UM scholar publishes four articles on mental health care during epidemic in Lancet

Prof Xiang Yutao

Four articles on mental health care, written by a research team led by Prof Xiang Yutao from the Faculty of Health Science (FHS), University of Macau (UM), have been published in prestigious medical journals, including Lancet and Lancet psychiatry. The articles suggest that the novel coronavirus (COVID-19) outbreak has presented great challenges for China in terms of mental health services. They suggest that timely and sufficient psychological interventions should be provided for different sub-populations in need. Compared to the traditional face-to-face psychological intervention, online mental health interventions, including hotline services, are more appropriate, more flexible, and safer during the COVID-19 epidemic.

The COVID-19 outbreak, which is believed to start at the end of 2019 in Wuhan, Hubei province, has attracted international attention. Because of the rapidly increasing numbers of infected cases and deaths, patients, health workers, and the public are all under great pressure. However, mental health services for those affected by the COVID-19 epidemic were under-addressed during the early stage of the epidemic. Against this backdrop, Prof Xiang and his team called for timely mental health care for pneumonia patients, health workers, and the general public, and have written four articles on mental health problems that might occur among people during the epidemic. The papers have been published in Lancet and Lancet psychiatry, whose five-year impact factors are 54.66 and 17.64, respectively.

Titled ‘Timely Mental Health Care for the 2019-nCoV Outbreak is Urgently Needed’, the first paper was published by Lancet Psychiatry on 4 February 2020. This article points out that since the outbreak of the disease, both patients and health professionals have been vulnerable to mental health problems, such as fear, anxiety, depression, insomnia, frustration, and feelings of isolation. Thus, timely mental health care should be provided for patients with COVID-19 pneumonia, their close contacts, and people in suspected cases who are isolated at home, patients in fever clinics, families and friends who are affected, health professionals caring for infected patients, and other members of the public who are in need. It is believed that the development and implementation of systematical mental health assessment, support, treatment, and services are critical and pressing goals for mental health response to the COVID-19 pneumonia. For a full version of the article, please visit:

With the growing awareness of the importance of timely mental health services, Chinese health authorities and related academic societies started to develop relevant expert consensus and guidelines for providing mental health services during crises, such as the ‘Principles for Emergency Psychological Crisis Intervention for 2019-nCoV Pneumonia Epidemic’ released by the National Health Commission of China. However, the fast transmission of the COVID-19 hinders traditional face-to-face psychological interventions. In contrast, online mental health services are flexible and safe. Therefore, on 18 February 2020, Prof Xiang’s team, together with their collaborators in Guangzhou, published a second article titled ‘Online Mental Health Services in China during the COVID-19 Outbreak’ in Lancet Psychiatry. This article summarised the three types of mental health services provided in China during the COVID-19 epidemic: 1) online mental health surveys, 2) online mental health education, and 3) online psychological counselling and psychotherapy services. The authors concluded that the online mental health services used for the 2019-nCoV epidemic could facilitate the implementation of emergency mental health interventions. For a full version of the article, please visit:

In addition, Prof Xiang’s team noticed that more than 80 per cent of those who have died from the COVID-19 were elderly people. In fact, China has the largest aging population in the world. There were 241 million senior citizens (age>60 years) in China in 2017, accounting for 17.3 per cent of the total population in China. The rapid transmission of the COVID-19 and the high death rate in older patients could exacerbate the risk of mental health problems and worsen their existing psychiatric symptoms, which could further impair their daily functioning and cognition. In addition, because of the limited access to internet services and smart phones, only a small fraction of senior citizens could benefit from mental health services available online. In order to draw adequate attention to this vulnerable population in the recently established crisis psychological services in China, Prof Xiang’s team published a third article, titled ‘Mental Health Services for Older Adults in China during the COVID-19 Outbreak’ on 18 February 2020. This article points out that the outbreak of COVID-19 has presented great challenges for mental health services for older adults. Sufficient and adequate attention should be paid to this vulnerable population. Stakeholders and health policymakers should work together to address this issue and provide high-quality crisis psychological services for community-dwelling older adults in a timely fashion. For a full version of the article, please visit

Titled ‘Timely Research Papers about COVID-19 in China’, the fourth article was published in Lancet on 17 February 2020. The author points out that since the outbreak of the COVID-19, many of the academic articles about the disease have been published in English-language journals. In order to remove language barriers, the research community should make an effort to disseminate the research findings related to the epidemic in Chinese among frontline health workers who need to understand the epidemiological and clinical features of the disease. For a full version of the article, please visit

The Lancet is a well-known international medical journal, which is considered the oldest and the most influential journal in the medical field.

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