What are Display Rules?


Display rules are a social group or culture’s informal norms that distinguish how one should express themselves.

They can be described as culturally prescribed rules that people learn early on in their lives by interactions and socialisations with other people. They learn these cultural standards at a young age which determine when one would express certain emotions, where and to what extent.

Emotions can be conveyed through both non-verbal interactions such as facial expressions, hand gestures and body language as well as verbal interactions. People are able to intensify emotions in certain situations such as smiling widely even when they receive a gift that they are not happy about or “masking” their negative emotions with a polite smile. As well, people learn to de-intensify emotions in situations such as suppressing the urge to laugh when somebody falls or neutralising their emotions such as maintaining a serious poker face after being dealt a good hand. Display rules determine how we act and to what extent an emotion is expressed in any given situation. They are often used to protect one’s own self-image or those of another person.

The understanding of display rules is a complex, multifaceted task. Display rules are understood differentially depending upon their mode of expression (verbal/facial) and the motivation for their use (prosocial/self-protective).


Emotions can be defined as brief, specific, and multidimensional responses to challenges or opportunities that are important to both personal and social goals. Emotions last up to a few seconds or minutes, and not hours or days. Emotions are very specific which suggests that there is a clear reason why a person may be feeling a certain emotion. Emotions are also used to help individuals achieve their social goals. Individuals may respond to certain challenges or opportunities during social interactions with different emotions. The selected emotions can guide a specific goal-directed behaviour that can either support or hinder social relationships.

Concepts of Emotion

Emotions can be broken down into different components. The first component of emotion is the appraisal stage. In this first stage, individuals process an event and its impact on their personal goals. Depending on the outcome, the individual will either go through positive or negative feelings. Next, we have distinct physiological responses such as blushing, increased heart rate or sweating. The next stage of emotion is the expressive behaviour. Vocal or facial expressions follow an emotional state and serve to communicate their reactions or intentions (social). The next component is the subjective feeling. This is the quality that defines the experience of a specific emotion by expressing it by words or other methods. Finally, the last component is action tendencies. This suggests that emotion will motivate or guide specific behaviour and bodily responses.

Theories of Emotion

Emotions can be expressed verbally, with facial expressions, and with gestures. Darwin’s hypothesis concerning emotion stated that the way emotions are expressed is universal, and therefore independent of culture. Ekman and Friesen conducted a study to test this theory. The study included introducing basic emotions found in the western world and introduced them to different cultures around the world (Japan, Brazil, Argentina, Chile, and the United States). Across the 5 cultures they were all able to accurately determine the emotion (success rates of 70-90%). They also introduced these selected emotions to an isolated community in Papua New Guinea that was not in contact with the western world. The results revealed that both the other cultures and isolated communities could effectively match and detect the emotional meaning of the different faces. This became evidence that emotions are expressed facially in the same way across the world.


Culture can be defined as “shared behaviors, beliefs, attitudes, and values communicated from generation to generation via language or some other means.” Unique individuals within cultures acquire differences affecting displays of emotions emphasized by one’s status, role, and diverse behaviours. Some cultures value certain emotions more over others. The affect theory argues that emotions that promote important cultural ideals will become focal in their social interactions. For example in America, they value the emotion excitement as it represents the cultural idea of independence. In many Asian cultures it is inappropriate to discuss personal enthusiasms. They place greater value on emotions such as calmness and contentedness, representing the ideal harmonious relationships. These different cultural values affect a person’s everyday behaviours, decisions and emotional display.

People learn how to greet one another, how to interact with others, what, where, when and how to display emotions through the people they interact with and the place they grow up in. Everything can be traced back to one’s culture. Gestures is an example of how one may express themselves, however these gestures represent different meanings depending on the culture. For example, in Canada, sticking out one’s tongue is a sign of disgust or disapproval however in Tibet it is a sign of respect when greeting someone. In America, holding one’s middle and index fingers up makes the peace sign, in some countries such as the UK and Australia it a sign of disrespect.

High and low-contact cultures also vary in the amount of physical interaction and direct contact there is during one-on-one communication. High-contact cultures involve people practicing direct eye contact, frequent touching, physical contact, and having close proximity to others. Examples of countries that have a high-contact culture include Mexico, Italy, and Brazil. Low-contact cultures involve people who practice less direct eye contact, little touching, have indirect body orientation, and more physical distance between people. Examples of countries that have a low-contact culture include the United States, Canada, and Japan.

