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PERSPECTIVE/VIEWPOINT - COUNTRY/REGIONAL
Year : 2020  |  Volume : 2  |  Issue : 2  |  Page : 109-111

A Chinese Perspective of Coronavirus Disease 2019 Outbreak through a Social Psychiatric Lens


Department of Psychiatry, The Second Xiangya Hospital, Central South University; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China

Date of Submission17-May-2020
Date of Decision29-May-2020
Date of Acceptance04-Jun-2020
Date of Web Publication14-Aug-2020

Correspondence Address:
Prof. Xiaoping Wang
Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/WSP.WSP_29_20

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  Abstract 


The 2019 Coronavirus disease (COVID-19) has posed an emerging threat to global public health and brought challenges to policy-makers. Concerns are rising about the potential mental distress among frontline health-care workers, patients infected with COVID-19, and the public during the epidemic. We aimed to share a Chinese perspective through a social psychiatric lens to better respond to public emergencies. The Chinese government has implemented a number of mental health care measures, including an issue of national guidance on the COVID-19 response in mental health management. We propose that the government should set up a national platform for remote psychological services, increase the number of psychological rescue personnel, and built a joint psychosomatic rescue system for disasters, accidents, and epidemics. Establishing a psychological service system and developing a pool of multidisciplinary mental health service teams are essential to improve the capacity for crisis intervention. Strengthening the interactive system of popular science and health education may mitigate potential negative psychological impacts. We suggest priorities the needs of vulnerable groups with developing mental illness, including depression and posttraumatic stress disorder in longer-term strategic programs.

Keywords: Mental well-being, novel coronavirus, psychological intervention, severe acute respiratory syndrome coronavirus 2


How to cite this article:
Zhong S, Wang X. A Chinese Perspective of Coronavirus Disease 2019 Outbreak through a Social Psychiatric Lens. World Soc Psychiatry 2020;2:109-11

How to cite this URL:
Zhong S, Wang X. A Chinese Perspective of Coronavirus Disease 2019 Outbreak through a Social Psychiatric Lens. World Soc Psychiatry [serial online] 2020 [cited 2020 Oct 28];2:109-11. Available from: https://www.worldsocpsychiatry.org/text.asp?2020/2/2/109/292118



Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rapidly spreading to worldwide within a short time since its outbreak.[1] The coronavirus disease 2019 (COVID-19) epidemic is a sudden public health crisis and brings emerging challenges to policy-makers. The Chinese government took strong measures, including hitting a “pause button” in the entire country for nearly 3 months and a lockdown of Wuhan and nearby cities in Hubei Province to control the rapid transmission of COVID-19. Two dedicated hospitals were built over 1 week and more than 42,000 health-care workers were organized and sent to support Wuhan.

In a result of fear and uncertainty threatening to life regarding the COVID-19, people from the general public, frontline health-care workers, to patients infected with COVID-19, and their family members experience intense pressure and mental health problems. Based on the author's frontline experience in Wuhan over 4 weeks, people, especially patients with COVID-19 and frontline health-care workers, suffered from insomnia, anxiety, depression, and somatic complaints. A few cases were with the previous history of mental illness or stress-related experience. Despite this fact, few people had actively reported their mental health issues nor sought professional help. With limited official guidance at an early stage, health-care workers immersed themselves in the fight against COVID-19 and thought they should bear the mental distress. They were busy with their rescue works and concerned they may increase the burden of the health system if they sought help.

To address the need of mental health and psychosocial support, the government issued a number of official documents for mental health services to guide the prevention and control of the COVID-19. On January 27, 2020, the National Health Commission of China issued the notice on “Principles for Emergent Psychological Crisis Intervention during COVID-19 Epidemic.”[2] On February 18, 2020, the State Council's Comprehensive Group on the Joint Prevention and Control of COVID-19 Epidemic Issued the official document-”Notice on Strengthening the Treatment and Management of Patients with Severe Mental Disorders during COVID-19 Epidemic.”[3] On March 18, 2020, the State Council's Comprehensive Group on the Joint Prevention and Control of COVID-19 Epidemic issued the “Notice on psychological counseling work plan during COVID-19 Epidemic.”[4] On February 20, 2020, the National Health Commission organized a national mental health team with 302 members, including psychiatrists, psychologists, and psychiatric nurses, to provide mental health services for patients with COVID-19, and frontline health-care workers.

