Recently, a number of film and television dramas with psychologists and psychological counselors as the professional background have been broadcast, which has aroused people's high attention to the profession of psychologists and once again triggered public discussion on mental health issues.
With the rapid development of the economy and society, problems such as emotions and stress continue to plague people. Mental health is becoming an important part of modern people's health. How has people's perceptions of mental health changed? How does trauma suffered as a child affect a person? How to correctly recognize depression and self-regulate? In the face of rapidly growing demand, what is the current status of the mental health industry in mainland China? With these questions in mind, we try to find answers.
Felt the same ease
"On the third day of isolation, I had a sore throat, a headache, an occasional low-grade fever, weakness, and fear of whether I was infected... Every day I look at the mobile phone to pay attention to the epidemic information, I feel that I must have a problem, I want to explain the aftermath, I feel that I am going to finish..." The words on the other end of the phone are intermittent, the helper has been crying, and Wang Hui has listened patiently here, and at the same time quickly made an analysis and preliminary diagnosis: the physical weakness caused uneasiness, coupled with the negative news of the long-term concern for the epidemic, amplified some physical feelings caused panic; a person was isolated, resulting in loneliness and fear and despair; suspected disease caused anxiety and depression, and the accumulation of negative emotions caused a physical reaction...
Next, Wang Hui conducted emotional science popularization to the helpers, assisted the other party to understand the positive meaning behind each emotion, conducted a malpractice analysis of the situation of "constantly looking at the mobile phone", and suggested that "arrange your own schedule every day to make life more controlled; every night before going to bed, write one or two words of affirmation to yourself." After a few hours, the helper was much more comfortable and his throat was not so tight, saying that he was "very touched by the interaction with the counselor and felt that the effect was very good."
Putting down the phone, Wang Hui, who had a dry mouth, also felt the same ease.
Wang Hui, a member of the Chinese People's Political Consultative Conference in Baqiao District, Xi'an City, Shaanxi Province, has another identity as a national second-level psychological counselor with more than 20 years of psychological work experience. At the end of last year, the epidemic in Xi'an suddenly raged, and emotional problems such as panic, anxiety and irritability also spread among the population. Whether it is a confirmed population, a suspected population, a healthy population or a medical staff, they all show different degrees of psychological stress and emotional problems. Wang Hui, who has two years of experience in the psychological expert group for responding to the epidemic, organized a psychological volunteer service team with the participation of 8 psychological counselors in the name of his own committee member studio, opened a psychological assistance hotline, and provided volunteer services such as emotional counseling and crisis intervention for people in need.
"How did you feel today?" "Call me at any time if there's a situation, at any time!" Since the epidemic, this is almost the words that Wang Hui has to repeat every day. Tirelessly, every word was gentle and firm, and she knew that what she could give at this time was companionship, that she was listening, that she was getting them out of the present predicament on the other end of the phone.
"We can say that we are the guardians of people's hearts." Wang Hui understands that patients who have been diagnosed and people who have been isolated will have more serious anxiety, because his life is threatened, so his emotions will rise to fear, and people at this stage will think more, when people face major psychological blows, their emotions will change from anxiety to depression, and then into despair. For desperate people, the counselor on the other end of the phone may be the last "life-saving straw" they can grasp.
Income is billed in hours, sitting precariously in the consultation room, and the conversation room can reduce the pressure of visitors and point out the confusion... As film and television works become more simplified and dramatically expressed, ordinary people portray the professional impression of psychological counselors in this way. But Wang Hui knows that a successful psychological counselor not only requires a lot of study and long-term accumulation of counseling practice, but also faces various problems, pressures and challenges in the process of growing up, which are beyond people's imagination.
If our hearts are really sick, who do we turn to for help?
"In recent years, the number of people suffering from depression and anxiety disorders has increased significantly." Qiao Ying, deputy chief physician of the Shanghai Mental Health Center and a national second-level psychological counselor, said in an interview with reporters.
The data shows that 20 years ago, the incidence of depression in Chinese was 5 in 10,000, and now this data is 6%. In other words, in 20 years, the incidence of depression in Chinese has increased by 120 times.
Qiao Ying told reporters that in the past 20 years, the prevalence of severe mental illness such as schizophrenia in the mainland has not changed much. However, the prevalence of mild psychological diseases such as anxiety and depression has increased significantly, "on the one hand, due to the profound changes in lifestyles brought about by the acceleration of the process of social development, which has increased the risk of mental and psychological problems; on the other hand, the public's awareness of mental illness has increased, and hospital treatment has made such diseases more easily detected." She said.
Mental health problems have become a major public health and prominent social problem in the mainland, and the importance of psychotherapy techniques has been recognized by society. Qiao Ying, who has 20 years of experience as a psychiatrist, went to the national second-level psychological counselor qualification certificate 8 years ago. When asked why, she said she wanted to be a better guardian of her heart. In her view, the mainland is in a period of rapid economic and social transformation, and individual psychological and behavioral problems and social problems cannot be ignored, but it is not realistic to rely entirely on professional medical institutions to help psychological crisis intervention, "should not and cannot rely only on psychiatrists and psychologists to do it."
