A
In the first few days after a family member dies, don't stay alone; if you have heart disease, high blood pressure or diabetes, keep taking your medicine as usual; if your chest feels pressed and painful, call 120
Value for cost Very high
In plain termsIn the first day after a family member dies, the probability of a heart attack is 21.1 times the usual, and it falls day by day after that. Among people aged 60 to 89, in the 30 days after their partner dies, the proportion who have a heart attack or stroke roughly doubles, and it falls back after a month. People who already have cardiovascular disease should not stop their medicine these few days. If your chest feels pressed and painful, you can't catch your breath, or the arm and leg on one side are weak, call 120 (ambulance) immediately.
- Cost
- No money. Don't stay alone these few days, and keep taking your medicine as usual.
No money
Done in passing
No willpower
Benefit size large
- Benefit
- 1985 patients with acute heart attack, each compared with themselves across different time periods before and after onset. Of these, 270 (13.6%) had lost someone important in the 6 months before onset, and 19 had lost them within 1 day before the heart attack. In the 24 hours after the death of someone important, the rate of acute heart attack rose 21.1-fold (95% CI 13.1–34.1; the true multiple is roughly between 13 and 34). After that it fell day by day. In actual numbers: among people with a 5% ten-year risk of heart attack, there is 1 extra case for every 1394 who have just lost a family member. Among people with a 20% risk, 1 extra case for every 320. Another study, in the UK, compared 30447 people aged 60 to 89 who had lost a spouse with 83588 comparable controls. In the 30 days after the bereavement, 50 people (0.16%) on the bereaved side had a heart attack or stroke. On the control side, 67 (0.08%). IRR 2.20 (1.52–3.15), that is, the probability of an event was about 2.2 times that of controls. Of this, heart attack 2.14 (1.20–3.81), about 2.1 times. Stroke 2.40 (1.22–4.71), about 2.4 times. After 30 days it weakened. Two more kinds of illness were looked at within 90 days. One was acute coronary syndrome short of a heart attack (the kind where the heart's blood supply suddenly goes wrong but it does not amount to a heart attack), IRR 2.20 (1.12–4.29). The other was pulmonary embolism (a blood clot blocking a blood vessel in the lungs), IRR 2.37 (1.18–4.75)
- Evidence grade
- A
- Notes
- Hand your pillbox to someone else to manage; don't rely on your own memory. Don't drive long distances these few days. Don't get through it by drinking; for the accounts on alcohol, see Section 2. For how to recognize a heart attack or stroke and how to call an ambulance, see Section 13. Both are studies that went back through population data, and they cannot tell how many of these people would have fallen ill anyway. But the two point in the same direction and to the same time window. If you have no one to hand your pillbox to and are bound to be alone at home these few days, see Item 6 of this section.
A
In the week you are told of a serious diagnosis, don't go to get the results alone, and put off decisions other than treatment
Value for cost Very high
In plain termsIn the first week after a cancer diagnosis, the probability of suicide is 12.6 times that of people without a diagnosis, and the probability of dying of cardiovascular disease is 5.6 times. By the first year, the suicide risk falls to 3.1 times, and this is more marked the harder the cancer is to treat. So bring someone with you on the day you get the results, and don't stay alone at home afterward. Things like quitting your job or selling your home can wait until the next clinic visit.
- Cost
- No money. Find someone to go with you to get the results. Push big decisions other than treatment back a few days.
