The last time that China suffered a natural disaster approaching the magnitude of the recent earthquake in Sichuan, its Maoist leaders considered psychology a "bourgeois" discipline. Survivors of the 1976 Tangshan quake, which killed at least 255,000 people, were left to cope on their own with posttraumatic stress disorder. On May 12, however, for the first time in its history, China's Communist Party leaders ordered a large-scale mobilization of mental-health workers alongside disaster-relief personnel. The need is great: the calamity killed as many as 80,000, created at least 5,500 orphans and left 5 million homeless. According to one local news report, 600,000 residents may need psychological assistance.
Help was available for 15-year-old Xiang Li, who along with 900 schoolmates was in class when the Juyuan Middle School collapsed. Pinned for three hours in the rubble, Xiang kept shouting encouragement to her friends. Out of her class of 66, she was among only 25 to survive. "I don't have nightmares," she told NEWSWEEK with a bold chirp in her voice. "The earthquake taught me to be brave." But moments later she confided to Dr. Yuan Linfang, head of a psychological-counseling team from Henan, that she actually does suffer flashbacks and nightmares. He gently encouraged her to acknowledge her symptoms. "Some survivors act tough, but they really are having problems," said Yuan, who heads a Henan crisis-intervention hotline organized by the Communist Youth League. Yuan has observed a number of traumatized reactions among Juyuan students, including one girl who couldn't even bring herself to open a textbook. Many more fear returning to school.
Experts such as Yuan are in short supply. By the end of 2006 China had just 19,000 trained mental-health professionals. Owing to the sheer number of quake survivors and first responders, says Dr. Rob Blinn, a Beijing-based clinical psychologist who specializes in disaster mental health and recently returned from a trip to Sichuan, many may not receive psychological assistance. Which means that in the wake of the Big One, China may see more walking wounded in the months to come.