How many times he has participated in crisis intervention, Wang Hui is a person who has walked up to the roof of the building to face despair. "The person on the other side thinks that suicide is the only way to solve the problem, and he can't turn the corner." My job is to help him turn the corner. She said. Listening, reassuring, persuading, repeatedly "circumventing", the most important thing is to establish a relationship of trust with the other party, and then make suggestions on the basis of trust, otherwise all persuasion is futile. "Getting them to give up the urge to commit suicide is a huge challenge for counselors." In Wang Hui's view, this is a job that has both a sense of mission and a challenge.
Qiao Ying said that psychological counseling is not "comfort" and "chat" in the usual sense, not "decision-making for others", but "helping others to help themselves"; not only "making people happy", but more importantly, making people achieve psychological growth. By listening, acknowledging the other person's pain and helplessness is often the first step in opening a conversation. The ability to empathize is particularly important among all intervention techniques. But empathy is only the beginning of the conversation, not the ultimate goal.
"If you say you want to open a little, can the other party want to open?" You said it would pass, and the other party really felt that it could pass? Often not. Qiao Ying stressed that a qualified or even excellent psychological counselor should have a keen and accurate judgment, and when psychological counseling cannot work, he should help the helper to seek help from a psychiatrist or psychologist in time.
Mental health issues are receiving increasing attention from all sectors of society. According to the 2020 Public Mental Health Insights Report released in May 2021, 19.8% of respondents in 2016 believed that psychological counseling was a sign of weakness, compared with only 2.79% of those who still held this view in 2020.
Now Qiao Ying is more doing science popularization work, and she strives to make the public realize that psychological problems can actively seek help, which is a responsible and wise performance. Audio and video of psychological counseling, and popular science articles on psychological promotion - in her view, popularizing mental health knowledge and improving mental health literacy is one of the most fundamental, economical and effective measures to improve the level of mental health of the whole people.
Long-term and negative emotions are intertwined, "emotional garbage cans", is a joke of many psychological counselors to themselves. When repeatedly throwing themselves into one sad emotion after another, how to solve and protect themselves in time is a real problem faced by Wang Hui and Qiao Ying. In addition to subconscious oblivion, institutionalized training and supervision are also required.
Such reforms should not continue in their tracks
Institutionalization and standardization are the two words repeatedly emphasized by Wang Hui and Qiao Ying in the interview.
Since entering the 21st century, focusing on mental health has gradually become the consensus of society. Qiao Ying and Wang Hui have the same feeling, that is, in recent years, the public's awareness, acceptance and tolerance of mental illness have been high, and more people have taken the initiative to seek regular psychological counseling services, but there are still institutional shortcomings in mental health services.
It is said that at present, the number of personnel shortage of psychological counselors in the mainland has reached more than 400,000. The size of the market is surging and professionals are few and far between. A number of experts and industry insiders interviewed by reporters pointed out that compared with the rapid growth of demand, the quality of psychological counseling practitioners in the mainland is worrying, and many practitioners do not have the knowledge reserves and professional skills of pathology, psychology, physiology and other related disciplines.
Qiao Ying's diagnosis and treatment fee for every 50 minutes in the hospital's psychology department is 120 yuan, most of Wang Hui's psychological counseling is voluntary volunteer service, and one of her "unqualified" students charges 3,000 yuan per hour in the name of a well-known psychological counselor.
According to the reporter's understanding, in 2001, the former Ministry of Labor officially launched the "National Occupational Standards for Psychological Counselors (Trial)", and officially listed psychological counselors in the "Chinese Occupational Codex", many people believe that this marks the chinese labor market, with the profession of psychological counselors.
Qiao Ying told reporters that the psychological counselor qualification certificate produced 20 years ago is not a concept with the psychological counselor we understand now. At the beginning, the purpose of the state issuing this certificate was mainly to solve the problem of reemployment of a large number of laid-off employees from the 1990s to the beginning of the 21st century, and it can barely be regarded as a skill appraisal certificate, so it has been criticized by the industry for its low threshold and low gold content.
According to the survey of relevant departments, among the more than 1 million people who have obtained the second and third level certificates of psychological counselors in the country, the number of people who can be competent for professional psychological counseling is about 2%-3%. Qiao Ying analyzed that a large proportion of certified people have not experienced long-term training in professional systems except for examination training and some scattered short-term training, and the lack of internship and supervision experience has led to these people not being able to master the skills that are essential for being competent as psychological counselors such as reflective practice, assessment, and intervention. "Even if there is a certificate, between the amateur and the professional, after all, is the gap in strength."
In September 2017, the Ministry of Human Resources and Social Security issued the Notice on Publishing the National Occupational Qualification Catalogue, which canceled the professional appraisal of psychological counselors. Qiao Ying believes that in the dimension of the development of the times, the cancellation of the psychological counselor certificate of the Ministry of Human Resources and Social Security is a node in the development of the psychological counseling industry, with the purpose of making the psychological counseling industry more professional and standardized. There is still a big gap in the public's demand for psychological counselors, and how to formulate regulatory access standards as soon as possible through relevant departments and industry associations to support the sustainable development of professional talents has become a top priority and a top priority.
Qiao Ying and Wang Hui have the same wish, that is, to formulate relevant regulations on psychological counseling as soon as possible, standardize psychological counseling fees, strictly train and assess psychological counselors, promote the dynamic review mechanism of counselors, strengthen industry market supervision, and strengthen the self-discipline of practitioners through industry associations... "Such reforms should not continue to be carried out. They said.
Reporter: Wang Huifeng
EDIT: Mo Shuo
Review: Jiajia Zhou
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