SHENZHEN • Hundreds of 24-hour mental-health support telephone hotlines have sprung up in China in recent weeks as millions of people fret about catching the coronavirus - and try to avoid infection by staying at home.
Medical professionals have welcomed the launch of several official services in a country where mental health remains a relatively taboo subject. But they have raised caution 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 are not many who are well-trained," said volunteer Er Jing. "It can be really traumatising to ask for support, but not get the right answers."
A survey by the Chinese Psychology Society published by state media found that of 18,000 people tested for anxiety related to the coronavirus outbreak, 42.6 per cent registered a positive response.
Of 5,000 people evaluated for post traumatic stress disorder (PTSD), 21.5 per cent had symptoms.
The hashtag #howtodealwithfeelingveryanxiousathome has been trending on social-media platform Weibo, as misinformation about the spread of the disease and travel bans feed public worries.
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 a 2008 Sichuan earthquake, in which 87,150 people were killed 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 coronavirus, with support from university psychology departments, counselling services and non-governmental organisations.
They have been inundated by callers in a country which has just 2.2 psychiatrists for every 100,000 people, according to data from the World Health Organisation, 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 last month, said Shanghai-based psychologist Cheng Qi.
While the number of calls has dropped as other lines open, the problems faced by callers have become more challenging to tackle, Ms Cheng said, noting one caller whose suicidal thoughts were triggered by a barrage of bad news.
"It's not the virus (that caused it), but the virus is stimulating it," she noted.
Mr Xu Wang, a psychotherapist at Tsinghua University, which is working with the Beijing city hotline, said a major hurdle was sieving out which callers showed real symptoms of the virus and which were instead suffering from anxiety.
"Callers might say, 'I can't eat well, can't sleep well, and I want to know if it's a virus infection,'" he added.
Medical researchers from Peking University have included telephone and Internet counselling for healthcare staff, patients and the public among six key strategies for coping with mental stress over the coronavirus outbreak.
The government recently issued guidance for the hotlines, saying they should be free, confidential, staffed by volunteers with relevant professional backgrounds and supervised by experts.
Still, concerns remain about enforcement.
"There are many individually initiated helplines and it's difficult to gain consistent support and supervision," said Ms Sami Wong, a Beijing-based psychotherapist.
Mr Xu said the very nature of the hotlines added to the challenges, preventing volunteers from gaining much-needed face-to-face rapport with people suffering from mental-health issues.
Ms Wong worries 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, adding: "PTSD training is not something you can achieve overnight."