| Hao Wei,Yang Fude,Operational risks and governance approaches in the transformation of China's mental health service system[J].SICHUAN MENTAL HEALTH,2026,(3):193-198 |
| Operational risks and governance approaches in the transformation of China's mental health service system |
DOI：10.11886/scjsws20260416006 |
| English keywords:Mental health Service system Quality management Medical insurance payment Continuous care Professional competence Patients' rights |
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| China's mental health service system is transitioning from an expansion-oriented stage focused primarily on addressing resource shortages and improving access to care toward a more mature stage that places greater emphasis on service quality， operational efficiency， patients' rights， and long-term outcomes. The principal challenge is no longer merely an insufficient overall supply of mental health resources， but rather inadequate alignment among service goals， the structure of service provision， payment incentives， allocation of responsibilities， and professional capacity. Recent incidents involving inappropriate psychiatric admissions and misuse of medical insurance funds in a small number of institutions， although not representative of the mental health sector as a whole， have exposed several structural risks within an inpatient-dominated service model. These include misalignment between inpatient services and medical insurance payment incentives， expansion of institutions and beds outpacing the development of professional capacity and quality governance， excessive concentration of social-risk management responsibilities in medical institutions， and inadequate continuity of care across hospitals， communities， and families. In practice， psychiatric hospitalization may simultaneously serve the multiple functions of clinical treatment， institutional financing， and the management of social risks. When the boundaries among these functions are unclear， and outpatient care， day services， community-based rehabilitation， and social support lack stable institutional and financial support， hospitalization may become systematically overused. The next stage of reform should shift mental health services from a hospital- and inpatient-dominated model toward a stratified and continuous system centered on patients' needs； establish medical insurance payment and evaluation mechanisms that balance costs， quality， functional outcomes， and long-term value； clarify the responsibilities of medical institutions， communities， families， and relevant government sectors； and make professional competence， ethical standards， patients' rights， and institutional governance the foundations of quality improvement. The key to the high-quality development of mental health services in China lies neither in simply increasing or reducing the number of psychiatric beds nor solely in strengthening post hoc regulation， but in aligning institutional incentives with patients' interests and promoting symptom improvement， functional recovery， and social participation. |
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