The Chinese public calls for support while the coronavirus has a mental cost

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SHENZHEN, China (Reuters) – Hundreds of 24-hour mental health support hotlines have emerged in China in recent weeks as millions of people worry about contracting the coronavirus and try to prevent infection by staying at home .
Medical professionals welcomed the launch of several official services in a country where mental health remains a relatively taboo subject, but warned that unofficial conversation lines could do more harm than good.

"There are many direct lines out there attended by many volunteers, but it just makes no sense because there are not many that can be well trained," said Cui Erjing, a Seattle-based volunteer for one of the direct lines, who is originally from the Guangdong Province of South China.
"It can be really traumatic to ask for support but not get the right answers."

A survey conducted by the Chinese Psychological Society, published by state media last week, found that of 18,000 people evaluated for anxiety related to the outbreak of coronavirus, 42.6% recorded a positive response. Of 5,000 people evaluated for posttraumatic stress disorder (PTSD), 21.5% had obvious symptoms.

The hashtag How to deal with feeling very anxious has been a trend in the Weibo social media platform, with more than 170 million visits, since misinformation about the spread of the disease and travel bans feed the public's concerns.
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The hotlines are part of the government's "first level response" to address the psychological impact of major health emergencies, a strategy that was first implemented after the 2008 Sichuan earthquake, a disaster in which 87,150 people died or listed as missing.

The National Health Commission said more than 300 hotlines had been launched across the country to provide mental health advice related to the coronavirus, with the support of the university departments of psychology, counseling services and NGOs.
They have been flooded by callers in a country that has only 2.2 psychiatrists available for every 100,000 people, according to WHO data, five times less than in the United States.
A national hotline run by Beijing Normal University was overwhelmed when it came into operation in late January, said Cheng Qi, a Shanghai-based psychologist.
While the number of calls has shrunk as other lines open, the content has become more challenging, Cheng said, noting that a caller with chronic depression had reported suicidal thoughts caused by the barrage of bad news.

"It's not the virus (which caused it), but the virus is stimulating it," he said.

Xu Wang, a psychotherapist at Tsinghua University, who is working with the official hotline of the city of Beijing, said an important challenge was to determine which callers showed real symptoms of the virus and who, instead, suffered anxiety.

"Callers often have somatic problems and might say:" I can't eat well, I 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 & # 39; Yong Xin Kang Yi & # 39 ;, which translates roughly as & # 39; use the heart to fight the virus & # 39 ;, focuses on helping medical staff with excess working in Wuhan, the epicenter of the virus.

"They leave messages that say they are exhausted, that they are afraid," Cui said. "Doctors don't know if they are going to get infected or if their co-workers or if they are going to get infected, and they don't know how bad it is spreading."

LEARNING CURVE

The medical researchers at the University of Beijing included telephone and Internet counseling for healthcare staff, patients and the public among the six key strategies to cope with mental stress from 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 an article published in the medical journal The Lancet. last week.

The government recently issued a guide for the hotlines, saying they should be free, confidential, attended by volunteers with relevant professional backgrounds and supervised by experienced experts.

Even so, concerns about the application persist.

"There are many help lines initiated individually and it is difficult to get consistent support and supervision," said Sami Wong, a Beijing-based psychotherapist.

Xu, from Tsinghua University, said the very nature of the hotlines added to the challenges, preventing volunteers from gaining face-to-face experience with people suffering from mental health problems.

Wong worried that untrained volunteers could easily put their feet in their mouths. Apparently an innocuous "I can understand how you feel" can make vulnerable people shut up, he said: "PTSD training is not something you can learn overnight."

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