No money
Done in passing
No willpower
Benefit size large
- Benefit
- Swedish national records followed more than 6.07 million people (6,073,240 people) from 1991 to 2006. Compared with people without a cancer diagnosis, the relative risk of suicide in the first week after diagnosis was 12.6 (95% CI 8.6–17.8), that is, about 12.6 times. The true multiple is roughly between 8.6 and 17.8. The incidence in this week was 2.50/1000 person-years, meaning 2.5 cases when 1000 people are followed for one year. By the first year it fell to 3.1 (2.7–3.5, 0.60/1000 person-years), about 3.1 times. Cardiovascular death in the first week was 5.6 (5.2–5.9, 116.80/1000 person-years), about 5.6 times. In the first 4 weeks, 3.3 (3.1–3.4, 65.81/1000 person-years). The raised risk fell back quickly within the first year after diagnosis. The harder a cancer type is to treat and the lower the chance of survival, the more marked the rise. Comparing the same patients with themselves across different time periods gave the same conclusion
- Evidence grade
- A
- Notes
- These are data on cancer patients. For other major diagnoses, there is no original research of equal weight. Very few people actually come to harm: the suicide rate in the first week is 2.50/1000 person-years, that is, 2.5 cases when 1000 people are followed for one year. This is written down not to frighten you, but to show that in “the first few days after you find out” someone should be at your side. For long-term management after diagnosis, reimbursement and follow-up checks, see Section 16 and Section 24. If you can't find anyone to go with you, see Item 6 of this section (replace “that person” with neighbors and the community list).
A
After losing your job, first fix your daily routine, your medical insurance and a rhythm for job hunting; don't stay home all day
Value for cost High
In plain termsPeople who lose their jobs have about a 60% higher probability of dying afterward than people in work; this is more marked in men and in people who are not old, and highest in the first ten years. Take out the effects of smoking and drinking, and the increase shrinks by about a quarter; this part is something you can control yourself. First register as unemployed and claim unemployment insurance benefits; while you receive them, your medical insurance (医保) contributions are paid for you by the unemployment insurance.
- Cost
- No money. First register as unemployed and claim unemployment insurance benefits, then turn job hunting into a fixed schedule. The hard part is still getting up on time when no one is pushing you.
No money
Done in passing
Some willpower
Benefit size large
- Benefit
- 42 studies, 235 estimates of the risk of death and more than 20 million people were pooled. After adjusting for age and other conditions, the average HR for the risk of death from any cause among the unemployed was 1.63, about 60% higher than among people in work. Higher for men than for women. The effect was marked for people in the early and middle stages of their careers, and smaller in the late stage. Risk was highest in the first 10 years of follow-up, and fell after that. In the subset of studies that also took into account health behaviors such as smoking and drinking, the average HR was 24% lower, that is, the calculated increase was about a quarter smaller
- Evidence grade
- A
- Notes
- This is a study that went back through population data, and it cannot tell the direction of cause and effect. People who were already in poor health are also more likely to lose their jobs. But “after taking out the part due to lifestyle habits, the effect is 24% lower” gives a direction you can act on. For what you can receive when unemployed, where to claim it, and how to keep your social insurance going, see Section 7. For how much compensation you should get if you are dismissed, and not signing a voluntary resignation, see Section 19.
A
If a family member died by suicide, accident or homicide, don't count on toughing it out; actively seek professional help
Value for cost High
In plain termsPeople whose spouse died by suicide are about 80% (men) and 70% (women) more likely than the general population to be diagnosed with a mental disorder within five years. Compared with people whose spouse died of other causes, it is also between 70% higher and double. People bereaved in this way are more likely to feel shunned and ashamed. That is exactly why you should actively reach out to people instead of waiting until you get better on your own.
- Cost
- Calling 12356 costs nothing. If you need to see a doctor, registering at a psychological clinic costs the same as an ordinary outpatient visit. The hard part is speaking up yourself to ask for help.
