Since the Covid lockdown in Shanghai began, Hu Bojun has received numerous inquiries about her and her hospital’s counselling services. This month, the US-educated clinical psychologist began facilitating lockdown support groups – in English and Chinese – to clients from “all walks of life”.
“Even people from different socio-economic sectors are now attending [counselling] together … My old clients have been coming back, and there are a lot more new clients as well,” she says, adding that a lot more Chinese people have begun talking to her about their mental stress and loneliness in a time of extreme uncertainty.
Mental health support is now a much sought-after service in China with more than 400 million citizens estimated to be under some degree of lockdown. Chinese search engine Baidu last week recorded a huge spike in searches for “psychological counselling” since March.
Although Covid has dominated news headlines in the past two years, mental illness is another crisis that is changing the lives of millions of Chinese families. Fifty-four million people in China experience depression and about 41 million suffer from anxiety disorders, according to the WHO. These are two of the most prevalent mental disorders in the country.
Mental health issues are becoming a growing problem as China ages. Many senior citizens face loneliness when children move away to build their future in big cities. In a 2021 study, researchers found a poignant correlation between the suicide rate of elderly people and companionship. They found that rate decreases by 8.7% during the annual lunar new year, when elderly people receive unusually high levels of family companionship.
Other age groups, especially young people are affected, too, by loneliness and isolation. According to recent studies, more Chinese middle school students have experienced insomnia, depression and anxiety during the pandemic. In 2020, a large-scale Chinese survey found that almost 35% of respondents had experienced psychological distress during the height of the pandemic.
‘My parents thought I was just thinking too much’
Yet, until recent years, mental health was not a widely discussed issue in China, and those who experienced mental illness were often misunderstood or stigmatised, says Li Yue, a 20-year-old university student in Luoyang of central China.
When Li was diagnosed with severe depression in 2018, her family was confused. Depression was not a familiar vocabulary in the part of China she’s from, and her parents did not know how to respond.
“My parents thought for a long time that I was just thinking too much. Sometimes they agreed with me to get treatment and sometimes they opposed it. At the beginning I was very lost and later turned desperate. I didn’t know what to do, and this feeling lasted for a long time,” she recalls.
That was four years ago. Last year, a series of popular culture productions touching on mental illness were shown in China. First, a broadway show Next to Normal got people talking about bipolar disorder. The musical toured in Shanghai, Beijing and Guangzhou. A documentary was also broadcast to accompany the tour. Then a few months later, a 40-episode TV series, Psychologist, sparked conversation about mental health.
Also in 2021, several art exhibitions that aimed to raise the public’s awareness of mental health were held in China. In Shanghai, a collection of abstract art at the No 600 Gallery that showcased works by patients with mental illness went viral. State-owned news agencies reported on it and on social media, a related hashtag was viewed more than 70m times.
Help on the horizon
Some enterprising individuals have seized on the opportunity, too. Hu says some of her friends have rolled out online training courses to people who wish to be therapists. They also use mobile apps to connect help-seekers with therapists virtually. “Even in smaller cities, there are lots of coaches to help cope with societal pressures,” Hu says.
But despite the growing awareness, the question of infrastructure and resources are still a problem. Li says that when she was in hospital, she saw many patients but too few doctors. Her experience reflects a 2017 report by the WHO, which found that there were fewer than nine mental health professionals for every 100,000 people in China.
The government has taken some steps to address the problem. In its nationwide Healthy China campaign that began in 2019, Beijing acknowledged the increasing extent of mental health issues in China and pledged to provide at least 80% of patients suffering from depression access to treatment by 2030.
The diagnosis four years ago turned out to be a big turning point for Li and her family. After years of treatment and counselling, Li’s life has begun slowly but steadily to get back on track. “It changed the way I look at things and myself,” she says. She’s now majoring in psychology at university.