Evolving role of the internet in China as a medium for promoting psychological well-being and mental health: a scoping review

Abstract

The rapid development of China's 5G 'Internet Plus' industry has led to increasing use of the Internet to provide healthcare services. Internet-based services in China are already widely used to prevent, identify, monitor, and manage mental disorders, but few of these services have been formally evaluated. To provide a clear baseline of this rapidly evolving field, we searched articles published before December 31, 2022, about internet-based interventions and surveys for mental health-related conditions in China in five international databases (Web of Science, PubMed, PsycINFO, Embase, and Cochrane Library) and four Chinese databases (CNKI, SinoMed, VIP, and WanFang). The 143 identified studies-54 in Chinese and 89 in English-described internet-based interventions and surveys in individuals with mental disorders, community residents, college students, older adults, pregnant women, and health professionals. The number of identified studies, which were mainly conducted in economically developed regions of the country, quadrupled after the 2019 onset of the COVID-19 pandemic. Available studies suggest-but do not prove-that internet-based interventions can reduce the severity of psychiatric symptoms, decrease healthcare costs, and improve the quality of life for individuals with mental disorders. Innovative smartphone applications could potentially improve the quality and expand the scope of internet-based interventions, making them a key component in ongoing efforts to prevent and monitor mental illness, enhance the self-management of mental disorders, and alleviate psychological distress among adolescents and other at-risk populations. However, achieving this long-term goal will require establishing standardised methods of administering internet-based interventions, training mental health professionals to implement and monitor the interventions, identifying methods of maintaining the confidentiality of collected information, and rigorously assessing the effectiveness of the interventions based on periodic assessment of uniform outcome measures. Clinical and policy research about expanding internet-based mental health interventions should focus on confidentiality, efficacy, and cost-effectiveness.

Keywords: China's mental health care; Digital hospital; Internet-based treatment; Management of mental disorders; Mental health.

Fig. 1

PRISMA flow diagram for the scoping review about internet-based mental health interventions and surveys in China.

Fig. 2

Number of reports about internet-based mental health interventions and surveys conducted in China from 2001 to 2022.

Fig. 3

Location of 143 studies about internet-based mental health interventions and surveys in China: 2001–2022∗. ∗For five regional (i.e., non-national) studies conducted in more than one province, fractional amounts are computed for the participating provinces so that each study is counted only once. Eight province-level administrative regions did not conduct province-specific studies: Gansu, Jilin, Liaoning, Macau, Qinghai, Shaanxi, Tibet, and Xinjiang.

Fig. 4

Number and type of 88 studies about internet-based interventions and surveys for different types of mental health disorders in China: 2001–2022. ∗Includes three studies about anxiety and depression; two studies about anxiety, depression, and insomnia; one study about insomnia, pain disorder, and eating disorder; and one study about autism and attention-deficit/hyperactivity disorder.

Fig. 5

Number and type of 52 studies about internet-based mental health interventions and surveys in different cohorts of healthy individuals in China: 2001–2022. ∗Includes one study about individuals seeking general health services, one about persons who have been traumatised, one about individuals hospitalised during COVID-19, and one about adolescents at risk for depression.