Depression screening will be included in Chinese students' health check-ups.

Dear Editor,

As psychiatrists, we found the article, ‘Overcoming telemental health disparities during the Coronavirus Disease 2019 (COVID-19) pandemic’ [1] thought-provoking. According to this article, the steady rise in mental health conditions such as depressive disorder, trauma- or stressor-related disorder and substance use related to the pandemic has been recorded in national surveys. This reminds us of a document released by the Chinese government in November last year [2], which proposed for the first time that depression screening should be included in the physical examination of students. Under the background of the COVID-19 epidemic, students’ mental health has become a global hot topic, so this document has aroused extensive discussion in society as soon as it was published. However, as the label of depression may cause discrimination, this document has also caused many people’s doubts.

The social attribute of depression, in essence, is a symbol with stigma [3]. This dilemma is based on the negative evaluation of depression shared by patients themselves and healthy people. Bringing depression into students’ routine physical examination is helpful to realize early detection and prevent tragedies caused by treatment delay. However, the stigmatization of the mentally ill is called the first barrier hampering their treatment and recovery: it leads to the rejection of such individuals, their discrimination and exclusion from participation in various areas of social life [3].

In order to better implement the policy of students’ mental health examination, the joint efforts of the government, schools and society are needed. The first is to strengthen popular science and public education to reduce prejudice and misunderstanding. Many students with depression tendency do not seek medical help as depression is perceived as a stigmatizing disorder, which leads to self-stigma and hampers early diagnosis and treatment. It is necessary to educate about the symptoms and treatment of depression and to implement diverse intervention techniques to change behaviors and attitudes as early as possible. Second, we should pay attention to protecting personal privacy [4]. Privacy usually includes private space, activities and information that individuals do not want others to know. The psychological screening results obviously belong to the category of privacy protection, which needs to be protected according to law and shall not be disclosed at will. In addition, the interaction between schools and families should be strengthened to form a joint force. For some students with mild depression, staying in the school environment and living with classmates may help them get out of the psychological haze. Therefore, it is necessary to improve teachers’ professional ability and parents’ mental health literacy, so as to pay close attention to students’ psychological problems and intervene in time and effectively.

People’s concern for depression is a good sign of change. However, it is more important to change the social environment and prejudice, otherwise, the prevention and treatment of depression can not be well solved. In a word, students’ mental health is vital to the future development of a country, so this topic deserves continuous dialog and careful scrutiny.