No money
Done in passing
Some willpower
Benefit size large
- Benefit
- Danish national records followed 6.7 million adults from 1980 to 2014, more than 136 million person-years in total (the number of years every person was followed, added up). For people widowed by a spouse's suicide, the risk of a new mental disorder diagnosis within 5 years, compared with the general population, was IRR 1.8 for men (95% CI 1.6–2.0), that is, about 80% higher. For women 1.7 (1.6–1.8), that is, about 70% higher. Compared with people widowed by other causes of death, IRR was 1.7 for men (1.5–1.9) and 2.0 for women (1.9–2.2), that is, between 70% higher and double. In this group, the rates of suicidal behavior, mortality and needing municipal assistance were also higher. The risks of physical illnesses such as cirrhosis of the liver and sleep disorders were raised as well. In addition, 57 studies were summarized one by one, without pooling the numbers. Bereavement by suicide was associated with the following four things. First, a raised risk of suicide in partners. Second, after a child's suicide, a raised risk of the parents being admitted to psychiatric care. Third, after an adult child's suicide, a raised risk of suicide for the mother. Fourth, after a parent's suicide, a raised risk of depression for the children. Compared with people bereaved by other violent deaths, people bereaved by suicide more often said they felt shunned and ashamed
- Evidence grade
- A
- Notes
- Sudden, violent deaths means accidents, homicides and disasters. After these kinds of deaths, the rates of post-traumatic stress disorder, depression and grief getting stuck are all higher than after death from illness. Recovery is also slower. For what to do when you yourself have suicidal thoughts, see Section 1, Item 25.
A
In the first half year after losing your spouse, hand your meals, sleep, chronic-illness medication and follow-up checks to one fixed person to watch over
Value for cost High
In plain termsWithin half a year after losing a spouse, the probability of dying in that period is about 40% higher than for people who have not lost a spouse. After half a year it falls to about 15% higher. For men it is about 23% higher; for women the difference is so small it may be just chance. This gap is not something you can get through by looking on the bright side. What to do is put the medicine, meals and follow-ups in the hands of one specific person, instead of counting on remembering them yourself.
- Cost
- No money. Find one specific person, a child, a sibling or a friend, and have them come by or call regularly. The hard part is speaking up and entrusting this to someone.
No money
Done in passing
Some willpower
Benefit size large
- Benefit
- 15 studies that registered people first and then followed them forward, with 2,263,888 people, were pooled. Less than 6 months after losing a spouse, the RR of death was 1.41 (95% CI 1.26–1.57), that is, the probability of dying in the same period was about 40% higher than for people who had not lost a spouse. After 6 months it was 1.14 (1.10–1.18), falling to about 15% higher. For men the RR was 1.23 (1.18–1.28), about 23% higher. For women 1.04 (1.00–1.08, not statistically significant, meaning this small difference may be just chance). No clear difference was seen between under 65 and 65 and over. Another analysis pooled 123 papers, 1377 risk estimates and more than 500 million people. After adjusting for differences in conditions, HR 1.23 (1.19–1.28), that is, about 23% higher overall. Men were again higher than women. Men 1.27 (1.19–1.35), 27% higher. Women 1.15 (1.08–1.22), 15% higher
- Evidence grade
- A
- Notes
- This is a study that went back through population data, and other factors mixed in cannot be removed. Couples' lifestyles and illnesses are similar to begin with. But the pattern that “the first half year is much higher than afterward” is the same in two independent pooled analyses, and is worth treating as a window for looking after someone. Men's risk is higher, and men are also less likely to speak up and ask for help. If there is a widowed older person in your family, sort out their accounts, guardianship and will together, following Section 17. If you can't find such a person (you live alone, have lost your only child, or your children have also died), hand this job to the community and your phone; see Item 6 of this section.
B
If you have no family and no friends, replace “the person watching over you” with three things: a neighbor who can get into your home, the community's visiting list, and the emergency contacts in your phone
Value for cost Standard
In plain termsWhen you have no family and no friends, there are two things to take care of: that someone finds you if something happens, and that you take your medicine and eat on time day to day. Taking your medicine and eating are up to you: write a checklist and set alarms rather than relying on memory. Being found depends on three things: leave a spare key with a neighbor, ask the residents' committee whether you can be put on the visiting-and-care list, and set up emergency contacts on your phone and don't switch it off.
