Archive | When college students say they're depressed

It has not been updated for a long time, mainly because I forgot the password of the mailbox, and the sense of security of modern information is so bound.

Some time ago, some old manuscripts written at work were removed from the shelves. Although most of the news has a shelf life, I am not very happy when it is removed from the shelves. I also hope that it can be archived. It is also a sense of security in the information age. Therefore, some manuscripts that are consciously worth reading are archived here.

This article is about depressed college students and the mechanism of colleges and universities. One of the reasons is the "Exploring the Special Service Work Plan for Depression Prevention and Treatment" issued by the National Health Commission of China last year. The policy requires schools to do depression screening and filing work. The essence of work and work ideas is not new, it has already pervaded schools, communities, and hospitals. In terms of implementation, it is also destined to be in a state of contradictions - another reason is that students who are sick are treated unreasonably.

Depression has been a frequent topic of discussion in recent years, and it really haunts us. But sometimes, I get tired of saying the right thing over and over again, and as a writer, I always want to bring some new information. For this report, I interviewed about 8 or 9 students, and some of the content was not useful. I know that when they talked about those experiences, they were not happy. Now that I think about it, I will be very grateful to them, especially for their willingness to trust me. Some students who are strangers will also reveal their own opinions - media attention is actually useless, and a lot of content is painless when it comes out. This is indeed the truth. Later, I forwarded the manuscript to a student, and he said, "It's really not "no pain or itching", which is a good evaluation.

This article was published in November 2020, and the times in the article are the dates at that time:

In early October, Yan Ying, a freshman of the 2020 class of a university in Guangdong, set off to report to the school early in the morning.

During the five or six-hour drive, Yan Ying was a little tired, but she couldn't sleep, so she took an extra sleep aid. What she didn't expect was that this normal action was like knocking down the first domino.

The sleeping pills took effect, but Yan Ying failed to wake up and go through the check-in procedures. When the father handled it for her, he also informed the counselor that his daughter was suffering from depression. When Yan Ying woke up, she got a message that "you may need to drop out of school". "You can't even check in." Yan Ying remembered what the counselor said. Since the start of the school more than a month, the word "drop out" has been repeatedly spit out from the counselor's mouth.

Yan Ying told the author that she was once diagnosed with depression and later diagnosed with bipolar disorder, but she had no tendency to harm herself or others at all, and she had no thoughts of suicide, and she went to see her doctor and took medicine on time. She tried to explain that "oversleep" with the simplest reason: "I just took one more medicine, and I will be fine after taking it on time."

But the explanation was of no avail—the personality test scale she took in the psychology department of the public hospital outside the school was taken away by the counselor in the name of archives, and some of the words were used to argue that she was not suitable to continue school; As a justification for dropping out; counselors and college leaders had four interviews with her before and after, and each time she felt "exhausted". What made her even more uncomfortable was hearing her father begging the counselor on the phone not to let her daughter drop out of school.

Wang Junjie, who was also diagnosed with bipolar disorder in high school, was ready to disguise on the day of school.

Before enrolling, he found various information about depression from the online question and answer platform, such as "depression, what should I do if my freshman was asked to be suspended by the school or accompanied by parents?" Parents and teachers, isn’t the privacy of students privacy?” and so on. From the group of patients, he learned that some depressed students are indeed treated differently. "I am very worried, for fear that (the school) will have a bad influence after knowing it, such as being registered on the record and letting me suspend school, etc. I don't Likes to be treated as an alternative".

He decided to hide it from the school. "My admissions psychological test is all fake. I go to the Internet to find out how to make a normal person's result." Wang Junjie told the author that he memorized the style and answer of the polygraph according to the name of the scale. Knowing that it's not enough to just circle the "mentally in good shape" answer, you have to fool the lie detector test. It turned out that he succeeded.