Social Influence

Family and Peers

Ekman and Friesen (1975) have suggested that unwritten codes or “display rules” govern the manner in which emotions may be expressed, and that different rules may be internalized as a function of an individual’s culture, gender or family background. For instance, many different cultures necessitate that particular emotions should be masked and that other emotions should be expressed drastically. Emotions can have significant consequences on the founding of interpersonal relationships.

Children’s understanding and use of display rules is strongly associated with their social competence and surrounding. Many personal display rules are learned in the context of a particular family or experience; many expressive behaviour and rule displays are adopted by copying or adopting similar behaviours than their social and familial surrounding. Parents’ affect and control influence their children’s display rule through both positive and negative responses. Mcdowell and Parke (2005) suggested that parents who exert more control over their children’s emotions/behaviour would deprive them of many opportunities to learn about appropriate vs. inappropriate emotional/rule displays. Hence, by depriving children from learning through control (i.e. not allowing them to learn from their own mistakes), parents are restraining children’s learning of prosocial rule display.

The social environment can influence whether one controls or displays their emotions. There are few factors influencing the children’s decision to either control or express an emotion that they are experiencing including the type of audience. In fact, depending on if children are in the presence of peers or of family (i.e. mother or father), they will report different control over their expression of emotions. Regardless of the type of emotion experienced, children control significantly more their expression of emotion in the presence of peers than when they are with their caregiver or alone.

School Environment

The school environment is also a place where emotions and behaviours are influenced. During a child’s grade school years, they can become increasingly more aware of the accepted display rules that are found in their social environment. They learn more and more about which emotions to express and which emotions not to express in certain social situations at school.

Emotions and Social Relationships

Emotions can serve as a way of communicating with others and can guide social interactions. Being able to express or understand other emotions can help encourage social interactions and help achieve personal goals. When expressing or understanding one’s emotions is difficult, social interactions can be negatively impacted.

Emotional intelligence is a concept that is defined by four skills:

  • The ability to accurately perceive other emotions.
  • The ability to understand one’s own emotions.
  • The ability to use current feelings to help in making decisions.
  • The ability to manage one’s emotions to best match the current situation.


Age plays an important role in the development of display rules, throughout life a person will gain experience and have more social interactions. According to a study by Jones, social interactions are the main factor in the creation and understanding of display rules. It starts at a very young age with family, and continues with peers. By meeting more people, facing more challenges and advancing in life, a person will develop different responses, those responses will depend mostly on the age of the person, this explains why a young person will have different social interactions than someone older.


Infancy is a complex period when studying display rules. At a very young age, an infant does not know how to talk, therefore they express themselves in different ways. In order to communicate with others, they use facial and vocal displays that are specific for each age-period. A study conducted by Malatesta and Haviland demonstrated that a baby can have 10 different categories for facial expression:

  • Interest.
  • Enjoyment.
  • Surprise.
  • Sadness/distress.
  • Anger.
  • Knit brow.
  • Discomfort/pain.
  • Brow flash.
  • Fear.
  • Disgusting.

However, fear and disgust will develop progressively during childhood. They are complex facial expressions that require knowledge and understanding, they must be learned and cannot be copied; this is why not everybody is afraid of the same things. Most of the facial expressions will be learned through the parents, mainly from the mother. The mother-infant relationship is key in the development of display rules during infancy, it is the synchrony of mother-infant expressions. To express themselves vocally; babies require the use of “screaming” or “crying”. There is no differentiation for the request of a baby, this is why the relation with the parents is important, they must teach the infant when and for what reason to cry (i.e. need of food).


During childhood, the expression of display rules becomes more complex. Children develop the ability to modulate their emotional expressions growing up, this development depends on the level of maturity and the level of social interactions with others. Children growing up start to become aware of oneself and slowly aware of others. At this time, they understand the importance of non-verbal communication, and shape the manner in which emotion may be expressed, with this change in perception, children will internalise different rules. Those rules are relative to two major factors:

  • The environment: The social environment impacts the way someone reacts emotionally. The audience and the context are essential to understand display rules among children.
  • The temperament: According to Leslie Brody, parents that socialise their kids the same way with equal level of nurturance, will observe different responses and reactions.

