A phone rang, breaking the silence. Wu Hengqian, a 29-year-old operator at a mental health support line, picked it up. On the other end, a caller in deep distress expressed thoughts of suicide. Acting quickly, Wu brought in a crisis intervention expert for additional assistance.

Despite their best efforts, the caller remained unstable and refused to provide her location or emergency contact information. With time running out, Wu and his colleague decided to contact the police — a decision that ultimately saved the caller's life.

The next day, Wu followed up with the caller to check on her wellbeing and was relieved to hear that she was going to seek treatment at a hospital.

This call was just one of over 1,000 that Wu has handled in his five years as a psychological assistance hotline operator.

"Helping others gives me a sense of fulfillment and constantly reminds me why my work matters," Wu said.

The hotline where Wu works was established in 2020 at Zhengzhou No 8 People's Hospital in Henan province.

On Jan 27 this year, the hospital joined the nationwide "12356"mental health support hotline, which officially launched on Jan 1. "Joining 1 2 3 5 6 has greatly improved access to psychological support, leading to a significant increase in the number of calls we receive," said Zhang Lixia, director of the hospital's Psychological Health Center.

The hotline operates 24/7, staffed by 22 professional psychotherapists, and supported by over 200 doctors and specialists from various departments.

"In urgent cases, or when operators need additional assistance, we quickly connect with the appropriate doctor or specialist for psychological intervention during the call," Zhang explained. "This three-way connection ensures callers receive immediate support and seamlessly links the hotline to medical services."

In late February, the hospital's hotline center introduced the AI model DeepSeek, which transcribes calls in real-time, allowing operators to access conversations instantly. This system also enhances the three-way call process by extracting key phrases, enabling operators to quickly identify core issues and connect with the right specialists.

Zhang believes mental health support hotlines are more cost-effective, accessible, and private compared to traditional psychotherapy, allowing callers to open up without revealing their identities.

"Hotlines also offer quicker responses than scheduled counseling sessions," she added.

However, Zhang also pointed out that hotlines have limitations. Without nonverbal cues, therapists may struggle with complex issues, and many therapeutic methods require in-person interaction and long-term follow-up.

Healing through listening

Before the launch of the 12356 service, several universities and social enterprises in China, including Zhengzhou No 8 People's Hospital, had already set up psychological support hotlines.

One such initiative is the MOECCNU Mental Health Service Platform. Established in 2020 by the Ministry of Education (MOE) and managed by Central China Normal University (CCNU) in Wuhan, Hubei province, the platform was originally designed to support frontline medical workers and the public during the COVID-19 pandemic.

The service continues to operate today, running daily from 6:30 pm to 10:30 pm.

According to Xia Mian, an associate professor at CCNU's School of Psychology, the platform is accessible via a WeChat mini-program and phone calls and has expanded to include AI-driven psychological services.

"The AI system offers free psychological assessments and therapy services online, available 24/7," Xia explained.

Feng Jing, 35, is a volunteer operator at the platform. After graduating from CCNU's School of Psychology, she now works as a psychological counselor at a college in Wuhan.

Feng joined the platform as a volunteer shortly after its launch and has been contributing her expertise for five years. "I want to use my knowledge and skills to help those in need," she said.

The platform provides comprehensive professional training and supervision, enabling operators to quickly assess risks and take appropriate action during emergencies.

"The key during calls is to be 'with' the caller," Feng said. "It's about listening attentively, showing empathy, and offering a steady, warm, and supportive space."

Zhang Han, 35, a psychological counselor, echoed this perspective. Between 2022 and 2024, she worked as a hotline operator for "Jiandanxinli" (translated as "simple psychology"), a startup mental health service platform in China.

"We focus on active listening, encouraging callers to openly express themselves, as many emotional and psychological struggles arise because people feel they aren't truly heard, accepted, or understood in their daily lives," she explained.

The hotline operates from 6 pm to midnight on weekdays and from 2 pm to midnight on weekends, offering each registered user up to 30 free calls.

Zhang Han shared that, of the nearly 600 calls she has handled, most callers are between 20 and 40 years old, facing a variety of issues such as academic pressure, career concerns, relationships, and personal struggles.

"Anxiety is the most common emotion expressed," she said, noting that intense competition and shifting social values often leave many young people questioning their sense of self-worth.

"Today's challenges are more about seeking spiritual fulfillment than material needs," she added.

The platform allows callers to leave feedback and share their feelings with the operator. After one particularly difficult call with a suicidal individual, Zhang Han received a message that read, "Thank you for saving me tonight."

"In psychology, pain isn't measured by its cause," she said. "Whether it's triggered by a single word or a significant loss, the emotion is real. Psychological hotlines are like band-aids, offering immediate first aid for emotional wounds."

Mental health counts

As a frontline mental health professional working with children and adolescents, Zhang Lixia has seen a rise in mental health issues among young people over the past decade.

In response, her hospital regularly provides mental health education and holds counseling sessions in schools and communities. With support from the local government, the hospital also trains village doctors in Zhengzhou on mental healthcare and treatment.

These efforts will be integrated with the hotline service. "In urgent cases, for example, if the caller provides their address, we can intervene both online and offline, with the help of local service stations or village doctors," Zhang Lixia explained.

On a personal level, Zhang Han advises individuals to be mindful of their emotions but cautions against labeling mental health issues.

"For example, if others perceive you as obsessive-compulsive, that's OK as long as you're comfortable and happy with your organized lifestyle," she said.

She added that if emotions cause significant distress or disrupt daily life, even leading to physical symptoms, it's crucial to seek professional help.

Zhang Han's two years as a hotline operator not only helped her develop professionally but also allowed her to build meaningful connections with her callers.

"In a confidential, professional environment, sharing deeply personal feelings with a stranger is an incredibly valuable experience," she said.

Contact the writers at mengwenjie@i21st.cn