Yan Ying and Wang Junjie suffer from bipolar disorder, commonly known as bipolar disorder. In the introduction materials of the World Health Organization (WHO), it is classified as an item of depression, and the introduction reads: "There is usually a period of mania and depression, and there is a period of normal mood in between." According to "China According to the Classification and Diagnostic Criteria for Mental Disorders, Third Edition (CCMD-3), bipolar disorder and depression are both mood disorders.

Yao Guizhong, the former vice president of the Sixth Hospital of Peking University, who has been engaged in psychiatry clinical and scientific research for more than 30 years, told the author that there is currently no census data on the number of depressed college students, and based on privacy considerations, it is difficult to have public data. But he noticed in his daily work that the trend of younger depression does exist.

In the document "Meta-analysis of the Detection Rate of Depressive Symptoms and Related Factors in College Students" published by researchers at Beijing University of Traditional Chinese Medicine, published in the "Chinese Journal of Mental Health" in November this year, the detection rate of depressive symptoms among college students was 24.71%. The study came to this data through an analysis of the literature over the past decade. According to the data of the National Health and Medical Commission, the national depression prevalence rate reached 2.1%, and the anxiety disorder prevalence rate reached 4.98%.

Topics such as depression at a younger age and depression in college students have received more and more attention in recent years. Since October this year, three suicide incidents of college students have been searched on Weibo. In the Baidu Index, search data for September this year showed that the user group who searched the most for the keyword "depression" fell in the age group of 20 to 29 years old.

This has also attracted attention at the policy level. In September this year, the National Health and Medical Commission announced the "Work Plan for Exploring Depression Prevention and Treatment Special Services" (hereinafter referred to as the "Work Plan"), proposing to carry out depression screening and evaluation for high school and college students, "to screen depression for depression" Include the content of students' health examinations, establish students' mental health files, evaluate students' mental health status, and pay special attention to students with abnormal evaluation results." One of its goals is to increase the national depression treatment rate by 50%, the treatment rate by 30%, and the annual recurrence rate by 30%.

However, from Yan Ying's experience and Wang Junjie's fear, it is obvious that there will be many difficulties in the screening and evaluation of depression in colleges and universities.

camouflage

Wanting to hide like Wang Junjie has almost become the norm for depressed students.

Several interviewed students and teachers told the author that most sick students are afraid of being discriminated against, which is also due to the low acceptance of depression in the social environment. There are also some students who have a sense of stigma and even find it difficult to accept the fact that they are sick.

In the evaluation criteria of colleges and universities, Lin Fan is an excellent student. He is a double-degree student, has top grades, receives professional scholarships every year, and always takes the most tasks in group work. But the other side that Lin Fan has been deliberately hiding is the mental troubles that started in high school - insomnia, depression, and even thoughts of suicide.

Lin Fan knew for a long time that he was "sick", but he just refused to seek medical attention and take medicine. In 2016, he was admitted to a university in Guangdong and enrolled in a major in communication. Because he was worried that his situation would be discovered, he always deliberately concealed his emotions. When he was doing a group filming assignment, he felt that his teammates were not serious enough. At that time, he happened to be in a manic state, but he didn't say a word, and he was "inflamed".

"I can't stand it anymore." The condition broke out in June 2019. Lin Fan attempted suicide twice, and was later diagnosed with bipolar disorder in the psychiatric department of the hospital. Since the onset of the disease, he has suffered from severe insomnia and does not want to talk to people. The cigarettes he quit have returned to his hands, and his classmates have noticed that there is "some problem". After much consideration, Lin Fan decided to stop pretending to be a "normal person".

"Actually, I've been ill for several years..." He typed these words in the circle of friends, thinking that it would be a relief to say it, but he didn't pretend to be successful anyway. A few hours later, Lin Fan regretted it - he didn't want so many people to know that he was sick. At this time, in the message area, even people who were not familiar with him came to greet and comfort him. He looked at the message in the circle of friends, and the delete button was not pressed after all, and it seemed that it was not bad to keep it.