- Cost
- No money. The hard part is speaking up yourself and saying to a neighbor and the residents' committee, “I live alone, and something has just happened in my family.”
No money
Done in passing
Some willpower
Benefit size medium
- Benefit
- 44,573 outpatients, all at risk of or with a history of atherothrombosis (the kind of condition where plaques build up in the blood vessels and they are easily blocked by blood clots). They were enrolled by doctors in many countries in the international REACH program and followed; they entered between December 2003 and December 2004 and were followed for 4 years. Of these, 8,594 (19%) lived alone. Over 4 years, death from any cause among those living alone was 14.1%, and among those living with others 11.1%. Cardiovascular death was 8.6% vs 6.8%. Both log-rank P<0.01: the differences are unlikely to be chance. The gap differed by age group (interaction P=0.03). At 45 to 65, death among those living alone vs with others was 7.7% vs 5.7%. After adjusting for other conditions, HR 1.24 (95% CI 1.01–1.51), that is, about 24% higher. At 66 to 80, 13.2% vs 12.3%, HR 1.12 (1.01–1.26), about 10% higher. Over 80, 24.6% vs 28.4%, HR 0.92 (0.79–1.06); here, by contrast, no increase was seen. A 2022 opinion from the Ministry of Civil Affairs and other departments, ten in all, provides for visiting-and-care services. They are for older people who live alone, are empty-nesters, are left behind, have lost the ability to care for themselves, are severely disabled, or are in families with special family-planning circumstances, among others. The services are delivered by “regular home visits, phone and video calls, and remote monitoring.” Township governments (subdistricts) carry out surveys, assisted by village (residents') committees, to gather basic information and “willingness to receive visiting-and-care services,” and include them in grassroots grid management, that is, people are assigned by area to specific staff who watch over them. By the end of 2025, “ensure that the monthly visiting rate for older people with special difficulties reaches 100%,” and “for older people with special difficulties who have lost the ability to care for themselves, visiting and care no less than once a month.” The document also encourages households to install smart call systems, smart electricity and water meters, health monitoring products and elderly monitoring devices, so that “once an abnormality is detected, a timely alert can be given, and a notification sent at the same time to emergency contacts.” When service staff discover an urgent problem, they “should assist in calling the emergency hotline immediately”
- Evidence grade
- B
- Notes
- How to do the three things specifically. One: give a spare key or a temporary door-lock code to a neighbor or the property management, and tell them, “I'm alone these few days.” You don't need to be close; you only need someone to know you are inside. Two: go to the community residents' committee, explain that you live alone, and ask whether you can be put on the visiting-and-care list. Older people who live alone, are empty-nesters, or have lost their only child are service recipients explicitly named by the government; while you are there, ask whether devices such as smart call buttons and smart water meters are installed for free locally. Three: set up emergency contacts and a medical emergency card on your phone, and don't mute it or switch it off these few days. There are two reasons for grade B. First, the link between living alone and mortality comes from a study that went back through population data, which cannot rule out the reverse explanation that “people who were already in poorer health or circumstances are more likely to live alone”; the original paper itself writes that this result needs confirmation. Second, the visiting-and-care document covers only older people. There is no corresponding dedicated system for people under 60. What you can count on is one provision in a document that requires grid workers and social workers to “promptly identify psychological crisis risks such as family misfortune, unemployment and dropping out of school” (see Item 11 of this section, call 12356 when you need someone to talk to). For why “someone in the home” is worth so much, see Section 13, Item 1 (chest compressions). Of cardiac arrests outside hospitals, 79.2% happen at home. When someone nearby does compressions, 16.1% survive to leave the hospital; with no one, only 3.9%. No one in the home means you land in the low group. Two more things that come along naturally. Arranging a funeral already means going to several counters: the funeral home, the community health service facility, the police and the housing provident fund (see Section 25). Make it a fixed schedule of going out once a day, and your outings for these days are already arranged. The hotline can be called again and again, not just once (see Item 11 of this section, call 12356 when you need someone to talk to). “Living alone” is itself also a long-term risk factor. The odds ratio of death for living alone is 1.32, about 30% higher; see Section 22, Item 9 (treat regularly seeing people as a health expense). But this item only deals with these few days; the long-term account is reckoned separately.
