China’s mental health record is tarred by social stigma and a lack of resources. While public initiatives are now seeking to rectify the issue, the country’s active startup ecosystem is also competing to fill the gaps.

According to a study published in 2011, a staggering 91.8% of Chinese people with a mental health diagnosis never seek help. Part of that has to do with the shortage of trained mental health professionals in China, as well as the country’s psychiatrist-to-patient ratio, which is as low as 1.24 per 100,000 patients, compared to the global average of 4.15 per 100,000.

“The problem is huge,” says Jin Hsueh, the co-founder and CEO of KaJin Health, a Taiwanese startup that provides an online counseling service to people in Chinese-speaking communities. “There are [90] million [people with] depression in China, and very, very [few] that ever seek for help, talking to a doctor or therapist.”

China’s mental health problem isn’t just an issue of resources. Social stigma continues to deter patients from seeking help, and severe mental health cases, including schizophrenia and psychosis, are treated as family issues, sometimes with disastrous consequences.

“In China… there’s always a huge stigma when you go to a physical clinic to seek [mental health] help,” Mr. Hsueh told TechNode. “That’s why we’re doing this business, because it allows you to talk to a…therapist at home, without any[one] knowing.”

While evidence shows the government is taking steps to acknowledge the problem, private enterprise, including startups, are also beginning to shoulder some of the load. KaJin Health is an early-stage company targeting Chinese-speaking users, such as those in Taiwan and mainland China. Through the company’s official WeChat account and website, users can book appointments and chat with Chinese-speaking therapists.

The app also aims to rectify another glaring issue: mental health resources in China are heavily skewed towards the country’s urban centers.

“[Our local Taiwanese and Chinese users] don’t know much about therapy, but by [providing] online access to therapy, it kind of lowers the barrier a little bit,” says Mr. Hsueh. “You don’t have to visit a physical clinic so they would like to give it a try. Seventy percent of [our] customers…are first-time therapy users.”

Different Approaches To Therapy In Mainland China

According to Mr. Hsueh, China requires a special approach when it comes to mental health therapy, believing that cultural differences play a role in designing effective therapy.

“The type of therapies in Taiwan [are] usually more long term…[guiding] you through the downturns and the stress,” he says.

Customers in China prefer more “straightforward” answers, where therapists provide instant solutions and instructions on how to get over their stress, he says. “In China, we position [our product] more…like coaching rather than [therapy].”

Currently, KaJin Health is partnering with brick-and-mortar clinics in Taiwan, where they refer customers to a certified medical facility if needed. To avoid any legal headaches, the startup has wisely chosen to outsource drug prescriptions and medical procedures to partner clinics. However, KaJin Health is struggling to find local partners in China.

“We haven’t found any trusted local clinics to partner with,” says Mr. Hsueh. “It’s hard for us to [identify] if they are qualified or not.”

Over the past decade, policies around mental health in China have slowly improved. In 2004, the country created local brigades of community-focused mental health clinicians, an initiative dubbed the “686 Program” that was meant to ease the disparity between cities and the countryside.

In 2012, the Chinese government enacted its first mental health law, which defined basic guidelines around the diagnosis, treatment, and rehabilitation of mental disorders, and promoted psychological well-being. Still, China’s mental health services have a long way to go.

In addition to online counseling services, the company also runs offline and online mental health awareness campaigns. According to Mr. Hsueh, KaJin Health is also in talks with Chinese insurance companies to create a new type of coverage just for “psychology treatments,” in order to increase the accessibility of its services, which currently cost around 60 USD per hour.

Currently, KaJin Health has offices in both Taipei and Shanghai, and was part of local incubator program Chinaccelerator’s ninth batch of companies. Though roughly half of the KaJin Health’s users are Chinese-language users living overseas, the company has its eyes set on the local Chinese market, where the company believes there’s a greater need and more potential to grow its business.

Similar services have also begun to crop up on the mainland. “Simple Psychology” (简单心里网, our translation), is a Beijing-based startup that also offers online counseling services as well. China also has a number of non-profit organizations that raise awareness around mental health, such as CandleX, one of KaJin Health’s non-profit partners that focuses on depression.

Image credit: Shutterstock

Update (6/13/2016 16:21): This article was updated to include a corrected figure from KaJin Health. Mr. Hsueh meant 90 million, not 900 million, when talking about the number of people suffering from depression in China.