Zihan rebuilds her mental health with help from a peer supporter

After a long day at school, Zhu Zihan, 17, returns to her family home in an apartment building in Zhangqiu, Shandong Province. She climbs the plain concrete stairs to the sixth floor and knocks on the last door. Her father, Zhu Chulin, welcomes her. It’s a bitingly cold autumn evening but warm and cosy inside. The small apartment is decorated with paintings of lotus flowers and red Chinese characters for good luck. Soft toys from Zihan’s early childhood, including the starfish from SpongeBob, still sit along the back of the sofa.

Zihan is tall for her age, wearing glasses and with her long hair in a bun. She’s a bit shy but highly articulate when she speaks. She goes with her father to the kitchen where they cook dinner together, before sharing a meal with chopsticks in the small dining area. They chat about Zihan’s progress at school. “Don’t worry if you don’t get high grades, as long as you do your best,” her father says. “If you need anything, you can call me. Dad will always be here.”

After dinner, Zihan goes to her bedroom to do her homework. Despite the comfortable environment, there is an obvious emptiness at the centre of the family. A family portrait in the lounge shows a younger Zihan smiling alongside her mother, Mingying. But six months ago, Mingying passed away from cancer at the age of 48.

“When my mum died, I cried so much,” Zihan says. “I knew she was sick, but I didn’t expect it to happen so soon. I felt completely lost. I struggled to sleep at night and couldn’t concentrate in class. I even had thoughts of not wanting to go on with life.”

“During that period, Zihan faced a huge psychological blow,” her father adds. “She couldn’t cope with what had happened.”

Peer-to-peer support

Luckily for Zihan, her school, Zhangqiu No 4 High School, is participating in the Adolescent Mental Health and Development Programme, run by UNICEF and partners. This includes training of peer supporters – students who volunteer to help their peers who have mental health challenges. They get training to provide basic support and refer students to the school counsellor when needed.

Zihan’s classmate Wenhao is one of these peer supporters. After Zihan’s mum died, Wenhao noticed how she had changed and offered to help. “Wenhao noticed I was struggling and reached out to me,” Zihan said. “Since then, I began to heal. I know this is what my mom would have wanted.”

The two girls already knew each other but, through the peer supporter toolkits and training, they became close friends. As they walk through the sprawling school campus, they hold hands, talk and listen to each other.

“I helped Zihan with her schoolwork and gave her words of comfort,” Wenhao explains. “I gradually guided her to move on from her loss. I often held her hand. Zihan and her mum used to have this habit of holding hands, so I wanted to give her the same sense of warmth and security. I also took her to see our school counsellor for professional psychological support.”

Adolescent mental health

Around the world, poor mental health is causing suffering for children and young people. It’s a top cause of death, disease and disability, especially for older adolescents. Globally, more than 13 percent of children and adolescents aged 10 to 19 (one in seven) are living with a diagnosed mental health condition, according to the World Health Organization and UNICEF. This is severely affecting their childhoods. However, with the right intervention, many of these conditions can be successfully prevented or treated.

UNICEF, the National Health Commission and the China Youth League are working together in over 300 schools across China to help adolescents improve their mental health through the Adolescent Mental Health and Development Programme. The main components are a “service package” of mental health lessons for students, “peer supporter” training for teachers and 500 peer supporters, and a referral pathway to local healthcare services.

UNICEF China’s Adolescent Development Officer Li Nan explains how the peer supporter component came about. “We did research to understand who adolescents talk and listen to about mental health,” he says. “We found that the main group was not their parents or teachers – it was their peers [cited by 78 percent of respondents]. That’s why we started training peer supporters.”

Li Nan adds that the peer support toolkits also aim to empower adolescents. “The toolkits help them develop the skills to look, listen and link cases,” he says. “This allows students to better support each other, to create better school environments, and to reduce stigma around mental health.”

In Zhangqiu No 4 High School, the programme is led by Zhao Peng, an experienced teacher who has worked on mental health for over 20 years. “Peer supporters play a crucial role in early identification and prevention,” he says. “They can help detect potential issues at an early stage.”

Zhao Peng explains that the toolkits help peer supporters learn skills such as observing and active listening, which can be applied in other aspects of life. “It helps with their every-day life, and interpersonal relations, he continues. “By sharing what they've learned, peer supporters are able to help many more students benefit from these methods.”

The impact of the programme on Zihan in just six months has been enormous. She no longer feels like she can’t go on with life. Instead, she is working through her grief, connecting with friends and family, and focusing on the future.

Her father has noticed the difference. “Over the past month, every time I picked Zihan up from school, she greeted me with a big smile,” he says. “We can’t stay buried in pain forever. We need to gradually step out of the shadows.”

Zihan is also aware of the change herself, and credits it to the help she received from Wenhao, her teachers and father. “Without them, I might not have been able to move on,” she says. “Now, I feel like I want to live my life and be happy. And if my friends or classmates face pressure or mental health challenges, I can also offer them support.”

When class ends, Zihan and Wenhao walk together to the school sports ground, holding hands as is their custom. The school, which hosts 9,900 students, is dominated by monumental red brick buildings. At lunchtime, it is often crowded and noisy, with year groups eating in shifts. Zihan and Wenhao pass a group of teenage boys, playing table tennis at a row of outside tables, and find a quiet spot on the stands above a running track. They lean over a wall, chatting together.

“Hey, what do you want to be when you grow up?” Wenhao asks Zihan, as they look out across the city skyline.

“I want to be a journalist,” Zihan replies. “Because then, I can travel the world and see more of the beautiful scenery that my mum wanted to see. I can see it for her instead.”