This entry received 2nd prize in an AY2024/2025 op-ed competition by Bridging GAP (Gender and Policy), a student group at the Lee Kuan Yew School of Public Policy which aims to enhance awareness of the importance of gender among public policy students.
China’s rapid urbanisation has widened the development gap between urban and rural areas, leaving more than 41 million children in rural areas without adequate parental care as their parents migrate for work. These left behind children (LBCs) face significantly higher rates of depression and anxiety compared with their non-left-behind peers, struggling with emotional regulation, interpersonal relationships, and self-esteem due to the long-term absence of parents. This issue is critical because rural LBCs have limited access to psychosocial education and services. Without timely mental support, rural LBCs are at risk of suffering from long-term mental illness, which may contribute to a broader subhealth of population and social instability.
This policy memo analyses the mental health challenges rural LBCs face and offers recommendations to the Ministry of Education (MOE) of China for addressing these issues.
Vulnerability of rural LBCs and the difficulties in accessing mental health education
Starting from the demand side, rural LBCs have a greater need for mental health services compared to their peers due to parental separation and the long-term absence of guardians. Most rural LBCs are fostered at school or cared for by their grandparents. Insufficient parental companionship leads to prolonged feelings of loneliness and loss, negatively impacting their mental health and daily performance. According to the Survey on the Mental Health of Children in Rural China, 28.5 per cent of them suffer from depression and 27.7 per cent experience anxiety. Compared to their non-left-behind peers, these children exhibit lower levels of adaptability, emotional regulation, interpersonal relationships and self-esteem, heightened vulnerability highlights the urgent need for targeted mental health interventions for this group. However, the mental health education resources available to rural LBCs are limited.
From the supply side, families, communities and schools are the primary environments where rural LBCs have the closest contact, yet these environments fail to provide adequate mental health education.
Grandparents, as the caregivers of rural LBCs in the family, mostly neglect children’s mental health because of low levels of education. They focus primarily on ensuring the children’s material needs, while emotional and psychological well-being is absent. Additionally, the generation gap between grandparents and grandchildren might further intensify this issue, with emotional concerns often mishandled. According to the Healthy China 2030, communities should provide essential social welfare services, which are usually underdeveloped in economically disadvantaged rural areas. The lack of infrastructure and talent means that rural LBCs hardly receive professional mental health support at the community level.
Schools are the most likely place for rural LBCs to access specialised mental health education compared to families and communities. However, only about 40% of primary and secondary schools in China have full-time mental health education teachers, with most of them concentrated in urban areas. Rural schools face significant shortages of mental health education staff, and those available are often part-time or responsible for other subjects. This staffing gap means most rural schools cannot provide comprehensive psychological education, and where such programs exist, they are often superficial and lack practical application. Additionally, rural schools generally lack adequate facilities, such as dedicated counselling rooms. As a result, due to the missing of basic knowledge, rural LBCs seldom seek help from their teachers when experiencing mental health problems. Teachers, in turn, are often unable to monitor the psychological changes of each student and provide professional care. Therefore, many of them become passive in their studies and withdraw from social interactions, further exacerbating their emotional and academic struggles.
Consequently, the three main scenarios of life for rural LBCs fail to provide basic mental health education and services to them.
The contradiction exists between the large demand of rural LBCs for mental health education and the shortage of mental health services.
Recommendations based on optimizing mental health education in three life scenarios
I. Flexibly mobilising urban mental health education resources. Given the difficulties faced by rural areas in providing psychological support, it is recommended to mobilise mental health resources from urban areas to tackle the mental health issues of rural LBCs more effectively. Cross-departmental cooperation and resource introduction appeal to the MOE to collaborate with non-profit organisations and volunteer teams to introduce urban mental health resources into rural families and communities. By establishing regular service points and offering in- home counselling services, rural LBCs in need can receive both in-person counselling and ongoing online support for specialised services and knowledge. Moreover, local volunteer teams should be formed within communities, led by the MOE and supported by the civil affairs department and social organizations, to provide regular mental health literacy for caregivers.
II. Short-term solutions on teacher training and mental health records as well as long- term development plans on special funds. Due to the shortage of dedicated mental health teachers assigned to every rural school, it is essential to provide training for existing teachers. The MOE can produce web-based training programmes, teachers can improve their psychological communication skills and better identify and address mental health issues among students. Furthermore, The MOE should produce a psychological health profile of rural LBCs for rural schools, and teachers could track students’ psychological well-being, maintaining regular communication according to the profile. Routine mental health screening and school-based psychological crisis intervention mechanisms are essential, which requires the MOE to set up special funds in the budget to ensure rural schools’ capacity to respond to crises of rural LBCs by improving the deployment of professional psychoeducational teachers and counselling equipment.
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