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In contrast to other studies on policy entrepreneurship that address frontline officials’ roles in formal legislative procedures, this case study focuses on how frontline officials promote policy innovation within inconspicuous administrative routines. Because frontline officials have no legislative power, they must overcome officialism by using bureaucratic skills and seeking consensus among multiple stakeholders. “Citizen agents” and “state agents” are both necessary roles. This case provides administrative details on how a deadlocked policy was gradually enlivened within undramatic administrative routines. The findings bridge the legislative–administrative gap and improve the understanding of the long-term effects of frontline administrative activities on policy innovations.
While China's efforts to maintain social stability by recruiting social elites and establishing Party branches in pre-existing social and market organizations have been thoroughly explored, much less attention has been devoted to how grassroots Party organizations (GRPOs) have proactively incubated society and constructed coherent, interrelated and systematic stability maintenance strategies to identify and eliminate social instability in its early stages and prevent its escalation. Using qualitative data gathered from local areas in China, we uncovered three major strategies used by GRPOs to manufacture society: incubating quasi-bureaucratic organizations, co-opting community elites and embedding Party organizations in market and social organizations. In general, GRPOs manufacture society for three reasons: to revitalize the mobilization capacity of the party-state; to increase the available social resources for grassroots authorities; and to establish an input mechanism for citizens. This study not only provides empirical data on how China's stability maintenance regime works in practice but also calls for a rethinking of the capacity of authoritarian resilience.
China's healthcare is improving together with rapid economic growth. Yet, mental healthcare is lagging behind. Prevalence of perinatal depression is high among women of the one-child generation, but access to qualified care is limited. Chinese healthcare professionals, policy makers and patients alike express concerns about insufficient knowledge among the public as well as healthcare providers regarding mental disorders. There appears to be a general lack of help-seeking behaviour for mental disorders owing to perceived risk of social stigmatisation. Social support through family and friends, use of online resources and community healthcare services are preferred, rather than seeking help from mental health specialists.
Major depressive disorder (MDD) is a leading cause of disability worldwide.
Aims
To examine the: (a) 12-month prevalence of DSM-IV MDD; (b) proportion aware that they have a problem needing treatment and who want care; (c) proportion of the latter receiving treatment; and (d) proportion of such treatment meeting minimal standards.
Method
Representative community household surveys from 21 countries as part of the World Health Organization World Mental Health Surveys.
Results
Of 51 547 respondents, 4.6% met 12-month criteria for DSM-IV MDD and of these 56.7% reported needing treatment. Among those who recognised their need for treatment, most (71.1%) made at least one visit to a service provider. Among those who received treatment, only 41.0% received treatment that met minimal standards. This resulted in only 16.5% of all individuals with 12-month MDD receiving minimally adequate treatment.
Conclusions
Only a minority of participants with MDD received minimally adequate treatment: 1 in 5 people in high-income and 1 in 27 in low-/lower-middle-income countries. Scaling up care for MDD requires fundamental transformations in community education and outreach, supply of treatment and quality of services.
This chapter discusses the results of the World Mental Health (WMH) surveys regarding the burden of mental disorders. The mental disorders were assessed with Composite International Diagnostic Interview (CIDI), a fully structured lay-administered interview designed to generate research diagnoses of commonly occurring mental disorders according to the definitions and criteria of both the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and International Classification of Diseases (ICD-10) Diagnostic Criteria for Research (DCR) diagnostic systems. Generalized linear modeling (GLM) was used to assess the effects of mental disorders on continuous outcome variables with skewed distributions. The CIDI included retrospective disorder age-of-onset (AOO) reports based on a special question sequence that has been shown experimentally to improve recall accuracy. Mental disorders are important causes of productivity loss and low perceived health. They are among the most important disorders at both individual and societal levels.