A cross-sectional analysis of the community-based management and treatment status of patients with severe mental disorders in Eastern China

中国东部地区重性精神障碍患者社区管理和治疗现状的横断面分析

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Abstract

BACKGROUND: Although the effectiveness of community-based services for severe mental disorders (SMDs) has been established globally, evaluations within specific contexts—especially in low- and middle-income countries, and particularly regarding national programs—remain relatively scarce. This study analyzes the current status of the National Information System for Psychosis during its implementation in Anhui Province, China, aiming to assess its impact and identify persistent challenges, to provide a reference for formulating targeted policies. METHODS: Data on SMDs were obtained from the National Information System for Psychosis. The registration, Management, and treatment status of patients with SMD in Anhui Province from 2015 to 2023 were analyzed and compared with national data. RESULTS: From 2015 to 2023, Anhui Province’s SMD management and treatment indicators showed significant improvement (P < 0.0001). Compared to 2015, 2023 rates increased substantially: registration (+ 41.69%), management (+ 13.22%), regular management (+ 109.29%), medication-taking (+ 116.02%), regular medication-taking (+ 231.23%), and patient stability (+ 148.35%). These rates were positively correlated (P < 0.0001). However, significant inter-regional imbalances persisted (P < 0.0001). In 2023, Anhui had 318,521 registered SMD patients, predominantly aged 18–59 (74.36%), with education below middle school (85.63%), and residing rurally (78.77%). Among six SMDs, patients with mental retardation and mental disorders had the longest mean Duration of Untreated Psychosis (DUP)(4.93 years), lowest medication-taking rate (82.75%), and lowest regular medication-taking rate (66.26%). CONCLUSIONS: The National Information System for Psychosis has produced a significant positive impact on service coverage and treatment outcomes in Anhui. However, significant disparities exist between different regions. This study has identified specific high-risk populations within the cohort of patients with mental disorders. These findings provide actionable evidence for policymakers: prioritizing resource allocation to reduce regional disparities, developing targeted interventions for rural populations and those with low educational attainment, and implementing specialized support strategies for patients suffering from schizophrenia and mental retardation with mental disorders are essential for achieving equitable and high-quality community mental health services in China. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07421-y.

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