacity of CBPR services. This study investigated how the NGOs in Shanghai perceived the challenges and opportunities for participating in the provision of government-purchased CBPR services.

Methods: A qualitative descriptive approach was employed in this study. The local NGOs' program directors who had been responsible for the provision of government-purchased CBPR services in Shanghai were interviewed regarding their perceptions of the challenges and opportunities. Interview transcripts were coded and analyzed using Braun and Clarke's thematic analysis method.

Results: A total of 19 NGOs' program directors were interviewed. The challenges perceived by them for NGOs to participate in the provision of government-purchased CBPR services included difficulty with engaging individuals with mental illness and their families, lack of resources, lack of knowledge and skills, inadequate collaborations with other stakeholders, and limitations of services. The opportunities could be grouped into external and internal ones. External opportunities included China's favorable policy environment, Shanghai's developed economic environment, and increased public awareness of mental health, while internal opportunities included NGOs' greater flexibility, high team cohesion, stronger focus on the holistic needs of clients, better resource integration capabilities, and ability to provide long-term follow-up and support for clients.

Conclusions: Based on the findings, recommendations for future actions are provided in the areas of research, public awareness, funding, training, referrals, collaboration, and service designing to improve the mechanism of government purchasing of CBPR services from NGOs in China.

Keywords: China; Community-based psychiatric rehabilitation; Government service purchasing; Non-governmental organization; Qualitative study.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed in accordance with the Declaration of Helsinki and was approved by the Medical Research Ethics Committee of the School of Public Health of Fudan University (IRB No. 2021–09-0916). Following a detailed description of the study, a verbal informed consent was obtained from all participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of the CBPR services that the participants were taking charge of. Some NGOs contracted with more than one district to provide government-purchased CBPR services. Light blue indicates that one NGO that participated in the current study had provided government-purchased CBPR services in this district, medium blue indicates that two NGOs that participated in the current study had provided government-purchased CBPR services in this district, and dark blue indicates that three NGOs that participated in the current study had provided government-purchased CBPR services in this district
Fig. 2
Fig. 2
Visual representation of themes and subthemes about the challenges and opportunities for NGOs to participate in the provision of government-purchased community-based psychiatric rehabilitation services in Shanghai, China
See this image and copyright information in PMC

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