"I always feel that I am quite lonely, and no one can understand me, but at least it is better to know that everyone is kind." Lin Fan said.

"Many people think (depression) is no big deal, or that he himself is not well." Wang Junjie hardly mentions his illness to his classmates, and he doesn't want to be "disappointed" - after revealing his illness, he will expect the other person to understand This disease, but sometimes, even the simplest comfort can not be obtained. He believes that it is impossible for people who have not experienced symptoms in their bodies to fully understand.

When his roommate asked Wang Junjie why he took medicine every day, he would say, "This is for the treatment of neurological disorders."

Chen Xi, who also went to college in Guangdong, chose to disclose her condition in class.

Chen Xi is a senior, studying psychology. Studying psychology also wanted to deal with her own problems - for six years in middle school, the exclusion of classmates and verbal violence were her nightmares, and she left a "cold mental diagnosis report".

In her final class speech a year ago, to more than 40 classmates in the classroom, she spoke little by little about her experience in middle school and the psychological impact it had caused. Finally, she told the class that she had bipolar disorder.

"No reaction, very indifferent." Chen Xi described the reaction of her classmates, and no one greeted her more. However, as a "farewell ceremony", after speaking, Chen Xi really felt that it helped her to come out of the shadow of the past.

Among the depressed students in colleges and universities, few are willing to speak out about their illness.

Wu Shanshan has been a teacher of a psychological counseling center in a university in Kunming, Yunnan for 13 years. She remembers that after a psychological consultation, it was just before get off work time, and the students who were going to leave together said to her, "Let's not go together, I'm afraid classmates will see it."

She told the author that in the current social culture, various diseases face discrimination, and the stigma of mental illness is even more serious. Even if they only receive psychological counseling, some students will be worried and afraid of attracting strange eyes.

Another teacher at a psychological counseling center in a university in Wuhan, Hubei Province, Li Min, believes that students' concerns about discrimination and stigma have little to do with the university environment, but rather the stigma in the social environment.

"The public's awareness rate of common mental disorders and psycho-behavioral problems is still relatively low, and there is a lack of knowledge of prevention and treatment and awareness of active medical treatment. Some patients and their families still have a sense of stigma." 2030)” described the status quo.

Lin Fan repeatedly mentioned that public illness can only happen on campus. Now working, he never mentions his illness in front of his colleagues, and even because he is afraid of community management, he does not dare to go to the hospital for follow-up, and only buys medicines in the online store. Looking back now, Lin Fan is glad that the school was tolerant at that time. Even some gay classmates were not discriminated against after coming out of the closet.

For a student suffering from depression, speaking out about the patient's identity is also tantamount to "coming out."

However, a few days after the Moments were posted, Lin Fan took the initiative to delete it.

After "coming out", it became a "safety hazard"

Depressed patients after "coming out" face not only love and encouragement, but also misunderstanding and even discrimination.

Based on the remarks of multiple interviewees, affected by the disease and drugs, their physical performance and behavior, when placed in their daily campus life, may be labeled as "weird", such as severe drowsiness or insomnia after taking the drug, insomnia, and insomnia. Regular work and rest, crying in public places, etc. Parents and teachers who lack understanding of depression will think that they are not motivated enough and hypocritical.

Before Chen Xi was diagnosed, he had an experience of "out of control". It was a hypnosis demonstration class. The instructor was a famous teacher from another school. There were many students outside the classroom. After Chen Xi was hypnotized, her traumatic memories flashed back, and she screamed uncontrollably in the classroom.

She still remembered the look in the eyes of the classmates around her after the hypnosis was over - alienated, even a little scared. When she walked out of the classroom, a familiar classmate saw her and immediately turned around and ran into the study room next to her.

"If even psychology students can't accept it, then the environment will be even worse." Chen Xi said.

