Vicarious trauma, social media and recovery in Hong Kong.

As noted by Hou and Hall (2019), 2019’s ongoing and large-scale protests in Hong Kong will significantly impact the mental health of the city’s population. The likelihood of wide-spread post-traumatic stress has been identified in relation to previous protest movements in the region (Lau et al., 2017) and through recent empirical research (Lee, 2019). As the threat posed by the spread of the novel coronavirus (Covid-19) further disrupts day-to-day life in Hong Kong and across the globe, finding ways to support individual and community mental health becomes more urgent. A key subpopulation for such research emerged from the protest maelstrom in late 2019. On 11th November 2019, in the wake of a city-wide strike, protesters moved en masse into the campuses of some of Hong Kong’s eight government-funded universities (BBC News, 2019). Face-to-face teaching was suspended, staff were directed to work at home, courses were offered online for the remainder of the semester and many international students left the region.

The most severely affected of these sites was The Hong Kong Polytechnic University (PolyU). When the campus was handed back to University officials after nearly two weeks of unrest, it was significantly damaged and extensive repairs were required. These events at PolyU disrupted the day-to-day lives of more than 30, 000 people (students and staff) directly connected with the university. There have been broad calls in Hong Kong for greater investment in mental health but as yet little data has been gathered from those affected which can help design community-level interventions.

A multi-method research study (reference: HSEARS20191122001) was conducted in the weeks immediately following these events at PolyU. Participants completed an anxiety scale and participated in interviews which included questions focused on community-level recovery. Interviews were conducted in English, Cantonese or Mandarin Chinese depending on individual preference. Preliminary analysis of the data highlights three important themes that warrant further investigation in relation to community-level recovery following large-scale disruption such as social unrest and population health emergencies.

One theme concerned stress and anxiety levels that suggested the presence of vicarious or second hand trauma. Vicarious trauma refers to the psychological impact (especially in terms of anxiety and stress) of second-hand exposure to traumatic events. It differs from trauma experienced or directly seen by an individual and which fits within the conventional description of post-traumatic stress disorder (PTSD) in the Diagnostic and Statistical Manual 5 (Yazdani et al., 2016; Zoellner et al., 2016). Although relatively few members of the PolyU community saw the events at the campus first hand, individuals reported symptoms of stress and anxiety such as disrupted sleep patterns, disturbing dreams and feelings of hopelessness. Acknowledging the legitimacy of vicarious trauma is likely to be key to recovery and resilience. This connects to the second theme which suggests that the sounds and images of adverse events circulated on social media channels increased individual’s stress and anxiety. This effect has been noted in relation to depression (Lee, 2019) and has been described as an “emotional contagion” (Goodwin et al., 2018) which spreads through social networks as graphic and constantly updated images and unverified ‘facts’ are repeatedly shared.

The third theme underscores the need for universities world-wide to acknowledge the unique mental health needs of these culturally diverse populations. Universities actively recruit international students but may underestimate the challenges faced by this group if confronted with large scale civil unrest or disruption. Acknowledging intercultural perspectives in recovery efforts is vital. Additionally, the profile of this subpopulation shows increased risks to mental health through relatively young age (i.e. undergraduate students are often between 18 and 23 years); limited access to social and familial support networks as well as difficulties accessing relevant information in a foreign language and a potentially unfamiliar cultural context. Protective factors known to promote mental health in times of unrest include maintaining everyday routines and work practices (Hou and Bonanno, 2018). However, in the case of Hong Kong and specifically PolyU it is the loss of routine and access to work and study sites that exacerbated the stress and anxiety described by some research participants.

Mental health support is urgently required in the current context of regional and global unrest. It is essential to acknowledge that the interface between individual and community recovery is key. An individual may seek and receive high quality mental health support but additional attention must be directed towards the reforming of community. As noted by Ni et al. (2020), even though social unrest is a part of human history, limited research has been conducted into the effects on community-level mental health. Our early findings suggest that the rapid provision of counselling services that reflect linguistic and cultural diversity, opportunities to talk about the significance of events with others familiar with the setting, as well as using social media channels to rebuild a sense of community offer ways forward.

Financial disclosure

No funding was received for this research.

Declaration of Competing Interest

The authors have no conflict of interests to declare.