A wealth of studies have examined the uptick of mental disorders among Chinese adolescents in recent years. A WHO report indicates that the rate of mental health issues among several developed and developing countries is between 12 and 29% (Global Burden of Disease Pediatrics Collaboration, 2016). Drawing on findings from a sample of over 70,000 Chinese adolescents in urban and rural areas, a 2021 study shows that the prevalence of behavioral and emotional issues among Chinese students aged 6-16 years is 17.6%, which is 4.63% higher than the results of a national survey in 1992 (Cui et al., 2021). 

Echoing previous findings, a 2022 UNICEF report finds that about 25% of adolescents in China have experienced mild to severe depression. In the same report, estimates show that at least 30 million children under 17 in China have consistently struggled with emotional or behavioral challenges (UNICEF, 2022). 

 Existing literature has looked into the factors behind such an alarming trend. UNICEF argues that the dilemma is ascribable to increasing stress and competition at school, high parental expectations, and changing socio-economic conditions (UNICEF). Another study puts the blame on China's rapid urbanization that separates parents from children in rural areas, an issue that will be detailed in the next section (Cui et al., 2021). Looking at the more recent development, a 2021 study on the impact of the COVID-19 pandemic reveals that the prevalence of insomnia, depressive and anxiety symptoms is linked to COVID-induced life changes such as school closures, lockdowns, strict prevention measures, and COVID-fear (Chi et al., 2021). 

All the aforementioned studies point to the need for a timely solution to alleviate the mental health crisis that puts Chinese adolescents in harm's way. 

Since the "Reform and Opening Up" in 1978, China has taken huge strides in economic development. One of the unwanted ramifications of such speedy growth was the increasing discrepancy between rural and urban areas. In particular, the educational level in rural areas has always been lower than that in urban areas, contributing to a low overall educational level in China (Gao and Li, 2022). As public education gradually shifted from central funding to local funding, the quality of education became dependent on the economic well-being of localities, thereby suffering from the ever-evolving economic disparity between urban and rural areas (Xiang and Sitwell, 2023). The relatively poor education quality in Chinese rural schools is evidenced by high dropout rates, poor teacher quality, subpar facilities, inadequate curricula, and a lack of resources (Ayoroa et al., 2010). 

The disparity also manifests itself strongly in the overall mental health status and access to mental health services between urban and rural populations. Based on the latest released China Family Panel Studies (CFPS) data in China in 2020, a 2023 study finds that urban respondents to the survey have better mental health status than rural respondents (Nie et al., 2023). Moreover, rural residents with mental health issues are less likely to seek and receive treatment than their urban counterparts as a result of insufficient services, perceived high costs of treatment, and entrenched superstitions (Yan and Tu, 2022). Although there might be mental health services in certain rural areas, the utilization of such services remains low due to income-related disparities in healthcare (Xu et al., 2018). Even if such services are present and utilized, China, as a country, has been suffering a severe shortage of pediatricians who specialize in child psychiatry, let alone in rural areas where such trained professionals are particularly scarce (Wang et al., 2021). 

In light of the pernicious disparities in both education and mental health status between urban and rural areas, how can rural schools function as safe spaces where students come together to learn and heal rather than a painful reminder of the inequalities that undermine their well-being?

Despite being historically known for its heavy emphasis on test-taking and rote, education in China has been framed differently in recent decades to encompass the "whole child." The 1986 Compulsory Education Law maintains that the ultimate goal of education is the "well-rounded development of children and adolescents in morality, intellect, and physical well-being" (Zhao, 2007). The idea was to produce a quality citizenry equipped with the skills and qualities to uplift China's national image and face the challenges of the new century. 

Under such guidelines, quality education, su zhi jiao yu has become the new education buzzword in the 21st century. The Ministry of Education re-articulated its commitment to quality education by making distinctions between quality education and test-oriented education: quality education focuses on the well-rounded development of children in academics, morality, physical well-being, and aesthetics whereas test-oriented education puts a premium on college enrollment rate (Ministry of Education, 2005). The emphasis is on helping students develop a sound character and moral sense while providing education that uplifts the student as a whole.

Despite numerous education reforms to promote quality education over test-centered education, China has largely left its high-stakes national exam Gaokao intact. A 2017 study finds that although Chinese students are aware of the issues around Gaokao and Chinese higher education, they tend to internalize Gaokao-induced pressure and adapt to its demands rather than collectively protesting it (Heger-Laube, 2017). Many Chinese students and families still perceive Gaokao as one of the most important, if not the only, avenues to gaining upward mobility on the social ladder and changing their fate (Ren, 2022).

If China is looking to promote quality education that focuses on the "full child" over test-centered education that restrains the child, what are some promising initiatives that can complement the existing system?