These two factors will help create “personal display rules” and the development of a sense of empathy toward others (i.e. feeling sad when a friend lost a relative even if one did not know the person).

This process will continue to change and grow until adulthood. During adolescence, a transition period where the person is not a child anymore but not an adult yet, is a test period as they learn to deal with internal conflict. Emotions are more intense and harder to control due to the hormonal changes that come at this period of time.


During adulthood, people are capable of using a lot of different display rules depending on the situation they are facing and the people they are with. Society governs how and when someone should express emotions, however display rules are not something static, they are in a constant evolution. Therefore, even during adulthood, a person will develop new ways to hide, express or cope with emotions. At the same time, adults will develop a greater control of their feelings and this can be seen mostly in the work environment. A study presented by the Journal of Occupational Health Psychology showed that nurses working in the same environment are more likely to share the same display rules in order to achieve an organisational objective. Display rules are not only personal, but they are shared between people and can differ according to the hierarchy of the society.

An Overview of Mental Health in China


Mental health in China is a growing issue. Experts have estimated that about 173 million people living in China are suffering from a mental disorder.

The desire to seek treatment is largely hindered by China’s strict social norms (and subsequent stigmas), as well as religious and cultural beliefs regarding personal reputation and social harmony. While the Chinese government is committed to expanding mental health care services and legislation, the country struggles with a lack of mental health professionals and access to specialists in rural areas.

Brief History

China’s first mental institutions were introduced before 1849 by Western missionaries. Missionary and doctor John G. Kerr opened the first psychiatric hospital in 1898, with the goal of providing care to people with mental health issues, and treating them in a more humane way.

In 1949, the country began developing its mental health resources by building psychiatric hospitals and facilities for training mental health professionals. However, many community programs were discontinued during the Cultural Revolution.

In a meeting jointly held by Chinese ministries and the World Health Organisation (WHO) in 1999, the Chinese government committed to creating a mental health action plan and a national mental health law, among other measures to expand and improve care. The action plan, adopted in 2002, outlined China’s priorities of enacting legislation, educating its people on mental illness and mental health resources, and developing a stable and comprehensive system of care.

In 2000, the Minority Health Disparities Research and Education Act was enacted. This act helped in raising national awareness on health issues through research, health education, and data collection.

Since 2006, the government’s 686 Program has worked to redevelop community mental health programs and make these the primary resource, instead of psychiatric hospitals, for people with mental illnesses. These community programs make it possible for mental health care to reach rural areas, and for people in these areas to become mental health professionals. However, despite the improvement in access to professional treatment, mental health specialists are still relatively inaccessible to rural populations. The program also emphasizes rehabilitation, rather than the management of symptoms.

In 2011, the legal institution of China’s State Council published a draft for a new mental health law, which includes new regulations concerning the rights of patients to not to be hospitalised against their will. The draft law also promotes the transparency of patient treatment management, as many hospitals were driven by financial motives and disregarded patients’ rights. The law, adopted in 2012, stipulates that a qualified psychiatrist must make the determination of mental illness; that patients can choose whether to receive treatment in most cases; and that only those at risk of harming themselves or others are eligible for compulsory inpatient treatment. However, Human Rights Watch has criticised the law. For example, although it creates some rights for detained patients to request a second opinion from another state psychiatrists and then an independent psychiatrist, there is no right to a legal hearing such as a mental health tribunal and no guarantee of legal representation.

Since 1993, WHO has been collaborating with China in the development of a national mental health information system.

Current Situation

Though China continues to develop its mental health services, it still has a large number of untreated and undiagnosed people with mental illnesses. The aforementioned intense stigma associated with mental illness, a lack of mental health professionals and specialists, and culturally-specific expressions of mental illness may play a role in the disparity.

Prevalence of Mental Disorders

Researchers estimate that roughly 173 million people in China have a mental disorder. Over 90 percent of people with a mental disorder have never been treated.

A lack of government data on mental disorders makes it difficult to estimate the prevalence of specific mental disorders, as China has not conducted a national psychiatric survey since 1993.

