What are the mental health consequences of COVID-19 in China?
It’s been almost nine months since fireworks lit up the sky over China during the Lunar New Year while TV screens also lit up but with increasing numbers of cases of the new coronavirus in Wuhan. Annual visits to parents were unexpectedly extended by the resultant lockdown. The excitement and joy of being together turned into tension and frustration as time passed in small apartments often with a mother’s (or mother-in-law’s) constant nagging to, “eat a bit more” or “here, drink this.”
The lockdown caused stressful situations and volatile emotions. Anxiety and depression have increased around the world during the coronavirus in 2020 and China is no exception. Grief over the loss of loved ones, concern for physical health, and worry about finances have led to an increase in mental health issues and even suicide.
By now most people are back to work, schools are open, and it is even possible to travel between provinces. So that means life is back to normal, right? In some ways it may look like that; in other ways China and the world are very different now than they were before January 2020.
Here we will look at one aspect—the emotional impact on the people of China.
To find out if what I’ve heard about the emotional impact of the virus is correct, I talked with a couple of Chinese counselors. As always the conversations were interesting and enlightening as to the specific needs of the people of China; reminding me of a phrase Thai hawkers use “same, same—but different.”
The first, and perhaps most obvious, thing I was told is that there is always a need for counseling in China. It didn’t start with COVID; the need is always there. But COVID-19 did increase the need and in some cases COVID stirred up emotions and trauma which were already there. I heard examples of couples who had struggled off and on in their marriages for years and how COVID was the final straw as previous issues were exacerbated during COVID and in some cases led to divorce.
We from the West need to remember that COVID-19 has created a sense of déjà vu for many in China. In 2003 SARS shook the country with required isolations and regulations. It was not that long ago and the experience is still fresh in their minds. COVID brought back memories and in some cases SARS-related grief and unresolved trauma.
Some good things resulted from SARS; some counseling centers were registered and people became aware that the church needs to step in and serve in a crisis. The 2008 Sichuan earthquake was also mentioned repeatedly as another national crisis during which NGOs, churches, and biblical counselors stepped in and served not only physical needs, but also cared for the emotional wounds of those affected.
So how has COVID-19 impacted the emotional state of the Chinese people?
Here is an attempt to list the things mentioned to me
Loss and Grief
Loss and grief made an immediate impact since many lost family members during the early days of the virus. We need to remember that even though the loss happened at the beginning of the year, the grief is still there.
As news about this virus called COVID was spreading and the country suddenly was locking down anxiety levels were rising. Many were stuck in the part of the country where they had been celebrating Chinese New Year. Lockdown led to many losing their jobs and family income. This impacted the whole family, but it especially affected many men who no longer could provide for their immediate family as well as for parents and in-laws. Anxiety often leads to insomnia which in turn leads to all kinds of emotions and outbursts of anger and frustration. Being stuck in a very small—some with only a room or two —apartment for an unforeseen time didn’t help. Increased anxiety leads to decreased hope.
China has never seen such high numbers of people suffering from depression. Hospitals are reporting that many are coming for help with depression and are given anti-depressants. The big increases are among men and teens, and even in children.
With lost income, anxiety, and sleepless nights comes hopelessness. The suicide rate has never been higher, especially among men. But it is not only in adults where we see an increase. I have been told several stories of teenagers and young children who are choosing to end their lives.
With people in lockdown for several months, addictions of various kinds have plenty of time to settle down and get rooted. The first and the biggest addiction I heard mentioned repeatedly was the addiction to cell phones and the internet. Other addictions mentioned were sleeping pills and alcohol.
Regarding phone addiction, one counselor used the phrase “bondage to their cell phone.” With no place to go, many people spent endless hours on their phones chatting with friends and playing games. The internet became a way to stay connected to the outside and explore the world online.
Several shared that teenagers found ways to buy sleeping pills and other drugs online. For some it became away to soothe the hopelessness they felt. For some it was a way to end their lives.
I was also told stories of young girls, very young girls as young as nine and ten years old, who had found new friends in chatrooms. After a while these new friends would ask them to send pictures of themselves. First it was all very innocent, but soon it led to offers like “If I send you 20 kuai, can you take off your top off for me” and other inappropriate offers. Some kids did not fully understand how wrong this was and sold pictures of themselves in order to make some extra pocket money.
Because many parents have very little experience with the internet, they are not fully aware of what is available there nor how to block pages or check what pages their child is viewing. For many this lack of experience and information results in parents not having needed conversations with their children about internet use.
And this issue overlaps with the next . . .
One counselor told me that, in her view, Christian parents need to repent. They failed to watch their kids and keep them safe. Keeping a child safe is the responsibility of the parents. She hopes to see Christian parents grow in their roles as fathers and mothers and so is organizing webinars this autumn to educate and encourage them. She shared with me that many of the parents who are having kids now are from one-child families and they copy the way their parents raised them. Most of them did not have Christian parents.
Many Christian families today have, when possible, two children. Having grown up without a sibling it is hard to know how to raise two children, especially when they are fighting with each other. Another big problem is that it is common that only one parent is a believer and often that parent is the mother. Conflicting parenting styles become a problem when a parent, often the father, has very different values and a parenting style different from the believing parent. She also mentioned that while the parents are fighting their kids get busy on their phones so they don’t have to hear their fighting parents.
Marital Tension Leading to Anger and Less Patience
I would dare say that China is not the only place where COVID-19 has caused tension in marriages. Uncertainties, anxiety, and lockdown that put couples together 24/7—on top of other things such as lost income—all have taken their toll on marriages around the globe. And for many Chinese marriages, COVID has been a challenge.
Anger has been a big problem between spouses and family members. As I already mentioned, many couples were struggling before COVID struck. I, personally, have had married women share with me about their angry husbands. Likewise, married men have also shared that their wives have emotional issues and are either angry “all the time” or cry a lot.
Lockdown saw a rise in domestic abuse. Being stuck together without anywhere to go when anger escalated meant that cases of abuse against wives and children have seen an increase. And while not reported, abuse of husbands is also likely. How much domestic abuse has taken place is not clear, but the numbers are probably higher than we think since underreporting and covering up is normal.
When the lockdown was over we heard about long queues and waiting lists to apply for divorce. One of the counselors shared with me that the government changed rules to expedite the divorce process. Divorce in itself always causes other problems and emotional needs.
“COVID is an opportunity!” said one counselor suddenly. “It is a reminder to people that we need to humble ourselves and connect to God again. And for those who do not know him yet, I use counseling as a way to share the hope and light which comes with the gospel.”
In my next blog I will share what I learned in these conversations about counseling in China, including biblical counseling, the impact of shame, and a bit on what’s available there.
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