Can Digital Healthcare Address the Alarming Rise of Adolescent Depression? — Insights from a Newly Filed IPO Prospectus

Every year, around the time of the National College Entrance Examination (Gaokao) and the Senior High School Entrance Examination (Zhongkao), it is not uncommon to see news reports about students experiencing mental health issues due to stress. Indeed, many have already dropped out of school because of severe mental health problems prior to these exams. In a recent municipal Zhongkao in one city, the excessive difficulty of a particular subject caused examinees to break down in tears, prompting schools to urgently issue notices urging parents and teachers to prioritize psychological support for students—a story that quickly went viral.

There was a time when the mental health of children and adolescents seemed like a distant issue. Occasional rumors served merely as casual gossip for after-dinner conversation. In recent years, however, we have been alarmed to observe that negative cases involving the mental health of children and adolescents are occurring with increasing frequency, affecting younger age groups, and presenting with greater severity. Moreover, the sources of information have shifted from secondhand hearsay to firsthand observations of examples in our immediate surroundings.

“The Mental Health of Children and Adolescents Is Probably at Its Worst Since the Reform and Opening-Up“,” this was the assessment made in a speech last April by a Ph.D. holder who had previously served at the Peking University Student Mental Health Education and Counseling Center. Even the least sensitive individuals can clearly perceive that addressing the mental health issues of children and adolescents in China has become an urgent imperative.

How Severe Are Mental Health Issues Among Children and Adolescents in China?

“Report on the Development of National Mental Health in China (2021–2022)” reveals that adolescents face a higher risk of depression than adults,Approximately 14.8% of adolescents are at varying levels of risk for depression.. Meanwhile,The Trend of Depression Risk Affecting Younger Age Groups Is Highly Evident, with a Detection Rate of 30% Among Junior High School Students, even more exaggeratedly, those who were previously considered carefreeThe detection rate of depression among elementary school students has also reached as high as 10%.。

A psychiatrist from a city in western China also mentioned in a recent post,In a class of 54 students at a key high school in a certain city, 18 were diagnosed with depression, five of whom had severe depression.。

Data from frontline clinical practice also underscores the severity of the issue. Kaixin Medical, which specializes in mental health for children and adolescents, operates a chain of psychiatric clinics across Shanghai, Hangzhou, Zhengzhou, Changsha, Nanjing, Shenyang, Shenzhen, and other cities. There has been a steady influx of children and parents seeking help, with a significant increase in patient numbers. Statistics show that during the 2022–2023 period, outpatient visits reached 8,564, generating 20,183 treatment records. At its Shanghai clinic, the total daily hours of psychological counseling (therapy) peaked at 45 hours during holidays, while the average year-on-year increase in new patients across all clinics was 48%. A notable trend toward younger ages has also emerged, with pediatric and adolescent patients accounting for 80% of the total patient population.

It is widely believed that immense academic pressure is one of the primary drivers behind the increasingly severe mental health challenges facing children and adolescents in China. Absurd scenarios related to this academic burden have frequently captured widespread public attention in recent times. For instance, elementary school students suffering from respiratory illnesses are seen completing homework while receiving intravenous infusions in hospitals; in other cases, children’s weekends are completely saturated with various extracurricular classes, requiring schedules to be executed with minute-by-minute precision. Such scenes, which appear excessively exaggerated even to adults hardened by the rigors of societal life, often cast doubt on their authenticity, yet they are circulating across social media platforms with increasing frequency.

Zhang Chen, Chief Physician at the Shanghai Mental Health Center, an Outstanding Academic Leader in Shanghai, and a Distinguished Young Psychiatrist in China, stated to VCBeat that the mental health of children and adolescents is not solely a medical issue, but rather the result of a combination of factors, including social and educational aspects.