These measures have shown beneficial in increasing the connection and understanding of the public and may be useful to prevent and reduce mental health problems of involving people over the COVID-19 epidemic. However, the fight against the COVID-19 is far from over. While some symptoms may subside naturally, it is recommended to focus on psychological problems that affect most people, such as insomnia and anxiety in the early stage of the epidemic. With the situation getting improved, providing supports for vulnerable groups with developing mental illness, such as depression and posttraumatic stress disorder (PTSD) is becoming essential. There are at least five approaches to consider in future.

The first is that the National Health Commission should take the lead in setting up a platform for remote psychological services to: (1) provide timely, unified, and authoritative psychological assessments. Given that several mental health services were constructed by different institutions and regions as an early response,[5] unnecessary irregularities, and duplication of assessments may occur. The national management may make full use of available resources and increase the accessibility and efficiency of mental health services; and (2) provide intelligently and rationally allocate human resources for effective and graded psychological services according to demand and combing online and offline approaches to improve the efficiency of psychological services.

A second program is to increase the number of psychological rescue personnel in the national medical emergency rescue team and built a joint psychosomatic rescue system for disasters, accidents, and epidemics. During normal times, volunteers should be recruited as frontline rescue medical personnel and training in professional psychological knowledge, and literacy should be strengthened.

A third approach is to build a psychological service system and develop a pool of multidisciplinary mental health service teams to improve the capacity to respond to a crisis. The team should adopt a group service model and members should include psychiatrists or clinical psychologists, psychological counselors, social workers, and volunteers in a reasonable proportion. Moreover, the government should establish a network of psychological services from the community, primary health-care institutions, and psychosocial services to mental health institutions.

A fourth measure is to strengthen the interactive system of popular science and health education. Although it remains further research on the psychological impact of the mass quarantine implemented by the entire country, evidence showed that most of the negative feelings among the population during the quarantine period stem from fear and inadequate information.[6] It is possible to adopt a live broadcast that is easily accepted by the general public and to invite authoritative expects to answer questions online. This approach combines public opinion responses with psychological counseling to ensure health education on the COVID-19 and to answer common questions from various groups of people, including patients and the general public.

The last is related to special populations that require proactive attention. (1) A priority should be given to critically ill patients, bereaved people, and frontline health-care workers. In particular, it is essential to provide continuing support for health-care workers during quarantine and postquarantine. (2) The frontline investigators (community workers, police, and volunteers, etc.) and the Center for Disease Control and Prevention and government personnel are in need of special attention at a later stage. Vulnerable groups also include individuals with existing mental illness, older adults, children, individuals with physical disabilities, and with low incomes. (3) Guidance on the establishment of support systems and psychological services at government lever should be issued. (4) Psychological problems such as depression and PTSD should be focused on, identified, addressed, and researched. The identification and management of bereavement and PTSD in target populations need continued attention in future.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
The Lancet. Emerging understandings of 2019-nCoV. Lancet 2020;395:311.  Back to cited text no. 1
    
2.
National Health Commission of China. Principles for Emergency Psychological Crisis Intervention for COVID-19 Pneumonia Epidemic; 27 January, 2020. Available from: http://www.gov.cn/xinwen/2020-01/27/content_5472433.htm [Last accessed on 2020 Apr 17].  Back to cited text no. 2
    
3.
National Health Commission of China. Notice on Strengthening the Treatment and Management of Patients with Severe Mental Disorders during COVID-19 Epidemic; 20 February, 2020. Available from: http://www.nhc.gov.cn/jkj/s3577/202002/f315a6bb2955474c8ca0b33b0c356a32.shtml [Last accessed on 2020 Apr 17].  Back to cited text no. 3
    
4.
National Health Commission of China. Notice on Psychological Counselling Work Plan During COVID-19 Epidemic; 18 March, 2020. Available from: http://www.gov.cn/xinwen/2020-03/19/content_5493051.htm [Last accessed on 2020 Apr 17].  Back to cited text no. 4
    
5.
Li W, Yang Y, Liu ZH, Zhao YJ, Zhang Q, Zhang L, et al. Progression of mental health services during the COVID-19 outbreak in China. Int J Biol Sci 2020;16:1732-8.  Back to cited text no. 5
    
6.
Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet 2020;395:912-20.  Back to cited text no. 6
    




 

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