Yan Ying's university dormitory is a five-person room. When her roommate asked her why she took medicine every day, she didn't think much about it, so she told the roommate about her condition, and the other party responded directly that she would not discriminate against her.

However, during the brief time together, she realized that the truth was not what the other party had promised verbally. When she quarreled with her roommate over the temperature of the air conditioner, the other party called her "crazy"; she also overheard that the roommate discussed her behavior with others and talked about her illness; the story of her illness was also passed on to the roommates. class.

Yan Ying changed the dormitory because of this. Facing the new roommate, she still spoke candidly about her condition. After the new roommate found out, although he didn't say anything, he always seemed "cautious" when getting along with each other.

Compared with the alternative eyes of classmates, sick students are more worried about being regarded as a "safety risk" by the school. "Hazardous safety" is a term used by Wang Junjie. He consciously sees the students suffering from depression as a hidden safety hazard in the school's eyes - risking self-injury and suicide.

"After finding out, most (schools) let themselves deal with it or suspend the school, and don't let the problem break out in the school," he found.

The informed consent form Yan Ying showed to the author shows that the school requires parents to take the students to the designated hospital for a psychiatric diagnosis immediately, and submit a copy of the diagnosis certificate to the college. The consequences will be borne by parents and students. The last sentence of the informed consent form is that if the above agreement is not abided by, the school has the right to ask students to suspend their studies or handle them as withdrawals.

Regarding the school's practice of requiring students to submit copies of the medical certificate, Yao Guizhong said that from the point of view of the school, it still wants to protect the students, so it is difficult to judge whether this request is reasonable, but such a request should be based on the students' voluntariness.

"Actually, this is what many students worry about after the (work plan) document comes out. It is true that after being diagnosed with depression, some students go back to school, and the counselors and school leaders (and students) talked and said that they were afraid that they would be in the school. Something happened at school." Yao Hao said.

Chen Xi did not take a break from school as suggested by the counselor, but she became the "key protection target" of the class committee. In a sand table experiment class, Chen Xi sat in the corner of the classroom, just blocked by the equipment. The monitor couldn't see her, so he sent a "kind" greeting: "What's the matter with you, don't you want to come to class?" Before that , Chen Xi and the monitor were not familiar with each other, and the sudden concern at this time made her quite uncomfortable.

Such greetings repeated, Chen Xi knew that this was the counselor's arrangement.

Yao Guizhong said that if the school itself cannot keep up with its manpower and technology, and is worried about students committing suicide in the school, sometimes they will adopt a "pushing method" - pushing them to the hospital or to the home. If they "can't push it out", then Just "see". In fact, the line between "seeing" and caring is difficult to draw, and if handled well, students won't feel bad about it.

"The key is to pay attention to the way, not to treat others as 'dangerous'. From the perspective of caring, be able to accompany him more and make him feel warm." Yao Guizhong said.

In Wu Shanshan's view, in terms of administrative management, the school has no right to advise students to suspend or drop out of school on the grounds of illness - these need to be dealt with in accordance with the regulations on student status management. At the same time, students should not be easily advised to suspend their studies due to mental illness. She analyzed that, firstly, some students' families are unable to support recovery at home, and after the students leave school, the condition may worsen; secondly, the proposal to suspend school has a great impact on parents, and it will be difficult for the school to communicate with parents in the future. She pointed out that when the situation is related to the safety of students' lives, schools cannot take too high risks. As for whether students should suspend school and how to deal with their illnesses, the decision is often made by parents, and schools are actually passive.

Yao Guizhong introduced that in the face of students at risk of suicide, most colleges and universities are to contact their parents as soon as possible. Because the management of colleges and universities is relatively loose, notifying parents to come to school can better ensure the safety of students. If the student does not need to suspend school, then parents can accompany them to school, which is a relatively reassuring approach.

Liang Mingkai was rescued by his classmates and a counselor when he tried to commit suicide. He had previously disclosed his suicidal thoughts to his classmates. The classmates chose the latter between keeping secrets and reporting to the counselor.