“Some parents, guided by their past perceptions, may believe that as long as their children gain admission to prestigious schools, they will secure desirable jobs and earn substantial incomes in the future. This mindset leads to the instrumentalization of education, with parents pushing their children to ‘study relentlessly until exhaustion.’ Misconceptions about learning are a significant contributor to mental health issues in children. Since many of these misconceptions are closely tied to parental attitudes, psychiatrists often remark, ‘The parents are ill, but the child takes the medication.’”

In addition to academic pressure, many parents also inadvertently project onto their children the stress stemming from their daily work and personal lives.

In recent years, the state has placed particular emphasis on psychological issues among children and adolescents. In 2019, the “Healthy China Initiative—Action Plan for Mental Health of Children and Adolescents (2019–2022)” called for the establishment of a collaborative mental health service model involving schools, communities, families, media, and medical and health institutions.

In 2021, the National Health Commission officially established the National Center for Mental Health and Psychiatric Disease Prevention and Control, incorporating research on the prevention and treatment of common psychological issues among key populations, such as children and adolescents, into its responsibilities. In the same year, the “Opinions on Further Reducing the Homework Burden and Off-Campus Training Burden for Students in Compulsory Education” introduced various measures to alleviate academic pressure on primary and secondary school students.

Gao Yan stated that these measures have indeed played a role in preventing mental health issues among children and adolescents. “My child has a psychology class every week at school, which was not available before. In these classes, specialized psychology teachers guide the students through various psychological activities, including meditation, stress reduction, and art therapy.”

Meanwhile, primary and secondary schools are gradually implementing preventive screening for students' mental health issues. This enables early identification and warning for children showing tendencies toward mental health problems, thereby providing opportunities for intervention at the initial stages of progression.

Nevertheless, mental health interventions for children and adolescents still face numerous challenges. The most prominent issue is the severe inadequacy of relevant medical service capacity. A parent, whose child was identified as having depressive tendencies through school-based screening, discovered upon seeking clinical care thatChild Psychiatry Outpatient Clinics Are Overwhelmed: Appointment Waitlists Extend Several Months。

According to statistics from the National Health Commission, by the end of 2021, there were only 64,000 psychiatrists in China, among whomThe shortage of child psychiatrists is even more severe, with only about 500 practitioners in 2022—a drop in the bucket when facing over 50 million pediatric patients that year.。

Mental health interventions for children and adolescents differ significantly from those for adults, making them unsuitable for non-professionals. Zhang Chen explained to VCBeat that this is because adults possess a complete self-awareness and clearly understand their needs, whereas children’s self-perception remains incomplete and in a state of flux. Failure to understand the unique characteristics of children and adolescents inevitably leads to an educational approach, which is precisely what this demographic resents most.

Furthermore, unlike other outpatient services, psychiatric treatment is mentally and physically demanding, limiting psychiatrists to conducting psychotherapy for only four to five patients per day. Paradoxically, patients typically require weekly psychotherapy sessions of approximately one hour each, with a treatment course lasting from as short as six months to as long as two years.

This further exacerbates the shortage of medical resources.

In addition to the severe shortage of service capacity, there are other pain points in various aspects of mental health prevention and treatment for children and adolescents. Taking screening as an example, it still relies on a combination of doctors' experience and psychological scales, which has long been considered too subjective with poor screening accuracy.

Gao Yan stated,Two factors can lead to bias in scale results.First, the scale contains a large number of items; if children lack sufficient subjective willingness to cooperate, they may respond randomly, thereby failing to yield accurate information. Second, even if children are willing to complete the scale, it often requires retrospective assessment of their status over a prior time period; children may be unable to recall their state at that time, thus also failing to provide accurate information.

“Mental health issues in children and adolescents are highly insidious in the early stages; unless parents are exceptionally attentive or possess substantial professional knowledge, they are difficult to detect. By the time these issues are identified, the condition has often progressed to moderate depression. Even at this stage, parents may still remain in denial,” she stated.