B
After a parent dies, tell the child the truth, let them take part in the farewell, and don't send them elsewhere for “a change of scene”
Value for cost High
In plain termsChildren who lose a father or mother before 18 have about a 50% higher probability of dying by early adulthood than children who have not had this experience. If the parent died by accident or suicide, about 80% higher; of illness, about 30% higher. What the family can do is tell the child the truth, let them take part in the farewell, not interrupt their schooling, and not send them to relatives for a change of scene.
- Cost
- No money. The hard part is that you are suffering too, and still have to explain things clearly to the child.
No money
Done in passing
Some willpower
Benefit size large
- Benefit
- The entire populations born in Denmark from 1968 to 2008 and in Sweden from 1973 to 2006 were included. Added to them were 89.3% of those born in Finland from 1987 to 2007, drawn as a sample. More than 7.3 million people in total. Of these, 189,094 lost a parent before 18. These children's mortality from any cause was 50% higher than that of people who had not been bereaved (mortality rate ratio 1.50, 95% CI 1.43–1.58, that is, about 1.5 times). For parents who died of unnatural causes such as accident or suicide, it was 1.84 (1.71–2.00), about 80% higher. For natural causes such as illness, 1.33 (1.24–1.41), about 30% higher. It was highest when the child's cause of death was of the same type as the parent's
- Evidence grade
- B
- Notes
- When you tell the child, don't make up “they've gone on a long trip”; put the arrangements for guardianship and upbringing in writing. The B grade is not because the numbers are weak. This is a follow-up study of the entire populations of three countries, and the numbers themselves are strong enough for an A. It is graded B because between these numbers and the specific practices of “how to tell the child, whether they should take part in the farewell,” there is no direct trial evidence. The authors also state that data on the parent-child relationship and the child's lifestyle after bereavement are missing. The increase includes both an inborn constitutional component and the long-term effects left by the bereavement. For naming a guardian and arranging property, see Section 17. For the child's support payments and schooling, see Section 18.
A
If after half a year your grief is still stuck in the same place and you can't get on with life, register at a psychiatry or clinical psychology department
Value for cost Standard
In plain termsAbout one in every ten bereaved adults gets stuck: for more than half a year they keep longing for the person so much that they can't eat, can't go to work or can't look after the children, they feel numb, and they feel life has no meaning. This is not a lack of strength; it has diagnostic criteria and specific treatments. Targeted treatment has a response rate of 51%, versus 28% for ordinary psychotherapy, and it also works faster.
- Cost
- Registration fees plus treatment fees. This kind of treatment is done as a course; in the trial it averaged 16 sessions over 19 weeks. The hard part is taking the step to register yourself.