It happened on the last day of 2017. Liang Mingkai was a freshman at a college in Beijing. After a whole semester of depression and lethargy, he decided to end his life on this day. In the dormitory bathroom, as the blade was about to be cut for the third time, classmates and counselors rushed in.

The next day, Liang Mingkai's parents who were working in the south came to the school office, and the teacher gave the only solution: they must be hospitalized. Liang Mingkai was reluctant, but with the mentality of "accepting the task" and "reforming", he entered the psychiatric inpatient department of the hospital. Before admission, he was reading Thomas Mann's "The Magic Mountain," a novel set in a nursing home that "magically" aligned with his reality.

One month after being hospitalized, he received a diagnosis of "depressive tendencies". Strictly speaking, he did not suffer from depression, nor did he experience any deterioration in his condition after he stopped taking the drug. In his own words, compared to depression, he is closer to "people are more pessimistic" and "behavior (suicide) is a bit extreme", and he described the suicide as an "accident".

It's been three years now. Liang Mingkai believes that, judging from the results, the school's handling at that time was still beneficial, but he felt that the teacher's attitude could be more relaxed. He used "kidnapping" to describe the feeling at the time, and what he heard from the teacher's words was that disobedience was tantamount to causing trouble for the school.

"I feel like they are shirking their responsibilities. After all, if you are in the hospital, the school won't take such a big responsibility." Liang Mingkai added. In the second semester, his mood has recovered, and he begins to attend classes normally. But at the end of the period, the counselor still "toughly" asked his family to accompany him on campus.

Li Songwei, a Ph.D. in psychology at Peking University and a popular science popularizer in psychology, analyzed in the article "Marked Depression Risk People" that in the intervention of patients with depression, there is a relationship that "you are in danger, we have to control ourselves for you". There is an indistinguishable mix of caring for the patient and preventing the patient from wreaking havoc. If there is too much emphasis on prevention, it will cause "expansion", that is, "some people do not have such a high risk, and they do not need to be included in the protection category, but for the sake of insurance, they should be managed."

The role of embarrassing school counseling center

Among them, as a college psychological counseling center that needs to "check out" students, it plays an extremely embarrassing role.

As early as 2004, Yuan Guiren, then deputy minister of the Ministry of Education, proposed that colleges and universities should establish a working mechanism that integrates the screening, intervention, tracking and control of psychological problems. carried out in the same year. The following year, the Ministry of Education issued a document requiring colleges and universities to monitor the mental health status of college students, and proposed that special attention should be paid to preventing suicide or harm to others due to serious psychological disorders.

Since 2007, Wu Shanshan's school has carried out mental health screenings for freshman students every year in the form of scales. Since 2016, the third-year students have been added to the screening object, and this year, the screening object has also been extended to graduate students and doctoral students. After screening at the psychological counseling center, a high-risk list and a problem-prone list will be drawn. The high-risk list includes recent thoughts of suicide, or attempted suicide within six months, and I have suffered from mental and psychological diseases. For the students on this list, the school's psychological counseling room will conduct further evaluation and intervention through interviews. About 300 students need to be interviewed every year.

Yao Hao, a resident physician at the Shanghai Mental Health Center, told the authors that depression screening has a positive effect in the context of low rates of depression diagnosis and treatment in China. Because it is now difficult to get a person with depressive symptoms to go to the hospital and keep the patient on treatment, screening can proactively identify people with depressive symptoms and provide help - including those who may not have been aware of it. People who suffer from depression. He optimistically speculated that after the National Health and Medical Commission issued the "Work Plan", the coverage of screening in colleges and universities will be wider, and colleges and universities will also pay more attention to post-screening help and intervention.

"But after we take the initiative to identify these patients, if we can't provide a suitable help, then it is of little significance to find out." Yao Hao worries that some colleges and universities will only pursue the screening rate stipulated by the superior and perform the screening mechanized. investigation, while ignoring that improving students' mental health is the real goal.

