Milan (AsiaNews) – In China, more and more people are turning to online psychotherapy to care for their emotional well-being.
Digital Mental Health Interventions (DMHIs), developed in the country during the COVID-19 pandemic and have since experienced significant growth, playing a prominent role in the healthcare sector.
As the name suggests, DMHIs involve the use of websites, mobile apps, chatbots, and text messages to deliver psychological and psychotherapeutic support services.
In China’s case, the most widely used platforms are WeChat, a popular Chinese messaging and social media app, Good Mood (Jiandan Xinli), KnowYourself (Yixinli), Good Doctor Online, better known as HaoDF or Hao daifu zai xian—and Ping'an Health (Ping'an jiankang).
These include features such as remote sessions via video calls or chats with experts, gradual exposure to immersive scenarios for the treatment of phobias, anxiety, and post-traumatic stress disorder, software specifically designed to manage specific disorders such as insomnia through guided exercises and monitoring, and tools for tracking mood, sending reminders, or supporting the therapist's clinical work.
These interventions are considered, in some cases, complementary and reinforcing to traditional treatments already used by patients.
The shortage of qualified providers
As indicated by a study recently published in the international journal npj Digital Medicine, the success of digital psychotherapy in China is due to multiple factors.
Mental disorders in the country have increased significantly in recent decades, affecting approximately 130 million adults. The increasingly fast pace of life, social competition, life uncertainty, and other pressures have contributed to a surge in the demand for emotional support and psychological healing.
Among the most recurring problems are mood disorders, anxiety disorders, and substance use disorders. And despite growing public demand for healthcare, less than 30 per cent of individuals suffering from psychological distress receive adequate treatment.
China has long suffered from a shortage and geographical imbalance in mental health resources. High-quality medical facilities and qualified physicians are concentrated primarily in first- and second-tier cities, while peripheral areas and rural areas are virtually devoid of them.
Furthermore, mental health issues still carry a persistent stigma, leading many to avoid in-person counselling services due to shyness, fear, and prejudice.
Although the Chinese government has invested in developing infrastructure for the treatment of major psychiatric illnesses since 2010, disorders such as depression and anxiety continue to be inadequately treated. Furthermore, the number of professionals in the field remains inadequate compared to demand.
In light of the above, digital psychological support undoubtedly offers a promising solution.
In a context like China's, where 96 per cent of the population owns a smartphone and is familiar with technology, DMHIs are not only cost-effective but can also fill gaps in the national healthcare system, reaching even the most disadvantaged areas where traditional in-person mental health services are scarce or non-existent.
Furthermore, DMHIs also help ensure privacy in a context where mental health stigma, as already mentioned, is still very present.
The invasion of psychological tests on the web
While digital technologies have made psychological treatments more effective and accessible, they have also become a fertile ground for the proliferation of pseudoscientific information outside of authorised channels.
The Chinese web has been literally flooded with psychological personality tests of questionable reliability, so much so that it has generated a veritable craze for "psychological self-assessment" (xinli zicha). Meanwhile, influencers without professional qualifications or clinical experience sell courses and consultations online, posing as “mentors” or “healing experts”.
By arbitrarily using diagnostic labels and industry jargon, like Narcissistic Personality Disorder (NPD), Post-traumatic Stress Disorder (PTSD), or Emotional Turmoil, to name a few, such web content presents a recurring narrative based on stereotypes and clichés.
Interpersonal conflicts are almost always traced back to the family of origin, individual differences are indiscriminately labelled as personality disorders, and temporary emotional fluctuations are invariably attributed to psychological trauma.
Even fleeting mood swings, normal everyday interpersonal tensions, and differences of opinion are amplified and exaggerated, passed off as serious mental illnesses or congenital personality defects.
In fact, only when content is emotionally engaging and capable of empathising with users does it have a greater chance of going viral and generating profits for creators.
Rather than increasing emotional literacy and fostering psychological communication, this trend merely fuels collective anxiety, triggering a vicious cycle in which the more one investigates, the more one's concern about one's condition grows; and the more one seeks a diagnosis, the worse one's health becomes.
To see this pattern, one can simply visit the "Top stories" section of the Chinese app WeChat. Here, you may come across articles titled “Why do parents with Narcissistic Personality Disorder (NPD) envy their children? The four main causes revealed”, “People with an unstable identity tend to show their 'instrumental' nature”, “How to tell if someone has been loved since childhood," and even "The 'competitive brain': trash school has left us”. The authors of such articles are often unidentifiable.
For their part, experts hope to see immediate action by the authorities, which is needed to remedy this situation.
Only by strengthening regulatory oversight, improving mechanisms for verifying the professional qualifications of content creators, and establishing a strict system of sanctions, including heavy fines and even the closure of social media accounts that violate the rules, will it be possible to eliminate the chaos generated by pseudoscientific dissemination in the field of psychology and stop speculation that harms users.
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