Conducted between 2001 and 2005, a non-governmental survey of 63,000 Chinese adults found that 16 percent of the population had a mood disorder, including 6% of people with major depressive disorder. Thirteen percent of the population had an anxiety disorder and 9 percent had an alcohol use disorder. Women were more likely to have a mood or anxiety disorder compared to men, but men were significantly more likely to have an alcohol use disorder. People living in rural areas were more likely to have major depressive disorder or alcohol dependence.

In 2007, the Chief of China’s National Centre for Mental Health, Liu Jin, estimated that approximately 50% of outpatient admissions were due to depression.

There is a disproportionate impact on the quality of life for people with bipolar disorder in China and other East Asian countries.

The suicide rate in China was approximately 23 per 100,000 people between 1995 and 1999. Since then, the rate is thought to have fallen to roughly 7 per 100,000 people, according to government data. WHO states that the rate of suicide is thought to be three to four times higher in rural areas than in urban areas. The most common method, poisoning by pesticides, accounts for 62% of incidences.

It is estimated that 18% of the Chinese population, about 244 million people believe in Buddhism. Another 22% of the population, roughly 294 million people believe in folk religions which are a group of beliefs that share characteristics with Confucianism, Buddhism, Taoism, and shamanism. Common between all of these philosophical and religious beliefs is an emphasis on acting harmoniously with nature, with strong morals, and with a duty to family. Followers of these religions perceive behaviour as being tightly connected with health; illnesses are often thought to be a result of moral failure or insufficiently honouring one’s family in current or past life. Furthermore, an emphasis on social harmony may discourage people with mental illness from bringing attention to themselves and seeking help. They may also refuse to speak about their mental illness because of the shame it would bring upon themselves and their family members, who could also be held responsible and experience social isolation.

Also, reputation might be a factor that prevents individuals from seeking professional help. Good reputations are highly valued. In a Chinese household, every individual shares the responsibility of maintaining and raising the family’s reputation. It is believed that mental health will hinder individuals from achieving the standards and goals- whether academic, social, career-based, or other- expected from parents. Without reaching the expectations, individuals are anticipated to bring shame to the family, which will affect the family’s overall reputation. Therefore, mental health issues are seen as an unacceptable weakness. This perception of mental health disorders causes individuals to internalise their mental health problems, possibly worsening them, and making it difficult to seek treatment. Eventually, it becomes ignored and overlooked by families.

In addition, many of these philosophies teach followers to accept one’s fate. Consequently, people with mental disorders may be less inclined to seek medical treatment because they believe they should not actively try to prevent any symptoms that may manifest. They may also be less likely to question the stereotypes associated with people with mental illness, and instead agreeing with others that they deserve to be ostracised.

Lack of Qualified Staff

China has 17,000 certified psychiatrists, which is 10% of that of other developed countries per capita. China averages one psychologist for every 83,000 people, and some of these psychologists are not board-licensed or certified to diagnose illnesses. Individuals without any academic background in mental health can obtain a license to counsel, following several months of training through the National Exam for Psychological Counsellors. Many psychiatrists or psychologists study psychology for personal use and do not intend to pursue a career in counselling. Patients are likely to leave clinics with false diagnoses, and often do not return for follow-up treatments, which is detrimental to the degenerative nature of many psychiatric disorders.

The disparity between psychiatric services available between rural and urban areas partially contributes to this statistic, as rural areas have traditionally relied on barefoot doctors since the 1970s for medical advice. These doctors are one of the few modes of healthcare able to reach isolated parts of rural China, and are unable to obtain modern medical equipment, and therefore, unable to reliably diagnose psychiatric illnesses. Furthermore, the nearest psychiatric clinic may be hundreds of kilometres away, and families may be unable to afford professional psychiatric treatment for the afflicted.

Physical Symptoms

Multiple studies have found that Chinese patients with mental illness report more physical symptoms compared to Western patients, who tend to report more psychological symptoms. For example, Chinese patients with depression are more likely to report feelings of fatigue and muscle aches instead of feelings of depression. However, it is unclear whether this occurs because they feel more comfortable reporting physical symptoms or if depression manifests in a more physical way among Chinese people.


According to various scholars, China’s psychiatric facilities have been manipulated by government officials in order to silence political dissidents. In addition to misuse by the state psychiatric facilities in China are also misused by powerful private individuals who use the system to advance their personal or business ends. China’s legal system lacks an effective means of challenging involuntary detentions in psychiatric facilities.

