Authorities in the southwestern Chinese province of Sichuan are drafting in large numbers of psychological counselors and trained volunteers to help survivors deal with the trauma of last week's earthquake.
Around one-third of survivors of the 7.8 magnitude tremor, in which 72,000 people have so far been reported dead, buried, or missing, are experiencing psychological problems, with children under 12 the most severely affected, experts say.
"This is called acute cardiogenic shock," Deng Xiaogang, associate professor with the Department of Sociology at the University of Massachusetts-Boston, said. "If not promptly cured, it might develop into a destructive shock syndrome which features nightmares and insomnia."
Deng said symptoms could last from two to 10 years, or for a lifetime, after an event such as the Sichuan earthquake.
According to Zhan Chunyun, a psychological counselor based in Guangzhou, symptoms of post-earthquake shock could include a sudden loss of confidence and feelings of depersonalization, or existing nowhere.
Safe haven needed
Such problems could extend not just to immediate survivors of the quake, but also to relief workers, soldiers, and journalists working in the worst-affected areas, Zhan said.
"To deal with it, doctors have to take the patient away from the dangerous area. For example, they should leave the quake zone," he added. "It is important to take the patient to a comparatively safe area and avoid more exposure to danger."
A caller to RFA's Mandarin call-in show, Voices of the People, called for greater awareness of the psychological impact of the disaster on ordinary people by government officials.
"I think what is more important to talk about here isn't the superficial
damage to buildings, but the sense of terror
that people feel now," the man, based in the northern province of Shaanxi, said.
"China really doesn't have enough psychologists; there is a real shortage. We shouldn't underestimate the importance of the effects of this kind of fear and trauma on people's psyches."
"The population was
terrified by this event. They had no idea what was happening...The
government needs to address this issue through education, and also in
its disaster relief efforts," said the man, who said thousands of rural one-story houses were destroyed near his home 500 kilometers from Sichuan.
China has dispatched about 45,000 medical personnel, who are now working in all quake-hit counties and townships in Sichuan, the Ministry of Health said.
The mental health profession is still in its infancy in China, which is home to just 14,000 psychiatrists and psychologists serving a population of 1.3 billion, the same number as France, with its population of 60 million.
But psychological counseling centers and hotlines have proliferated in recent years, with the relatively short-term, practical cognitive psychotherapy favored for people struggling to cope with massive disasters.
Zhang Jie, of the State University of New York-Buffalo State College, said the cognitive therapy in psychological healing could be helpful for those with acute cardiogenic shock.
"Doctors can talk about the trauma with a patient, and you don’t need to avoid it," he said.
Cognitive therapy for quake victims
"By reflecting on the painful past, the patient will become less and less sensitive to the experience. There are many psychological therapies in the West and the cognitive therapy is the major one now introduced to China," he added.
Around 600,000 people are believed to be in need of psychological help in Sichuan, a need highlighted in the national media when President Hu Jintao toured worst-hit Beichuan county and spoke to a psychological counselor there.
Deng called for psychologists to go to Sichuan as volunteers to help those coping with the shock of the quake.
"China currently lacks the ability to deal with such a huge level of need in the area of psychological healing," Deng said.
"Therefore, psychological experts should go to the quake-hit areas as quickly as possible to provide support, especially to children."
"I think China can use its public television system to let experts to teach basics of psychological counseling. It can help children by letting them write and paint, and let them express what they have seen."
Counseling center planned
According to local media reports, the Chinese Academy of Sciences is planning a psychological counseling base in the Sichuan quake area to provide support for the reconstruction effort in the next five years, with a focus on youths and children.
Zhan Chunyun said that along with the help of experts, the support of the social environment is also crucial to psychological healing after such an event.
"To a survivor, support from his family members, relatives, and all of society is extremely important. If left to himself to face such a harsh challenge, he would be in despair."
Hong Kong psychologist Luo Zhihua said he was heading for Sichuan on Friday to provide psychological counseling to local people affected by the quake.
He said symptoms of problems weren't always apparent in the immediate aftermath of a disaster. "Destruction sequela will emerge after a while," he said, using a clinical term for a pathological condition resulting from an earlier injury or illness.
"Some people can feel it after a week, some take two. Therefore, not all the people will have symptoms right away."
Luo said that it was easier for youths to recover, while older children and the elderly needed more time to make a full recovery.
He said the psychological healing process should begin as soon as possible.
"If they are not treated, they will suffer psychologically with disturbed sleep and psychological stress," Luo said, adding that treatment should begin within days of a major disaster.
Original reporting in Mandarin by Han Qing and Yan Xiu. Mandarin service director: Jennifer Chou. Translated by Chen Ping. Written for the Web in English by Luisetta Mudie. Edited by Sarah Jackson-Han.