A little money
A few hours
Some willpower
Benefit size large
- Benefit
- 14 studies were pooled, covering adults whose family member did not die violently and who were not themselves psychiatric patients. The prevalence of prolonged grief disorder was 9.8% (95% CI 6.8–14.0), that is, about 10 in every 100 bereaved adults. The older the age, the higher the proportion. Another study tested whether these diagnostic criteria are accurate: it recruited 291 bereaved people and interviewed them three times, at 0–6, 6–12 and 12–24 months after the bereavement. The core feature of the diagnosis is intense longing for the deceased. On top of that there must be at least five of these nine. The first five are emotional numbness, being stunned, feeling life has no meaning, distrust of others, and distress over this loss. The last four are difficulty accepting it, confusion about who one should be, avoiding reality, and being unable to go on with life. These features must occur every day, or be severe enough that the person cannot function. And they must still be present at least 6 months after the death, and still affect daily life. There was also a trial in which 95 people were randomly split into two groups, with 16 treatment sessions over an average of 19 weeks. The response rate for treatment targeted at complicated grief was 51%. For ordinary interpersonal psychotherapy, 28% (P=0.02, the difference is unlikely to be chance). The former also worked faster. The number needed to treat was 4.3, meaning that on average, for every 4.3 people treated, one more improves
- Evidence grade
- A
- Notes
- Don't hold yourself to counting months. The real test is whether it is “affecting eating, sleeping, going to work, looking after the children”; if it is, go and register. The department is called psychiatry, psychology or clinical psychology, and public psychiatric specialty hospitals all have one. In different materials this diagnosis is called complicated grief, and also prolonged grief disorder. Different criteria also require different durations; some say 6 months, some 12 months. The 9.8% figure comes from 14 studies whose methods differed considerably, and the authors also caution that it may not carry over directly to other populations.
A
Don't start by spending money on grief counseling; first see whether your grief is really stuck (the symptoms in Item 8)
Value for cost High
In plain termsArranging counseling for everyone who is bereaved has very small benefits that are no longer visible after a while, because most people would recover on their own anyway. But for people who are clearly not coping, treatment is as effective as treatment for other psychological problems. So first check against Item 8 (if grief is stuck, go to psychiatry), and spend this money only if it matches.
- Cost
- No money; on the contrary, you save a counseling fee.
No money
Done in passing
No willpower
Benefit size medium
- Benefit
- 61 controlled studies were pooled. Psychological interventions given to bereaved people in general had very small benefits right after treatment ended, and when looked at again after some time, no benefit could be seen. Interventions that enrolled only bereaved people “already clearly not coping” worked as well as psychotherapy for other psychological problems. Studies that did no screening in advance had poor results, because the group that got no intervention would also have recovered on its own over time. A further 14 randomized trials were pooled: treatment for people who already had problems was clearly better than control both after treatment and at later follow-up, and the effect was still growing after some time. Preventive interventions given broadly to people who did not yet have problems were ineffective. Another study followed 205 people from before losing their spouse to 6 and 18 months after. It identified five trajectories: common grief, chronic grief, chronic depression, improvement during bereavement, and resilience (holding up). Of these, the resilient type was the most common, and the common grief type was relatively rare
- Evidence grade
- A
- Notes
- This means “not everyone needs it,” not “no one should do it.” High-risk bereavement of the kind in Item 4 (a family member died by suicide, accident or homicide) and people already stuck as in Item 8 (if grief is stuck, go to psychiatry) are exactly the people for whom there is evidence that they should do it. A Lancet review reaches the same conclusion: grief is not an illness, and most people do not need professional intervention. The effort should go to people at high risk. And also to people who already have complicated grief, depression after bereavement, or stress disorders.
A
After separation or divorce, don't let your medical insurance lapse, and don't lean on alcohol to get through
Value for cost Standard
In plain termsPeople who are separated or divorced are clearly more likely to die early than people still married, and the rise is larger for men and younger people. This is not necessarily caused by the divorce; people who divorce may already have differed in health and income to begin with. There are two things you can control yourself: don't let your medical insurance and checkups lapse, and don't lean on cigarettes and alcohol to get through.
- Cost
- No money. Keep your medical insurance going and stop drinking. The hard part is that during this time it is easy to lean on alcohol to get through.
