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 Medical professionals welcomed the launch of several official
services in a country where mental health remains a relatively taboo
subject, but cautioned that unofficial talk lines could do more harm
than good.
"There are a lot of hotlines out there staffed by a lot of
volunteers but it just doesn't make sense because there’s not many
that can be well-trained," said Cui Erjing, a Seattle-based
volunteer for one of the hotlines, who is originally from China's
Southern Guangdong province.
"It can be really traumatising to ask for support but not get the
right responses."
A survey by the Chinese Psychology Society published by state media
last week found that of 18,000 people tested for anxiety related to
the coronavirus outbreak, 42.6% registered a positive response. Of
5,000 people evaluated for post traumatic stress disorder (PTSD),
21.5% had obvious symptoms.
The hashtag #howtodealwithfeelingveryanxiousathome has been trending
on social media platform Weibo, with more than 170 million views, as
misinformation about the spread of the disease and travel bans feed
public worries.
HOTLINES OVERWHELMED
The hotlines are part of the government's "first level response" for
dealing with the psychological impact of major health emergencies, a
strategy that was first deployed following the 2008 Sichuan
earthquake, a disaster in which 87,150 people were killed or listed
as missing.
The National Health Commission said more than 300 hotlines had
launched across the country to provide mental health advice related
to coronavirus, with support from university psychology departments,
counseling services and NGOs.
They have been inundated by callers in a country which has just 2.2
psychiatrists available for every 100,000 people, according to WHO
data, five times fewer than in the United States.
A national hotline run by Beijing Normal University was overwhelmed
when it went live at the end of January, said Cheng Qi, a
Shanghai-based psychologist.
While the number of calls has dropped as other lines opens, the
content has become more challenging, Cheng said, noting one caller
with chronic depression who had reported suicidal thoughts triggered
by the barrage of bad news.
"It’s not the virus [that caused it], but the virus is stimulating
it," she said.
Xu Wang, a psychotherapist at Tsinghua University, which is working
with the official Beijing city hotline, said a major challenge was
working out which callers showed real symptoms of the virus and
which were instead suffering from anxiety.
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"Callers often have somatic issues, and might say, 'I can’t eat
well, can’t sleep well, and I want to know if it’s a virus
infection,'" he said.
A volunteer group of more than 400 therapists called 'Yong Xin Kang
Yi', which roughly translates to 'Use Heart to Fight the Virus',
focuses on helping overworked medical staff in Wuhan, the epicenter
of the virus.
"They leave messages saying they’re exhausted, that they’re scared,"
Cui said. "The doctors don’t know if they’re going to get infected
or if their co-workers or going to get infected, and they don’t know
how bad it’s spreading."
LEARNING CURVE
Medical researchers from Peking University included telephone and
internet counseling for healthcare staff, patients, and the public
among six key strategies for coping with mental stress over the
coronavirus outbreak.
"We believe that including mental health care in the national public
health emergency system will empower China and the world during the
campaign to contain and eradicate
2019-nCoV," the researchers said in a paper published in The Lancet
medical journal last week.
The government recently issued guidance for the hotlines, saying
they should be free, confidential, staffed by volunteers with
relevant professional backgrounds and supervised by experienced by
experts.
Still, concerns remain about enforcement.
"There are many individually initiated helplines and it’s difficult
to gain consistent support and supervision," said Sami Wong, a
Beijing-based psychotherapist.
Tsinghua University's Xu said the very nature of the hotlines added
to the challenges, preventing volunteers from gaining much-needed
face-to-face experience with people suffering mental health issues.
Wong worried that untrained volunteers could easily put their foot
in their mouth. A seemingly innocuous "I can understand how you
feel" can cause vulnerable people to clam up, she said: "PTSD
training is not something you can learn overnight."
(This story corrects transliteration of names in paragraphs 3, 15
and 16)
(Reporting by David Kirton; editing by Jane Wardell)
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