Precision mental healthcare : identifying service preferences through discrete-choice experiments in Chinese megacities

Abstract

Designing mental health services that align with individual preferences is a cornerstone of patient-centered care, enhancing both service utilization and treatment outcomes. This study applied the precision framework of mental healthcare to explore preferences for first-contact mental health services among community residents and family members with mild psychiatric symptoms in Chinese megacities. Using a discrete choice experiment, an online survey was conducted with 4,057 participants from Beijing, Shanghai, Guangzhou, and Shenzhen. Mixed logit analysis identified service providers as a key determinant of mental health service utilization across cities. While both potential patients and family members favored lower-cost public services, notable variations emerged in preferences for psychological counseling/therapy across cities and between patient and family contexts. Latent class analysis further revealed four distinct preference groups among potential patients. Psychological distress levels and hukou type were significantly associated with preferences. These findings highlight the importance of tailored interventions that accommodate patient and family needs, leveraging the unique features of China’s mental healthcare system to improve access, quality, and equity in mental health services.