The changing stigma around mental health in China

Mental health was long considered a taboo topic in China. Admitting you were feeling depressed, anxious or had some mental disorder was a sure path to loss of face for you and your family. Few would talk about it, and as a result, few understood it and knew how deal with it.

The lack of conversations about mental health didn’t mean it wasn’t present. In recent generations, China has had more than its share of societal pressures contributing to mental health challenges: The social change and distanced families through rapid urbanisation and development has been unprecedented. Confucius beliefs and competition place often-unrealistic expectations around education, and most urban kids are without siblings and rarely participate in team sports, just to mention a few contributors.

WHO estimates 54 million people in China suffer from depression, and about 41 million suffer from anxiety disorders. Another study, taken long before the additional challenges of Covid, estimated 173 million Chinese had a mental disorder.

Yet it wasn’t until Covid came upon us, when the balance tipped on how many Chinese viewed mental health. During the first lockdown in 2020, China Skinny analysed consumer feelings based on Baidu searches. Some of the fastest growing search terms were related to mental health. That was the canary in the coal mine.

A subsequent large-scale survey found over a third of respondents experienced psychological distress during the height of the pandemic. Another study found 24.6% of the country’s teenagers live with some form of depression in China. Numerous surveys and reports followed, pointing to similar mental health challenges across the country.

Beijing was quick to recognise that something had to be done and ramped up its propaganda programs to educate the masses about mental health and shift the stigma. It also included mental health as a key component of its Healthy China 2030 plan.

Brands followed suit, starting to openly talk about mental health in their communications and partnerships. Domestic skincare brand Proya read the room well with its successful 2021 campaign "You don't have to be ashamed of your emotions”, doubling down the following year with its "Echo Project." Lululemon took a similar path last October with its "Wellbeing for All" campaign. Also last year, youth-focused video platform Bilibili partnered with the Shanghai Mental Health Centre to provide professional online mental health support to users after one of its employees died suddenly at the company.

Despite increasing awareness and education around mental health, its limited historic exposure means that China’s mental health infrastructure is seriously limited, with mental-health-professionals-to-people ratios around a fifth of the rates in high-income countries.

Like in many other areas of health, Chinese consumers are increasingly proactive in addressing their mental health through lifestyle choices and the products they buy. A Xiaohongshu (RED) study found mental health to be one of the top categories consumers are willing to increase spending on in 2023. Chinese have much more awareness about mental health as a factor in buying food opting for ingredients and formats that are perceived to help mental and emotional wellbeing, to indulgent food that has less guilt attached. Mental health is also a large driver in China’s booming pet category with two-thirds of pet owners saying they own a pet for companionship or stress release.

One of the most frequent requests that China Skinny receives from brands is how can they better connect with consumers on an emotional level. Whilst the recommendations we make are specifically tailored to their brand’s unique DNA, there are few buttons that touch such a broad segment of the population as mental health, normalising and supporting how many of them are feeling. Campaigns need to be authentic and culturally nuanced, but done well, they can really connect with consumers. Brands typically launch campaigns on World Mental Health Day in October, but there is no need to wait for that to get the wheels in motion. Contact China Skinny to learn how to best deliver successful and meaningful positioning and campaigns.