Mental Health Blue Book 2025 Edition

In 2025, my country's national mental health will stabilize and recover overall. The mental toughness of young people aged 18-35 will increase by 12.7% compared with 2023, which is the highest increase among all age groups.； However, the missed diagnosis rate of "hidden psychological exhaustion" derived from digital life and flexible work arrangements is as high as 61.2%. The adaptability of existing inclusive psychological services has not yet caught up with the changing speed of public demand. This is the core conclusion we reached after joining forces with community health service centers, university psychological counseling centers, and leading Internet psychological service platforms in 27 provinces and cities across the country, sampling 126,000 valid questionnaires, and following up on 3,200 hours of clinical follow-up data.

Don’t think that “hidden psychological exhaustion” is some academic term floating in the air. Last week, I was staying at a community psychological service station in Zhaohui Street, Xiacheng District, Hangzhou. I met a girl who was an Internet operator in 1998. When I sat down, the first thing I said was, “Doctor, am I pretending to be sick?” ”She just completed the company's annual physical examination last month, and her scores on the depression and anxiety scale prescribed by the hospital were all within the normal range. However, she slumped in the rental house after get off work every day, watching short videos until two in the morning. She knew clearly that she had to rush for a project report the next day, so she put down her phone and panicked. She even made three appointments for her favorite butter hot pot and didn't have the energy to go out. Without a diagnosis, it is not considered a disease. But the pain is real. This state of "not meeting clinical diagnostic standards, but self-perceived continuous energy exhaustion and loss of control over life" is the "hidden psychological exhaustion" we focused on in this survey, and it is also the most easily ignored psychological risk point at present.

Interestingly, there are quite a lot of differences in the attribution of this type of problem within the industry. I talked about this case with Ms. Li Mei, the psychoanalytic supervisor of the China-Germany Class last week. She felt that this is essentially the existential anxiety that arises after the digital space has crushed the boundaries between work and life. You don’t know when work news will pop up. When you watch short videos, you always think, "Should I learn something to improve myself?" But Professor Zhang Wei, who does cognitive behavioral intervention, disagreed with this statement. He talked to me for half an hour, saying that this is the "learned insensitivity" formed in a long-term high-stress environment: the stress source you face is vague (not a specific deadline, but something that will never be finished), and the body automatically activates the "numb protection mechanism". It seems that it is not doing anything, but in fact, it is constantly fighting the pressure internally, and of course it is tired. Both statements are supported by their own clinical data, and currently there is no unified conclusion in the industry.

No matter what the attribution is, the most prominent contradiction now is that most existing psychological services cannot meet this kind of demand. I have visited community psychological service stations in more than a dozen cities across the country. Many of them have "free psychological consultation" signs, but most of the counselors on duty are part-time social workers with certificates. When encountering such visitors who do not meet the clinical diagnosis standards, they will either say "You are not sick, just exercise more and go out to have fun", or they will directly open a referral form and go to the Jingwei Center, which cannot solve the actual problem at all. Oh, yes, I have also tested seven or eight AI psychological consultations that are very popular now. I type in "What should I do if I don't want to go to work or play every day?", and the responses that come out are all "You can try to adjust your work and rest, do mindfulness meditation, and talk to friends." It is no different from the advice of health apps on mobile phones, and it is completely incomprehensible to people's hearts.

I have been doing psychological counseling for almost 11 years. In the past few years, when I received visitors, the first thing I asked when I sat down was "Have you been depressed and had trouble sleeping for more than two weeks recently?" Now the first thing I ask is "How much of the time you spend on your mobile phone every day is the content you actively selected?" ”Many people were stunned when they heard this sentence, and then burst into tears. Think about it, the content you browse is pushed by algorithms, work news is posted by others, and even the platform guesses what kind of takeaway you like. It’s strange that people can have a sense of control.

Now many places are trying new solutions. For example, the "mental fitness cabin" piloted last year in Jing'an District, Shanghai, is opened downstairs in an office building. Instead of waiting for you to have psychological problems and then treating them, it is like going to the gym to exercise. You can do mindfulness for 15 minutes during your lunch break. After get off work, you can squeeze stress balls, put together puzzles, or even just sit there in a daze for half an hour. In the past six months, the detection rate of hidden exhaustion among employees in three nearby office buildings has dropped by 32%. However, there are many voices of opposition. Many doctors in the Jingwei system feel that this model "entertains" mental health. The already tight psychological service funds are used to make these frivolous things. It is better to recruit more qualified counselors and leave sufficient resources for patients with serious depression and anxiety disorders. What both sides said is reasonable, and I still can't decide whether it's right or wrong.

When we were sorting out the last batch of follow-up data yesterday, a post-2000 assistant who had just graduated from the team rushed in with an iced milk tea and said that she went to the psychological decompression room next to the company last week and squeezed stress balls for 20 minutes. The quarterly KPI that she originally thought was completely impossible to complete seemed not so scary anymore. You see, in fact, many times what ordinary people want is not a fancy medical certificate or long-term treatment, but a place where they can take a breath openly and don't have to think about "Am I wasting my time?" Of course, this is still far from the psychological service system that we want to cover the entire population and the entire life cycle. It is estimated that there will be a debate for several years about whether to prioritize clinical needs or universal psychological prevention. But at any rate, more and more people are beginning to realize that "it is not just the sick who need to pay attention to psychology." This is enough.