No money
Done in passing
Some willpower
Benefit size medium
- Benefit
- 32 studies that registered people first and then followed them forward were pooled, covering more than 6.5 million people, 160,000 deaths, more than 755,000 divorces and 11 countries. Compared with people still married, separated or divorced adults had a clearly higher risk of early death. In men and younger people the rise was more marked than in women and older people. The authors discussed four possible pathways. First, social selection: people whose health or circumstances were different to begin with are more likely to end up divorced. Second, disruption of resources: income and security are cut off. Third, changes in health behaviors: smoking, drinking and daily routines get worse. Fourth, chronic psychological stress (being tense for a long time)
- Evidence grade
- A
- Notes
- The original paper only says “clearly higher” and gives subgroup comparisons, with no multiple that can be cited, so no specific number is given here. The size of the benefit is rated medium on the basis of “the direction is known, but there is no size of reduction tied to a threshold that can be applied.” For property, debts and the betrothal gift (caili) in a divorce, see Section 8 and Section 10. For arrangements for raising the children, see Section 18.
- Sources
- Sbarra DA, et al. (2011). Divorce and Death: A Meta-Analysis and Research Agenda for Clinical, Social, and Health Psychology. Perspectives on Psychological Science. https://doi.org/10.1177/1745691611414724
B
If you need someone to talk to, call 12356; minors and young people call 12355; if you need a doctor, register at a psychological clinic
Value for cost High
In plain termsIf you want someone to talk to, call 12356, the national psychological assistance hotline; it is free. Minors and young people also have the 12355 youth comprehensive service platform. If you need a doctor, register at the psychological clinic of a psychiatry, psychology or clinical psychology department. When there is a family misfortune, a job loss or dropping out of school, community grid workers and social workers are in any case supposed to notice it on their own initiative.
- Cost
- No money. Both hotlines are free. Registering at a psychological clinic works like registering at an ordinary outpatient clinic.
No money
Done in passing
No willpower
Benefit size medium
- Benefit
- A 2026 plan from the National Health Commission and other departments, 25 in all, requires improving the working system of the 12356 psychological assistance hotline. It must ensure stable operation and raise the connection rate. It must promote building provincial-level 12356 information platforms. It must strengthen the building of linkage mechanisms with hotlines such as 110 (police). It must also build up and make good use of the 12355 youth comprehensive service platform, linking and cooperating with 12356. There are three targets for 2030. First, 80% or more of administrative villages and urban communities have a psychological counseling room or social work room and provide psychological services. Second, public psychiatric specialty hospitals at all levels, and at least 1 hospital in every county (district), provide psychological outpatient services. Third, every province has built a provincial-level 12356 psychological assistance platform. The psychological crisis intervention and psychological assistance teams are made up of psychiatrists, psychotherapy technicians, psychological counselors, social work professionals and volunteers. The plan also requires three kinds of people to stay alert day to day and spot problems early. These three are grid workers (community staff each responsible for a designated area), social work professionals and volunteers. They must promptly identify psychological crisis risks such as family misfortune, unemployment and dropping out of school (nationwide, issued in March 2026)
- Evidence grade
- B
- Notes
- It is graded B because the counseling rooms in villages and communities and the county-level psychological clinics are targets to be completed by 2030, not something every place has now. 12356 and 12355, on the other hand, can be called right now. For when 12356 opened and how many hours a day it is answered, see Section 1, Item 25. Psychological counseling and psychotherapy are not the same thing. Diagnosis and prescribing must be done by a psychiatrist, and treatment must take place in a qualified medical institution. The “healing” and “spiritual counseling” sold by the hour on the market are not part of this system.
C
In the first three months after a major upheaval, put off every irreversible big decision
Value for cost Standard
In plain termsDuring this time your judgment of all kinds of “opportunities” is at its worst. People who say they can contact the dead, who say they can help you win your money back, who urge you to quit your job and start over somewhere else, who pull you into a partnership: they will all come looking for you. Anything involving more than a month's income, or that would be very costly to reverse, push back three months, every time. First talk it through with someone who has no stake in the matter; don't decide on the same day.
- Cost
- No money; you just put decisions off, and may miss some opportunities as a result. The hard part is that at the time it will feel as if opportunities won't wait.