Unresolved pain points also persist during the treatment phase. Taking depression and anxiety in children and adolescents as an example, three therapeutic modalities are available: psychotherapy, pharmacotherapy, and physical therapy.

Pharmacotherapy is currently a more common treatment method, but there is a market gap for antidepressant and anti-anxiety medications specifically designed for children and adolescents. Since teenagers are still in their developmental stage and have high drug sensitivity, they experience more pronounced side effects from medications compared to adults.

Therefore,Currently, the few available medication options are all used across diverse populations. They are selected not for superior efficacy, but due to their relatively lower side-effect profiles. Even so, these medications may still cause significant declines in cognitive and learning abilities in pediatric patients during treatment.。

Physical therapy mainly includes electrical stimulation and magnetic stimulation. However,If physical stimulation protocols are not personalized for individual patients, therapeutic outcomes vary significantly; however, personalization remains the greatest clinical challenge.。

Finally, there is psychotherapy, which relies primarily on physicians. As previously mentioned,Due to a severe shortage of qualified professionals, psychotherapy often requires a waiting period of several months to secure an appointment.。

Evidently, addressing mental health issues among children and adolescents is extremely challenging and requires the involvement of fresh forces.

In the field of mental health, digital healthcare is considered to have broad development potential due to its minimal side effects.. In particular, digital therapeutics has seen mental health emerge as one of its most critical development branches. Digital therapeutics can be used independently, delivering therapeutic interventions directly via software. In an era where nearly everyone owns a smartphone, this mode of intervention may be more readily accepted.

Clinical trials conducted over the past several years have demonstrated that digital therapeutics exhibit significant efficacy in managing behavior-mediated conditions that are not adequately addressed by conventional pharmacotherapy, such as depression, post-traumatic stress disorder (PTSD), smoking cessation, type 2 diabetes, and insomnia. For these conditions, traditional medication offers limited benefit and carries a high risk of adverse drug reactions.

However, there are few digital health products in China specifically targeting depression and anxiety in children. According to VCBeat, these companies are primarily exploring stages such as screening and treatment, for example, Lingben Robot in the screening stage, and Weiming Naonao and Yi Xin An in the treatment stage.

During the screening phase, digital health is considered to potentially offer a more objective assessment method than the scales currently in use.。

Gao Yan explained to VCBeat that digital health may provide more objective biomarkers in the screening and prevention phase, which, when combined with existing methods, could assist in early screening. “Depression and anxiety are fundamentally disorders of the brain. Currently, there has been progress in using AI to detect biomarkers such as eye movements, speech patterns, and even brainwaves. Once these technologies mature, they are expected to complement existing rating scales to aid in screening.”

Zhang Chen stated,Currently, many of children’s social interactions take place on smartphones or smartwatches for kids; these devices could potentially serve as first-line screening tools.: “For instance, by embedding AI into mobile games and analyzing players’ various behavioral patterns—including text and voice inputs—early warnings can be issued for abnormal signs. Compared with existing screening methods, this approach, being integrated into daily life, may offer greater precision.”

This is not a pipe dream; in fact,In addition to screening, video games have been found in practice to effectively relieve stress and improve mental health in certain situations.—Although theoretically it should not possess such a function. In 2016, the then-prominent new media outlet VICE reported on the true story of Scottish singer Hamish Black, who treated his depression by playing video games.

In an interview, Black stated that he had found a game that truly resonated with his experiences. He likened himself to the protagonist, striving to survive and thrive in a world indifferent to his existence. “Having a game reflect this perspective is one of the key reasons I believe has helped prevent my depression from recurring.”

It’s not just Black who feels this way; some players in the relevant gaming communities have also expressed agreement.

Of course, strictly speaking, this is at best a coincidence and cannot be applied to all scenarios. Therefore, the next step is to develop functional games, which then evolve into gamified digital therapeutics.

So-called functional games are a special category of games distinct from traditional ones. Their primary purpose is not merely to entertain players, but to add practical utility on top of entertainment value. This allows players to experience or learn more while playing, thereby offering greater educational significance or practical functionality.