A number of interviewed students revealed that the appointments for on-campus psychological counseling are quite full; two teachers from the school’s counseling center told the author that the students’ general concern was whether what they said in the counseling would be known to others.

Last year, Zhang Mingli, who suffers from bipolar disorder, was admitted to a graduate school at a university in Fujian province. Shortly before school started, doctors thought she was recovering well enough to stop taking the medicine. One of the activities for new students after admission was a lecture on mental health. The speaker was the director of the school's psychological counseling center, and Zhang Mingli exchanged with him about the stigma of mental illness. The director specifically mentioned that if students are afraid of being stigmatized, they may not declare their illness during psychological counseling.

Out of trust, Zhang Mingli truthfully filled in a piece of information during consultation, including whether there was a history of using psychotropic drugs.

"Would you like to let the counselor know about this situation?" Before the end, the counselor asked Zhang Mingli.

Zhang Mingli agreed.

According to the "Code of Ethics for Clinical and Counseling Psychology of the Chinese Psychological Association (Second Edition)", the content of psychological counseling should comply with the principle of confidentiality, as well as psychological counseling on campus. But the code also lists three exceptions to confidentiality, including "a psychologist who finds that a person seeking professional services is in serious danger of harming themselves or others". In addition, the "Mental Health Law" also stipulates that "psychological counselors shall respect the privacy of the counselees and keep them secret".

Li Min, a psychological counselor in a university in Wuhan, told the author that if a student is already at a high risk of suicide, he must break through the principle of confidentiality and inform the college and parents of the situation. high risk. Whether it is the application of the confidentiality exception requires a comprehensive assessment by the consultant.

A research article published in the "Chinese Journal of Mental Health" in 2018 pointed out that for the suicide risk of clients, college counselors usually analyze the risk of suicide from suicidal thoughts-suicide plan-suicidal behavior, as well as family suicide history, mental status, depression, social support System and other aspects to comprehensively investigate. Although the assessment system is basically the same, there is still considerable disagreement among the consultants on the boundaries of the breach of confidentiality.

Li Min said that in practice, in the face of students who have been diagnosed with depression and other diseases, she usually asks them if they are willing to inform the college. In the case of students she has contacted with, all the students agreed to report the situation to the college.

The aforementioned research points out that many psychological counseling institutions in colleges and universities are subordinate to the student work department. In addition to the role of counselors, psychological counselors often serve as managers and administrators. The article analyzes that in such a counseling relationship, the psychological counselor is in a more obvious active position, which tends to make the psychological counseling relationship lose its original equality and lead to more violations of counseling ethics.

After the illness was reported, in the eyes of the college teachers, Zhang Mingli became a patient who needed special attention. The college talked to her many times and asked her to go to the hospital for a psychiatric diagnosis. Finally, the counselor took her to the hospital for examination, and the diagnosis was "persecution delusional tendency". Although this was only a tendentious diagnosis, Zhang Mingli felt that she was immediately regarded as a "person without insight", and her parents were immediately notified to come to school. After about half a month, she dropped out of school.

"I didn't expect to be suspended from school at the time. I didn't have any thoughts of hurting others, self-harm or suicide. Logically speaking, I could not be suspended from school." Zhang Mingli emphasized. Because of this experience, she also completely lost trust in the school's psychological counseling center.

"Standing in this position, we are actually in a dilemma. We both represent the school and have to protect the school." Wu Shanshan said that in daily work, psychological counselors must avoid risks for the school, based on helping students recover, but also human nature "But we can't completely ignore the student and his family."

Chen Xi has mentioned many times that he is "lucky" because he met a good psychological counselor.