No money
Done in passing
Some willpower
Benefit size medium
- Benefit
- This avoids making property decisions you cannot take back during the period right after a blow, when your judgment is at its worst. These include selling a home, quitting a job, investing a death benefit or compensation payment all at once, remarrying hastily, and guaranteeing someone else's debts. The amounts involved in such decisions are usually on the order of tens of thousands of yuan up to a home, which is why the benefit is rated medium. Official documents likewise list “family misfortune, unemployment and dropping out of school” as psychological crisis risks that communities should actively screen for; the state you are in during this time is already treated as one in which outsiders need to lend a hand
- Evidence grade
- C
- Notes
- If there is no such person without a stake around you, call 12356 and talk it through (see Item 11 of this section, call 12356 when you need someone to talk to), or write it down yourself and read it again three days later. “Three months” is a line the author drew; no literature supports this specific length, so it is graded C. For common scams targeting bereaved people and older people, see Section 17 (elder-care investment, home-for-pension schemes) and Section 6 (fortune-telling). For the pitfalls of guarantees and IOUs, see Section 8. Some money you need to go and claim actively, and it is not among the things to “put off”: housing provident fund balances, social insurance benefits, and the three work-related death payments; see Section 25 and Section 19.
A
Don't use death as a way to pay off debts: life insurance doesn't pay within two years, it isn't recognized as a work injury, and debts still come out of the estate first
Value for cost Very high
In plain termsUnder a life insurance contract, suicide within two years is not paid out; only the small amount refundable from the policy is returned. It isn't recognized as a work injury either, and not a cent of the three work-related death payments is paid. Your debts are deducted first from the estate you leave behind, and your family gets only what is left. They also have to bear the health cost described in Item 4 of this section (bereavement by suicide or violent death).
- Cost
- No money; it just means working this account out clearly.
No money
Done in passing
No willpower
Benefit size large
- Benefit
- Article 44 of the Insurance Law (保险法) governs contracts under which insurance money is paid on condition of the insured person's death. If the insured person commits suicide within two years from the date the contract is formed or its validity is restored, the insurer is not liable to pay the insurance money. This does not apply where the insured person had no capacity for civil conduct at the time of the suicide, that is, a person who in law cannot be held responsible for their own actions. In such a case, the insurer shall refund the cash value of the policy as agreed in the contract, that is, it only refunds the small amount refundable from the policy and does not pay the sum insured. Life insurance sums insured are usually in the hundreds of thousands of yuan, which is why the benefit is rated large. Article 16, subparagraph (3) of the Regulations on Work-Related Injury Insurance (工伤保险条例) provides: self-harm or suicide shall not be determined to be a work injury or deemed a work injury. The three work-related death benefits in Article 39 are then all lost. First, the funeral allowance: 6 months of the local average monthly wage of employees in the previous year. Second, the pension for dependent relatives. Third, the one-time work-related death allowance: 20 times the national per capita disposable income of urban residents in the previous year. Article 1159 of the Civil Code (民法典) provides: in dividing an estate, the taxes and debts that the deceased was legally obliged to pay shall be paid off, that is, the estate first pays the taxes and debts, and only what remains is divided. Article 1161 provides: heirs pay off debts up to the actual value of the estate they receive, that is, they pay only out of what they inherit and do not have to pay out of their own pocket, and those who renounce the inheritance need not bear liability for paying off debts
- Evidence grade
- A
- Notes
- This only works out the money account. The other items in this chapter and in Section 1 are about not reaching this point. Article 44 of the Insurance Law covers only the first two years; it is written out to state the provision in full, not to give a timetable. For the family's health cost, see Item 4 of this section (for people whose spouse died by suicide, the risk of a new mental disorder within 5 years is 70% to 80% higher). For what to do when the thought arises, see Section 1, Items 25 and 32; for the aftereffects after being saved, see Section 1, Item 33. For the standards of the three work-related death payments, see Section 19, Item 15. For the specific procedures for the estate and debts, see Section 25, Item 9 (go one by one to claim the housing provident fund and social insurance benefits)
