Correspondence
Mental health services                           inevitably become a major barrier to
                                                 access maintenance treatments for
for older adults in China                        this group.
during the COVID-19                                The outbreak of COVID-19 has
                                                 raised great challenges for mental
outbreak                                         health services for older adults in
Over the past several weeks, the total           the community. There seems to be                               Published Online
number of patients with 2019 novel               insufficient and inadequate attention                          February 18, 2020
                                                                                                                https://doi.org/10.1016/
coronavirus disease (COVID-19) and               paid to this vulnerable population                             S2215-0366(20)30079-1
the number of associated deaths                  in the recently established crisis
has been increasing. Of the deaths               psychological services in China.
caused by COVID-19, most were                    Stakeholders and health policy makers
older adults.1 China has the largest             should collaborate to resolve this
ageing population globally. In 2017,             barrier in order to provide high-quality,
there were 241 million older adults              timely crisis psychological services to
(>60 years) nationwide, accounting               community-dwelling older adults.
for 17·3% of the total population,2              The authors declare no competing interests. YY, WL,
of whom around half were empty-                  QZ, and LZ contributed equally.
nest elderly (ie, without children,              Yuan Yang, Wen Li, Qinge Zhang,
or whose children left home and                  Ling Zhang, Teris Cheung,
worked elsewhere) with little social             *Yu-Tao Xiang
support. More than 30 million people             ytxiang@um.edu.mo
were older than 80 years, and more               Unit of Psychiatry, Institute of Translational
than 40 million required long-term               Medicine, Faculty of Health Sciences (YY, WL, Y-TX),
care due to disabilities.2,3 Mental              and Center for Cognition and Brain Sciences (YY, WL,
                                                 Y-TX), University of Macau, Macau Special
health problems are common in                    Administrative Region, China; Department of
older Chinese adults (ie, ≥55 years),            Psychiatry, Southern Medical University Nanfang
with the prevalence of depressive                Hospital and Guangdong-Hong Kong-Macau
                                                 Greater Bay Area Center for Brian Science and
symptoms reported to be 23·6% in this
                                                 Brain-Inspired Intelligence, Guangdong, China (YY);
population.4 The rapid transmission of           The National Clinical Research Center for Mental
the severe acute respiratory syndrome            Disorders and Beijing Key Laboratory of Mental
corona virus 2 (SARS-CoV-2) and high             Disorders, Beijing Anding Hospital and
                                                 The Advanced Innovation Center for Human Brain
death rate could exacerbate the risk of          Protection, Capital Medical University, Beijing,
mental health problems and worsen                China (QZ, LZ); and School of Nursing, Hong Kong
existing psychiatric symptoms, further           Polytechnic University, Hong Kong Special
                                                 Administrative Region, China (TC)
impairing their daily functioning and
                                                 1	   Li Q, Guan X, Wu P, et al. Early transmission
cognition.                                            dynamics in Wuhan, China, of novel
  Public transport in many regions                    coronavirus-infected pneumonia. N Engl J Med
                                                      2020; published online Jan 29. DOI:10.1056/
has been suspended to lower the risk                  NEJMoa2001316.
of disease transmission; thus, online            2	   Liu YL, YL. China’s aging population: from a
mental health services have been                      global perspective (in Chinese). Beijing: Social
                                                      Sciences Acadeimc Press, 2019.
widely adopted.5 Older adults have               3	   National Health Commission of the People’s
limited access to internet services                   Republic of China. Report on the family
and smart phones, and as such only                    development in China, 2015 (in Chinese).
                                                      Beijing: Social Sciences Acadeimc Press, 2015.
a small fraction of older adults can             4	   Li D, Zhang DJ, Shao JJ, Qi XD, Tian L.
benefit from such service provision.                  A meta-analysis of the prevalence of
                                                      depressive symptoms in Chinese older adults.
In addition, in most areas of China,                  Arch Gerontol Geriatr 2014; 58: 1–9.
clinically stable older adults with              5	   Liu S, Yang L, Zhang C, et al. Mental health care
psychiatric disorders or their guardians              in China during the COVID-19 outbreak.
                                                      Lancet Psychiatry 2020; published online Feb 20.
usually need to visit psychiatric                     https://doi.org/10.1016/
outpatient clinics monthly to obtain                  S2215-0366(20)30077-8.
the maintenance medications.
The current mass quarantines and
restrictions to public transport have
www.thelancet.com/psychiatry Vol 7 April 2020	                                                                                             e19