She went to the hospital and was diagnosed with bipolar disorder under the advice of a school psychologist. Afterwards, the psychological counselor organized a tripartite conversation between parents, counselors and Chen Xi. Both the counselor and the parents suggested that Chen Xi be suspended from school. At the end of the conversation, the consultant said, "It's better to listen to Chen Xi's own thoughts." Only then did she have the opportunity to say "I don't want to drop out of school".

Help is the real goal

After screening, helping depressed students to improve their mental health is the real goal. But this goal is not easy to implement.

Hu Yun is an associate researcher at a scientific research institution in Yunnan Province. For the past few years, she has been involved in cross-school student groups locally. In the process of interacting with students, she has encountered many students who are emotionally troubled, and even suffer from depression and bipolar disorder.

"I feel that the (psychological support, mental health services) needs of college students are really strong. Because of the psychological counselors and professional doctors that the group activities come into contact with, they will hold on to the connection. There may also be a premise that they are not interested in the group. I am very trustworthy, so I feel that the doctors and teachers I have contacted here are credible.”

She believes that it is difficult for sick students to get help and the lack of access to help resources is a real predicament. For example, some parents and teachers have little understanding of depression; students worry that asking for help in school will expose their privacy; and the price of off-campus psychological counseling is high, which is unaffordable for ordinary students.

Yao Hao, a resident physician at the Shanghai Mental Health Center, pointed out that building a social support network for students is the most important, especially the "base". He introduced that the mental health service and intervention system is a pyramid structure. Professionals such as psychiatrists are only a small part of the top; and the biggest "base" in the system is the students' family members, friends and teachers. People can give the most direct help. "During the entire support intervention process, they are closest to the students. We hope to train these people to improve their knowledge and skills of mental illnesses including depression."

But if those who have the closest contact with students are precisely those with a strong prejudice against mental illness, it could be counterproductive. Yao Hao said that making training effective is not easy, and school leaders need to pay attention to this issue.

Yao Guizhong, the former vice president of the Sixth Hospital of Peking University, suggested that colleges and universities can start from two aspects. One is to increase the number of psychological counseling staff. As far as he knows, most schools currently have psychological counseling services, but the efficiency of psychological counseling itself is low, and there will be too long waiting times for appointments; the second is to let students know through publicity, such as club activities and lectures. Knowledge about depression.

In addition, he notes, the online depression self-screening scale is also a good tool. These scales are anonymous and students prefer to do their own screening. He came into contact with some students who consulted, who sought medical treatment after self-screening.

Another status quo is that some depressed students have insufficient trust in the school help system. Yao Hao said that the lack of trust is common in the whole society. Regarding the situation in schools, he believes that it is the schools and teachers who should make changes. They should change their attitudes and focus on helping students rather than reducing risks.

"It should be difficult to carry out reforms within the school... How to carry out this (depressed student support) service can it be based on the interests of students, not the interests of the school. (Change) may be a relatively long process. "Hu Yun said.

She believes that the general direction of the school service system needs to be changed by leaders and even the education department. In addition, providing mental health services for students through social organizations will be a more effective "open source" way, and social organizations are relatively independent of the school system. However, as far as she knows, there is no such service in Yunnan at present.

"Companionship" and "understanding" are the frequently used words in the interviewed students' mouths. For them, having a friend for a walk, or just being by their side, has been an effective support when things are bad. "Understanding" is based on the premise of popular science. What they expect is that classmates and teachers can understand depression and other diseases at the knowledge level.

"If my counselor really understands these things (depression), then the attitude to deal with the problem will be a little more gentle." Liang Mingkai believes that his experience is not an exception, and he hopes that more people can understand the real situation of depressed students .

(Except Yao Guizhong and Yao Hao in this article, they are all pseudonyms)

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Because I've read a lot of articles about depression, and I think most people can relate to that feeling (without using metaphors), I haven't written much about depression, although I think that It's very emotional, but I've always had doubts about this treatment. Another and more important point is that I still hope to present as much new information/different content as possible within the limited word count.