By Ariel Hyunseo Kim
Since its onset in 2019, the COVID-19 pandemic has caused major disruptions of critical mental health services in 93% of countries worldwide, according to the World Health Organization. Concurrently, the strains of social isolation have led to an increase in the demand for mental health care. This article focuses on China and South Korea, two countries that were among the earliest to be hit by the pandemic but have also attempted to provide their citizens with adequate mental health resources.
In late January, a few months following the first case of COVID-19 in China, the Joint Prevention and Control Mechanism of the State Council (JPCMSC), China’s central authority in response to COVID-19, published the national guidance of mental health intervention. The guidance outlined a support system involving local governments, health professionals, social workers, and volunteers to address the mental health needs arising from the pandemic. The JPCMSC stratified the general population into four different groups that required different levels of support: hospitalized patients with confirmed COVID-19, self-quarantining patients with confirmed COVID-19, those related to patients with confirmed COVID-19, and those affected by prevention and control measures (the general public).
To provide mental health support for the people, the government focused on disseminating accurate and reliable information through daily press conferences, official governmental websites, educational videos, and social media platforms. Some hospital websites also began to offer self-assessment tools to measure current mental well-being. In addition, more than 300 mental health hotlines have operated since the beginning of the outbreak to provide tele-counseling services.
Stepping up mental health support for those most severely affected in Wuhan, the JPCMSC deployed a national psychological rescue team to the city in February 2020. The team consisted of more than 400 mental health professionals designated to help those hospitalized due to confirmed COVID-19.
Despite the programs and policies implemented in China during the pandemic, the accessibility of psychological services are still incredibly low. There is a relative shortage of mental health professionals in China — among every 100,000 people, there are only 2.19 registered psychiatrists and 5.51 psychiatric nurses. In addition, physical accessibility to these very few mental health professionals, worsened by the isolation and quarantine requirements that came with the virus, is also a major challenge. Some groups have limited access to the internet, preventing access to tele-counseling services.
Accessibility is not the only problem, however; few people in China actively seek mental health care due to poor mental health literacy and the stigma associated with mental illnesses. In the mid-1900s, mental illness was deemed a delusion in the country, and the existing psychiatric system was eliminated — this has led to persisting discrimination and stigma surrounding mental illness, preventing people from actively seeking help during the pandemic. With unacceptance compounded onto inaccessibility, few people have access to or are utilizing the psychosocial support they may need during the pandemic.
The first Korean COVID-19 case was detected on January 20, 2020. The week after the first case was reported, the Korean Ministry of Health and Welfare established the Integrated Psychological Support Group for COVID-19 composed of national and local mental health welfare centers to provide psychological support to confirmed patients, people in isolation or quarantine, and their families. The group provided stress relief kits, mental health screenings, tele-counseling, and audio recordings for Korean citizens who had just flown in from Wuhan and were isolated in government facilities. Throughout the course of the pandemic in Korea, the group continued to provide tele-counseling services and psychoeducation to confirmed patients.
In late February, the COVID-19 outbreak began to reach the level of community infection in Korea. In response, the government established the Seoul COVID-19 Psychological Support Team that provided mental health information and helped to reduce anxiety among citizens in Seoul. The team not only worked to normalize anxiety and fear, particularly among confirmed patients, children, and adolescents, but also emphasized the dangers of falling under the trap of misinformation regarding COVID-19.
In addition, the Korean Society for Traumatic Stress Studies (KSTSS) published numerous informational webcomics, news cards, and guidelines regarding positive psychology and psychosocial care for both the community at large as well as more specifically for frontline health workers.
The South Korean government has taken heed of its past experiences with the MERS and SARS outbreaks and demonstrated centralized teamwork during the COVID-19 crisis that resulted in a rapid response. Utilizing not just internal networks within governmental organizations but also external networks such as health organizations, public and private hospitals, mental health agencies, universities, media, and the general public, the Korean government and KSTSS were able to collect comprehensive data on people’s psychosocial needs and effectively distribute available resources to the people.
Despite the fast implementation of necessary mental health policies and deployment of important programs and resources, Korea’s interventions have not been able to avoid criticism. Because of the isolating nature of the pandemic, COVID-19-related mental health issues have been found to be connected to social isolation, loss of social support, and stigmatization. However, many of the policies and programs that have been implemented focus on addressing individual aspects of mental health rather than the social aspects. As such, the government should establish a public system or program to help maintain people’s social networks and prevent them from losing social support.
Moreover, although Korea’s mental health interventions have had an individual focus, they lack a specificity for different demographics of people that have differing mental health needs. For instance, a study found that teenagers had the highest demand for physical activity programs, whereas the elderly had the highest demand for self-management programs. The government should begin to develop tailored programs and services for specific age groups or communities in different regions, as they have contrasting needs.