Chinese Military Mental Health


Military mental health has recently become an area of focus and improvement, particularly in Western countries. For example, in the United States, it is estimated that about twenty-five percent (25%) of active military members suffer from a mental health problem, such as PTSD, Traumatic Brain Injury, and depression. Currently, there are no clear initiatives from the government about mental health treatment towards military personnel in China. Specifically, China has been investing in resources towards researching and understanding how the mental health needs of military members and producing policies to reinforce the research results.


Research on the mental health status of active Chinese military men began in the 1980s where psychologists investigated soldiers’ experiences in the plateaus. The change of emphasis from physical to mental health can be seen in China’s four dominant military academic journals: First Military Journal, Second Military Journal, Third Military Journal, and Fourth Military Journal. In the 1980s, researchers mostly focused on the physical health of soldiers; as the troops’ ability to perform their services declined, the government began looking at their mental health to provide an explanation for this trend. In the 1990s, research on it increased with the hope that by improving the mental health of soldiers, combat effectiveness improves.

Mental health issue can impact active military members’ effectiveness in the army, and can create lasting effects on them after they leave the military. Plateaus were an area of interest in this sense because of harsh environmental conditions and the necessity of the work done with low atmospheric pressure and intense UV radiation. It was critical to place the military there to stabilize the outskirts and protect the Chinese citizens who live nearby; this made it one of the most important jobs in the army, then increasing the pressure on those who worked in the plateaus. It not only affected the body physically, like in the arteries, lungs, and back, but caused high levels of depression in soldiers because of being away from family members and with limited communication methods. Scientists found that this may impact their lives as they saw that this population had higher rates of divorce and unemployment.

Comparatively, assessing the mental health status of the People’s Liberation Army (PLA) is difficult, because military members work a diverse array of duties over a large landscape. Military members also play an active part in disaster relief, peacekeeping in foreign lands, protecting borders, and domestic riot control. In a study of 11,000 soldiers, researchers found that those who work as peacekeepers have higher levels of depression compared to those in the engineering and medical departments. With such diverse military roles over an area of 8.4 million square kilometres (3.25 million square miles), it is difficult to gauge its impacts on soldiers’ psyche and provide a single method to address mental health problems.

Researches have increased over the last two decades, but the studies still lack a sense of comprehensiveness and reliability. In over 73 studies that together included 53,424 military members, some research shows that there is gradual improvement in mental health at high altitudes, such as mountain tops; other researchers found that depressive symptoms can worsen. These research studies demonstrate how difficult it is to assess and treat the mental illness that occurs in the army and how there are inconsistent results. Studies of the military population focus on the men of the military and exclude women, even though the number of women that are joining the military has increased in the last two decades.

Chinese researchers try to provide solutions that are preventative and reactive, such as implementing early mental health training, or mental health assessments to help service members understand their mental health state, and how to combat these feelings themselves. Researchers also suggest to improve the mental health of the military members, programmes should include psychoeducation, psychological training, and attention to physical health to employ timely intervention.


In 2006, the People’s Republic Minister for National Defence began mental health vetting at the beginning of the military recruitment process. A Chinese military study consisting of 2500 male military personnel found that some members are more predisposed to mental illness. The study measured levels of anxious behaviours, symptoms of depression, sensitivity to traumatic events, resilience and emotional intelligence of existing personnel to aid the screening of new recruits. Similar research has been conducted into the external factors that impact a person’s mental fortitude, including single-child status, urban or rural environment, and education level. Subsequently, the government has incorporated mental illness coping techniques into their training manual. In 2013 leak by the Tibetan Centre for Human Rights of a small portion of the People’s Liberation Army training manual from 2008, specifically concerned how military personnel could combat PTSD and depression while on peacekeeping missions in Tibet. The manual suggested that soldiers should:

“…close [their] eyes and imagine zooming in on the scene like a camera [when experiencing PTSD]. It may feel uncomfortable. Then zoom all the way out until you cannot see anything. Then tell yourself the flashback is gone.”

In 2012, the government specifically addressed military mental health in a legal document for the first time. In article 84 of the Mental Health Law of the People’s Republic of China, it stated, “The State Council and the Central Military Committee will formulate regulations based on this law to manage mental health work in the military.”

