China’s Work in COVID-19 Virtual Mental Healthcare

China is implementing online psychological solutions to combat coronavirus.

Posted Apr 24, 2020

Photo by Jagoda Kondratiuk on Unsplash
Source: Photo by Jagoda Kondratiuk on Unsplash

By Stuart Jacobson

Each day, we are updated by the minute with increasing numbers of confirmed cases and deaths due to the Novel Coronavirus Disease, or COVID-19. Much of the focus in the media has been on reducing the spread of the disease and its effects on the public.

However, shouldn’t our focus also be towards preserving the psychological well-being of the medical professionals and staff who are working around the clock at great risk trying to heal us? Their stress, depression, insomnia, and anxiety levels are likely off the charts.

On that front, there is some positive news from China. Chinese researcher Shuai Liu reports that there have been significant breakthroughs:

“During the severe acute respiratory syndrome epidemic in 2003, internet services and smartphones were not widely available. Therefore, few online mental health services were provided for those in need. The popularization of internet services and smartphones, and the emergence of fifth-generation (5G) mobile networks, have enabled mental health professionals and health authorities to provide online mental health services during the COVID-19 outbreak. Fast transmission of the virus between people hinders traditional face-to-face psychological interventions. By contrast, provision of online mental health services is safe. To date, several types of online mental health services have been implemented widely for those in need during the outbreak in China.”

Following the guidelines for emergency psychological crisis intervention for the COVID-19 epidemic published by the National Health Commission of China in January 2020, a rapid large-scale inclusive study was conducted to enable authorities to allocate resources and develop effective treatments for medical staff suffering from mental health problems.

Participants in the study were from a variety of different populations associated with the COVID-19 outbreak in China, such as students, medical staff, and patients from many provinces, municipalities, autonomous regions, and unspecified areas around the country.

As of Feb 8, 2020, 72 online mental health surveys targeting different populations associated with the COVID-19 outbreak were distributed in a survey program called, “Questionnaire Star” through WeChat, a Chinese multi-purpose messaging, social media, and mobile payment application. WeChat is one of the world's largest mobile applications with over 1 billion monthly active users.

The following are the population descriptions surveyed (including the number of surveys): medical staff (23), patients with COVID-19 (1), students (18), the general population (9), and mixed populations (21); in Hubei province (5), other provinces (15), all provinces, municipalities, and autonomous regions (36), and unspecified areas of China (16).

I can only imagine the harmful psychological effects caused by COVID-19 as each day we are bombarded with information on new infections and deaths worldwide to enforce social distancing rules. In the U.S. as of March 26, 2020, the death rate was 1.5 percent and the total number of people infected surpassed China. However, the rates of infection and mortality in the U.S. are minimal in comparison to the percentage of people in China suffering from mental health problems, according to Liu’s findings:

“...a survey involving 1563 medical staff, with our center at Nanfang Hospital, Southern Medical University (Guangzhou, China) found the prevalence of depression to be 50.7 percent, anxiety to be 44.7 percent, insomnia to be 36.1 percent, and stress-related symptoms to be 73.4 percent.”

At the start of 2020, COVID-19 rapidly spread throughout China and both medical staff and the public experienced equal increases in psychological problems such as anxiety, depression, insomnia, and stress. The popular emergence of fifth-generation (5G) mobile networks has enabled China’s mental health professionals and health authorities to provide some online mental health services, healthcare information, and communications programming, including 29 books on COVID-19 available electronically for free. Liu adds:

“ psychological counselling services (e.g. WeChat-based resources) have been widely established by mental health professionals in medical institutions, universities, and academic societies throughout all 31 provinces, municipalities, and autonomous regions in mainland China, which provide free 24-h services on all days of the week. Online psychological self-help intervention systems, including online cognitive behavioral therapy for depression, anxiety, and insomnia (e.g. on WeChat), have also been developed. In addition, several artificial intelligence (AI) programs have been put in use as interventions for psychological crises during the epidemic. For example, individuals at risk of suicide can be recognized by the AI program Tree Holes Rescue, by monitoring and analyzing messages posted on Weibo, and alerting designated volunteers to act accordingly.”

Last time I checked global statistics, infections and deaths in China are being reported as having drastically declined. It may, therefore, be time for us to look at how they're handling the aftermath and respond in a similar manner. We need to produce books, online mental health services, and programming that are relevant, available, and understandable to everyone.

Stuart Jacobson is a graduate student in Humanitarian and Disaster Leadership at Wheaton College. He is a disaster recovery volunteer with Send Relief and a transformational community development intern with One Collective. Stuart is an international entrepreneur and financial consultant; and Michigan-licensed home builder. He can be contacted at the following email:


Shuai Liu, et al. “Online mental health services in China during the COVID-19 outbreak” The Lancet Psychology.