Dealing with the mental scars of disasters

Experience gained from 2008 Sichuan earthquake helps psychologist develop national body to treat trauma

One month after a magnitude 8 earthquake hit the southwestern province of Sichuan on May 12, 2008, traces of crumbled hills, fallen boulders and collapsed houses stood as reminders of the tremor. When night fell, a sorrowful mood gripped the region.

The same month, Wu Kankan, a first-year graduate student in applied psychology at the Institute of Psychology of the Chinese Academy of Sciences in Beijing, arrived in Beichuan county, one of the worst-hit areas near the epicenter.

It was the first time Wu participated in psychological first aid in a disaster-stricken area, a less-developed sector of the country's overall disaster response capabilities.

He had little inkling that mental healthcare targeting people who have been through traumatic events would define his career path for more than a decade.

"I studied general psychology as an undergraduate, and the first year of a master's degree in applied psychology only gave an overview of the field. The class did not delve deeply into the mental trauma chapter," he said.

He didn't go straight to the Sichuan site though. A one-week intensive training program was held in Beijing, where Japanese experts were hired to teach psychology students like Wu measures to deal with post-disaster mental health conditions.

Despite the professional guidance, on-site psychological first aid, at its infancy in China during the 2000s, was constrained by the volatile situation in the quake-hit mountains in Sichuan, according to Wu.

"Fortunately, the basics of psychology, such as the framework for psychological evaluation that helps gauge the severity of mental distress and pain, were useful," he said.

"Our academic specialty also allows us to be aware of what type of questions are appropriate when conversing with residents. It is crucial to deliberate on the words we use."

His work later spread to Mianyang and Deyang cities in the province where severe injuries had also taken a toll on the mental health of survivors.

Symptoms of mental distress include heart palpitations, sweating, insomnia, and young children are especially prone to tears and outbursts, according to Wu.

"For instance, when a heavy truck passed by and caused the house to shake slightly, some kids would have episodes of anxiety because they think a tremor is happening," Wu said.

For about two years, Wu took on multiple roles in the region, from assisting teachers to play recreational games with children at makeshift schools, to collecting and cataloging records of people's mental health status in the region and dispatching specialists to different areas.

After wrapping up his assignment in Sichuan in 2010, which culminated in the establishment of eight work stations that were equipped with necessary personnel and facilities to provide long-term mental consultations, Wu continued his work.

He brought first-aid support and professional counseling to the doorsteps of sufferers, including survivors of a deadly 2010 mudslide in Gansu province and the travelers injured during a terrorist attack at a train station in Kunming, Yunnan province in March 2014.

In the meantime, he was contemplating a viable model that could combine fragmented resources of post-disaster mental care into a nationwide network to spur the development of the country's psychological aid services during emergencies.

The healing of mental scars requires patience and incremental progress, and there is no such thing as a one-off solution, according to Wu.

"Zhang Kan, director of our institute, once proposed that care for mental stress during emergencies should be sustained for about two decades," he said.

In 2015, the National Alliance for Psychological Aid, under the administration of the academy's Institute of Psychology, was set up in Beijing. Wu has since taken up the position of the alliance's secretary-general. "The alliance serves as the main avenue for local governments and the public to seek assistance relating to alleviating emotional distress, grief, and other post-disaster feelings," Wu said.

So far, the alliance has recruited nearly 100 psychology professors from top universities and worked with dozens of local institutions-including nonprofit organizations, foundations and government bodies-that can invest funds or deploy personnel when a disaster strikes.

On June 17, a magnitude 6 earthquake rattled Changning county in Sichuan. Having received messages from local officials seeking assistance, Wu-together with members of the alliance-dived in, evaluating the conditions, selecting a location for a work station, reaching out to institutions to prepare funds and arranging volunteers to travel to affected areas.

"The network has now covered all provincial-level regions in China, and we have trained about 150 volunteers who are able to provide care for mental health issues for more than one month, the shortest period we consider appropriate for a psychological first aid worker," he said.

Training programs aimed at fostering teams of local nonspecialists who are taught to notice people in distress and provide first-aid emotional support are also underway.

The large-scale psychological care operation that Wu first took part in during the summer of 2008 is now considered "ground zero" for improvements in China's post-disaster mental relief work, Wu said, adding that more needs to be done to bolster the alliance's resilience.

"When several emergencies hit us around the same time, it still feels hectic due to a shortage of hands," Wu said.

"We consider ourselves veterans in the field of psychological first aid, and in the future, it's significant to nurture more young professionals and volunteers to cope with demand."