As for digital therapeutics, it represents a further step toward medical applications. It falls within the scope of digital health and refers to an innovative approach that leverages digital technologies and software applications to deliver medical interventions and treatments. By integrating medicine, technology, and data analytics, it aims to improve patients’ health outcomes, manage diseases, and facilitate recovery.

Pok City’s subsidiary, Pok Medical, a well-known domestic gaming enterprise, secured China’s first digital therapy certification in the gaming industry as early as 2022. It also, in 2022,JMIR Serious Gamespublished inClinical trial results demonstrate that gamified digital therapeutics can effectively enhance patients' subjective well-being and reduce anxiety when access to in-person service interventions is unavailable during the COVID-19 pandemic.。

The results of clinical trials indicate that online psychological interventions (such as coloring games) are effective for mental health during specific periods. Meanwhile, it is feasible to embed scientifically validated psychological interventions into existing commercial games, which can help fill the gap in psychological crisis intervention and serve a broader population during critical times.。

During the treatment phase, Weiming Naonao, under Gao Yan’s leadership, is collaborating with Anding Hospital to explore how digital healthcare can address critical clinical needs. “Clinicians have an urgent need for tools that assist in diagnostic testing and recommend individualized pharmacotherapy regimens for each patient. We have developed a generative artificial intelligence model, leveraging multidimensional data including brain-computer interface metrics and physicians’ clinical expertise, to help doctors identify more suitable medication plans for their patients. The solution has now been standardized, and we are currently applying for medical device certification.”

As of press time, Weiming Brain-BrainPrecision Diagnostic System for Depression Based on Multi-Dimensional Multi-Omics Data Analysis—A02 EEG Data Processing Software Has Obtained Class II Medical Device Registration Certificate in Beijing.

“In another area, we are also developing physical therapy modalities such as neuromodulation. Of course, this also involves personalized, precision treatment.”

In terms of assisting physicians, Zhang Chen believes that digital health also holds significant potential to help address current challenges.。

“One is the ‘digital human.’ For instance, if a doctor’s ‘digital twin’ can be trained, it could assist physicians in handling initial consultations and clarifying patients’ questions. Although it cannot replace face-to-face psychotherapy, it can indeed help alleviate the current shortage of corresponding medical resources to a certain extent.”

“Digital technology can also significantly assist with the documentation required after psychotherapy, reducing physicians’ administrative burden and thereby freeing up certain medical resources,” he added.

“The other is a ‘digital playmate,’ meaning that AI serves as an online companion for the child. It not only provides companionship and listens to the child’s thoughts, but also offers encouragement, subtly influencing the child and fostering a positive outlook on life. Furthermore, it can provide early warnings if signs of potential issues are detected.”

Beyond this, digital health holds significant potential in the field of child and adolescent mental health. Of course, translating this potential into reality is another matter altogether. This will require time, and more importantly, concerted efforts from the entire industry and society at large.

Unless seen with one’s own eyes, it is difficult to imagine the severity of current mental and psychological health issues among children and adolescents. It should be noted that while advances in various intervention strategies, including digital health, are promising, they still only address the symptoms rather than the root causes.

“Children actually lack a sense of security the most, and their sense of security comes from their family. However, the very family members who should provide this sense of security have destroyed it, causing immense harm. The root of solving the problem lies in parents first understanding their children and empathizing with their inner feelings, rather than simply handing the child over to doctors or teachers—blaming the doctor if treatment fails, or blaming the teacher if academic performance suffers. If parents hold such rigid beliefs, any therapeutic intervention will be of no value.”

This appeal from medical professionals is intended for all parents to reflect upon and act accordingly.

References:

Zhu Changjun, Guangming Online - Commentary Channel: "Mental Health Sector Faces 'Talent Shortage'; Gaps Must Be Addressed Early"