Besides screening, assessments and an excerpt of the manual, not much is known about the services that are provided to active military members and veterans. Analysis of more than 45 different studies, moreover, has deemed that the level of anxiety in current and ex-military personnel has increased despite efforts of the People’s Republic due to economic conditions, lack of social connects and the feeling of a threat to military livelihood. This growing anxiety manifested in both 2016 and 2018, as Chinese veterans demonstrated their satisfaction with the system via protests across China. In both instances, veterans advocated for an increased focus on post-service benefits, resources to aid in post-service jobs, and justice for those who were treated poorly by the government. As a way to combat the dissatisfaction of veterans and alleviate growing tension, the government established the Ministry of Veteran Affairs in 2018. At the same time, Xi Jinping, General Secretary of the Communist Party of China, promised to enact laws that protect the welfare of veterans.

Book: Mental Health in a Multi-Ethnic Society

Book Title:

Mental Health in a Multi-Ethnic Society: A Multidisciplinary Handbook.

Author(s): Suman Fernando and Frank Keating (Editors).

Year: 2008.

Edition: Second (2nd).

Publisher: Routledge.

Type(s): Hardcover, Paperback, and Kindle.


This new edition of Mental Health in a Multi-Ethnic Society is an authoritative, comprehensive guide on issues around race, culture and mental health service provision. It has been updated to reflect the changes in the UK over the last ten years and features entirely new chapters by over twenty authors, expanding the range of topics by including issues of particular concern for women, family therapy, and mental health of refugees and asylum seekers.

Divided into four sections the book covers:

  • Issues around mental health service provision for black and minority ethnic (BME) communities including refugees and asylum seekers.
  • Critical accounts of how these issues may be confronted, with examples of projects that attempt to do just that.
  • Programmes and innovative services that appear to meet some of the needs of BME communities.
  • A critical but constructive account of lessons to be drawn from earlier sections and discussion of the way ahead.

With chapters on training, service user involvement, policy development and service provision Mental Health in a Multi-Ethnic Society will appeal to academics, professionals, trainers and managers, as well as providing up-to-date information for a general readership.

What are the Factors Associated with Suicide in Chinese Adults?

Research Paper Title

Factors associated with suicide risk among Chinese adults: A prospective cohort study of 0.5 million individuals.


Suicide is a leading cause of death in China and accounts for about one-sixth of all suicides worldwide. The objective of this study was to examine the recent distribution of suicide and risk factors for death by suicide. Identifying underlying risk factors could benefit development of evidence-based prevention and intervention programmes.


The researchers conducted a prospective study, the China Kadoorie Biobank, of 512,715 individuals (41% men, mean age 52 years) from 10 (5 urban, 5 rural) areas which are diverse across China in geographic locations, social economic developmental stages, and prevalence of disease patterns. After the baseline measurements of risk factors during 2004 to 2008, participants were followed up for suicide outcomes including suicide and possible suicide deaths. Risk factors, such as sociodemographic factors and physical and mental health status, were assessed by semi-structured interviews and self-report questionnaires.

Suicide and possible suicide deaths were identified through linkage to the local death registries using ICD-10 codes. The researchers conducted Cox regression to calculate hazard ratios (HRs) for suicide and for possible suicide in sensitivity analyses.


During an average follow-up period of 9.9 years, 520 (101 per 100,000) people died from suicide (51.3% male), and 79.8% of them lived in rural areas. Sociodemographic factors associated with increased suicide risk were male gender (adjusted hazard ratios [aHR] = 1.6 [95% CI 1.4 to 2.0], p < 0.001), older age (1.3 [1.2 to 1.5] by each 10-yr increase, p < 0.001), rural residence (2.6 [2.1 to 3.3], p < 0.001), and single status (1.7 [1.4 to 2.2], p < 0.001). Increased hazards were found for family-related stressful life events (aHR = 1.8 [1.2 to 1.9], p < 0.001) and for major physical illnesses (1.5 [1.3 to 1.9], p < 0.001). There were strong associations of suicide with a history of lifetime mental disorders (aHR = 9.6 [5.9 to 15.6], p < 0.001) and lifetime schizophrenia-spectrum disorders (11.0 [7.1 to 17.0], p < 0.001). Links between suicide risk and depressive disorders (aHR = 2.6 [1.4 to 4.8], p = 0.002) and generalized anxiety disorders (2.6 [1.0 to 7.1], p = 0.056) in the last 12 months, and sleep disorders (1.4 [1.2 to 1.7], p < 0.001) in the past month were also found.

