Characteristics and challenges of psychological first aid in China during the COVID-19 outbreak.

With the outbreak of the 2019 coronavirus disease (COVID-19) (Wang et al., 2020), mental health professionals in China actively participated in combating the disease, especially in the psychological first aid. There are several features in the present psychological first aid which are different from previous rescue works in China such as the severe acute respiratory syndrome (SARS) in 2003 and the Wenchuan Earthquake in Sichuan in 2008. There are some reflections that are useful for us to prepare for the future as well.

Distinguishing features

The first feature is the fast response of psychosocial intervention to COVID-19. As early as January 24, 2020, just one day after the lockdown implementation of Wuhan, the Wuhan Mental Health Center launched the first free crisis intervention hotline of mental health to the public. On January 26, the Clinical and Counselling Psychology Registration System of Chinese Psychological Society begun to recruit registered supervisors to provide nationwide supervision for psychotherapists, psychological counselors, social workers and volunteers. On January 28, the Ministry of Education deployed the psychological assistance hotline for teachers and students in the education system nationwide (Chinese Young, 2020).

The second feature is the full use of mental health resources across the country. After the epidemic outbreak, major national professional organizations, such as the Chinese Association for Mental Health, the Chinese Psychological Society, the Chinese Psychiatrist Association, and the Chinese Society of Psychiatry, all set out the psychological assistance programs nationwide and/or provincially. By February 28, 430 psychiatrists have been sent to Hubei Province to support the local health service.

Thirdly, a better professional service quality is demonstrated. Under the guidance released by the National Health Commission, the major professional associations have issued several guidelines or protocols of psychological interventions for different populations and settings under the epidemic. The ethics of psychological intervention are highly valued in related guidelines and training. It has been repeatedly emphasized how to avoid vicarious trauma and occupational burnout. In addition, more emphasis has been placed on the evaluation of the effectiveness of psychological interventions and the provision of supervision.

Fourthly, more psychosocial intervention is based on the internet, which maximizes the beneficiaries from the intervention. The development of the fourth-generation (4G) and fifth-generation (5G) wireless networks makes online lecture, training, supervision and outreach medical services possible via smartphone applications. Telemedicine platforms allow online consultations which provide convenient access to medical and mental health service for the public. In addition, with online survey tools, big data can be collected and analyzed quickly and in real time, enabling subsequent precision interventions.

Challenges needed to be prepared for in the future

Firstly, the liaison mechanism of mental health services needs to be strengthened and improved. During this epidemic, the Mental Health Division of the Disease Control and Prevention Bureau in the NHC plays an important role in coordination. However, dialogues and communication among medical organizations, medical institutions, and psychological organizations are not sufficient. A management system that promotes collaboration among organizations is extremely urgent.

In addition, a few mental hospitals lack enough prevention awareness and measures in this outbreak compared to general hospitals, leading to a certain number of infections in psychiatric inpatients (Ying et al., 2020). Therefore, the biomedical education including the training courses regarding COVID-19 should be reinforced (Shi et al., 2020).

In the past ten years, the number of psychiatrists in China has increased from 24,000 to 40,000 (Shi Chenhui et al., 2019). However, even together with 10,000 registered psychotherapists, the group of mental health professionals still cannot satisfy the needs of psychosocial intervention during this large-scale epidemic, especially the needs outside the hospitals, relatives of the COVID-19 patients for example. Moreover, the majority of mental health workers lack professional training for psychological crisis intervention, making the quality of services in some places questionable. Therefore, the team of mental health professionals needs to be expanded and strengthened.

Declaration of interest

The authors declare no competing interests.