Recommended psychological crisis intervention response to the 2019 novel coronavirus pneumonia outbreak in China: a model of West China Hospital

Zhang, Jun; Wu, Weili; Zhao, Xin; Zhang, Wei

Since December 2019, Wuhan and gradually other places of China have experienced an outbreak of pneumonia epidemic caused by the 2019 novel coronavirus (2019-nCoV, later named SARS-CoV-2). 1 The World Health Organization has declared the current outbreak of COVID-19 in China as a Public Health Emergency of International Concern. As of 10:00 Feb 13, 2020, the epidemic has caused 1366 deaths out of 59 834 confirmed and 16 067 suspected cases. 2 Some unprecedented measures were taken to stop the spread of the virus including cancelling of gatherings, extending the Chinese New Year holidays, and limiting the number of people in public places (e.g. train stations and airports). The outbreak itself and the control measures may lead to widespread fear and panic, especially stigmatization and social exclusion of confirmed patients, survivors and relations, which may escalate into further negative psychological reactions including adjustment disorder and depression. [3] [4] [5] Sudden outbreaks of public health events always pose huge challenges to the mental health service system. Examples include the HIV/AIDS epidemic that captivated world attention in the 1980s and 1990s, the severe acute respiratory syndrome (SARS) in 2002 and 2003, the H1N1 influenza pandemic of 2009, the Ebola virus outbreak in 2013, and the Zika virus outbreak in 2016. 6 During these epidemics, the consequences on the psychosocial wellbeing of at-risk communities are sometimes largely overlooked, especially in the Ebola-affected regions, where few measures were taken to address the mental health needs of confirmed patients, their families, medical staffs or general population. 7 The absence of mental health and psychosocial support systems and the lack of well-trained psychiatrists and/or psychologists in these regions increased the risks of psychological distress and progression to psychopathology. 8 The lack of effective mental health systems added to the poverty in Sierra Leone and Liberia. 9 In China, the mental health service system has been greatly improved after several major disasters, especially the Wenchuan earthquake. In the process of dealing with group crisis intervention, various forms of psychosocial intervention services have been developed, including the intervention model of expert-coach-teacher collaboration after the Wenchuan earthquake 10 and the equilibrium psychological intervention on people injured in the disaster incident after the Lushan earthquake. 11 With the support for remote psychological intervention provided by the development of Internet technology, especially the widespread application of 4G or 5G networks and smartphones, we developed a new intervention model to handle the present COVID-19 public health event. This new model, one of West China Hospital, integrates physicians, psychiatrists, psychologists and social workers into Internet platforms.