All HRs were adjusted for sociodemographic factors including gender, age, residence, single status, education, and income. The associations with possible suicide deaths were mostly similar to those with suicide deaths, although there was no clear link between possible suicide deaths and psychiatric factors such as depression and generalised anxiety disorders. A limitation of the study is that there is likely underreporting of mental disorders due to the use of self-report information for some diagnostic categories.


In this study, the researchers observed that a range of sociodemographic, lifestyle, stressful life events, physical, and mental health factors were associated with suicide in China. High-risk groups identified were elderly men in rural settings and individuals with mental disorders. These findings could form the basis of targeted approaches to reduce suicide mortality in China.


Yu, R., Chen, Y., Li, L., Chen, J., Guo, Y., Bian, Z., Lv., Yu, C., Xie., Huang, D., Chen, Z. & Fazel, S. (2021) Factors associated with suicide risk among Chinese adults: A prospective cohort study of 0.5 million individuals. PLoS Med. doi: 10.1371/journal.pmed.1003545. eCollection 2021 Mar.

Book: Breaking the Barriers

Book Title:

Breaking the Barriers: Early Intervention to Mental Health Issues.

Author(s): Lade Hephzibah Olugbemi.

Year: 2020.

Edition: First (1st).

Publisher: Independently Published.

Type(s): Paperback and Kindle.


“If you don’t know what your barriers are, it’s impossible to figure out how to tear them down.” – John Manning, author of The Disciplined Leader.

This is true about mental health in the community. Barriers to information and understanding have affected people with mental health issues, as well as their friends, work colleagues and family members. This book seeks to shed light on the many factors that causes barriers to preventing mental health problems. It demystifies the various issues surrounding mental health, especially within the Black, Asian and Minority Ethnic (BAME) communities. It also explores the various factors that trigger mental illness, the role of the media, religion and culture in complicating the barriers.

By reading Breaking The Barriers, you will become more aware of the various issues around mental health, and better equipped to overcoming the barriers.

Book: Encyclopedia of Mental Health

Book Title:

Encyclopedia of Mental Health.

Author(s): Howard S. Friedman.

Year: 2015.

Edition: Second (2nd).

Publisher: Academic Press.

Type(s): Hardcover and Kindle.


The Encyclopedia of Mental Health, Second Edition, tackles the subject of mental health, arguably one of the biggest issues facing modern society. The book presents a comprehensive overview of the many genetic, neurological, social, and psychological factors that affect mental health, also describing the impact of mental health on the individual and society, and illustrating the factors that aid positive mental health.

The book contains 245 peer-reviewed articles written by more than 250 expert authors and provides essential material on assessment, theories of personality, specific disorders, therapies, forensic issues, ethics, and cross-cultural and sociological aspects. Both professionals and libraries will find this timely work indispensable.

  • Provides fully up-to-date descriptions of the neurological, social, genetic, and psychological factors that affect the individual and society.
  • Contains more than 240 articles written by domain experts in the field.
  • Written in an accessible style using terms that an educated layperson can understand.
  • Of interest to public as well as research libraries with coverage of many important topics, including marital health, divorce, couples therapy, fathers, child custody, day care and day care providers, extended families, and family therapy.

Causes of Mental Illness

Currently, mental illness is thought to be caused by a complex interaction of factors, including the following:

  • Hereditary;
  • Biologic (physical factors);
  • Psychologic; and/or
  • Environmental (including social and cultural factors).

Research has shown that for many mental health disorders, heredity plays a part. Often, a mental health disorder occurs in people whose genetic make-up makes them vulnerable to such disorders. This vulnerability, combined with life stresses, such as difficulties with family or at work, can lead to the development of a mental disorder.

Also, many experts think that impaired regulation of chemical messengers in the brain (neurotransmitters) may contribute to mental health disorders.

Brain imaging techniques, such as magnetic resonance imaging (MRI) and positron emission tomography (PET), often show changes in the brains of people with a mental health disorder.

Thus, many mental health disorders appear to have a biologic component, much like disorders that are considered neurologic (such as Alzheimer disease).

However, whether the changes seen on imaging tests are the cause or result of the mental health disorder is unclear.