Abstract
When the 2019 novel coronavirus disease (COVID-19) was rapidly spreading in China in early 2020, China’s National Health Commission quickly responded to the psychological crisis by issuing guidelines for establishing mental health intervention systems, including providing psychological assistance hotlines. However, recent critiques have emphasized China’s lack of pre-established mental health interventions which resulted in an inefficient response. This is the first empirical study to systematically examine mental health service use in China during the COVID-19 outbreak. The current study focused on the use of mental health hotlines in a Northern Chinese region. This region originally had a regional level hotline. During the outbreak, 12 out of its 16 sub-regional juridical areas started providing their own hotlines. Data regarding the regional level hotline and the 12 sub-regional level hotlines were obtained, including daily number of calls received, strategies for disseminating hotline services, and callers’ expressed concerns. Confirmed COVID-19 cases in China, in the region, and in each of the sub-regional juridical area were also recorded daily during China’s peak period of COVID-19. Analyses of these data revealed that the mental health hotlines tended to have low usage overall. Hotlines that merely provided their numbers to community centers and quarantine centers tended to receive few calls. Hotlines that encouraged individuals to advertise the service on personal social media accounts tended to receive more calls. The daily number of confirmed COVID-19 cases in the country was closely related the number of phone calls received at the regional hotline. Sub-regional hotline operators reported that a significant proportion of callers had concerns about contracting COVID-19, negative emotions from prolonged social isolation, and family conflicts while stay-at-home policies were implemented. It was also observed that the sub-regional level hotlines did not start until COVID-19 cases in the country started to decline. Overall, the psychological assistance hotlines provided during COVID-19 satisfied some mental health needs. However, consistent with recent commentaries, the hotline services were not established during the time that demand likely peaked. Future studies are warranted to determine the best strategies to improve the accessibility of mental health hotline services.
Highlights
In 2019, China was the first country to be affected by the novel coronavirus disease (COVID-19), which would eventually become a worldwide pandemic
The relatively high usage rate of the Area 11 hotline may be related to its method of service dissemination, as it relied the most heavily on dissemination through individuals’ personal social media
Overall, encouraging individuals to post the hotline service on their social media accounts appeared to be an effective way of service outreach
Summary
In 2019, China was the first country to be affected by the novel coronavirus disease (COVID-19), which would eventually become a worldwide pandemic. In January 2020, the number of confirmed cases and deaths due to COVID-19 rapidly increased in China. Several studies have since reported emotional distress and symptoms of anxiety and depression experienced by people in China (Wang et al, 2020; Xiang et al, 2020; Zhou, 2020). A national study of 52,730 Chinese individuals revealed that 35% experienced psychological distress during the COVID-19 pandemic (Qiu et al, 2020). Soon after COVID-19 started to rapidly spread in China, on January 27th, 2020, The National Health Commission of the People’s Republic of China (NHCC) issued guidelines for responding to the psychological crisis and distress created by the disease (National Health Commission of China, 2020c)
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