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29. After experiencing a major setback

Losing a loved one, receiving a serious diagnosis, losing a job, or going through a divorce — these events share one thing in common: they affect not only a person’s mood but also their physical health. The period of highest risk spans from the first few weeks up to the first year. This section does not discuss how to “get over it.” Instead, it outlines which matters need close attention, which decisions should be postponed, and when to seek medical help. Most figures here refer to the risk of death. The four items dealing with costs and benefits relate to money: avoid rushing into grief counseling right away (item 9), call 12356 and schedule a mental health appointment (item 11), postpone any irreversible major decisions (item 12), and never treat death as a way to settle debts (item 13). These two sets of numbers are not interchangeable. For those without family or friends to rely on, item 6 explains how to arrange for someone to keep an eye on things.

Details on funeral procedures, handling the body, and claiming benefits after a loved one’s death are covered in section 25. Information on guardianship and wills for elderly relatives appears in section 17. Section 7 describes unemployment benefits. Sections 3 and 22 discuss exercise and light exposure as ways to ease low mood. If suicidal thoughts arise, call 12356 first (see item 25 in section 1); the time frame for such thoughts is explained in item 32 of section 1, while lasting effects after recovery are described in item 33 of section 1. None of these topics are repeated here.

1. After a loved one passes, don’t stay alone for the first few days. Those with heart disease, high blood pressure, or diabetes should keep taking their medication. If you feel pressure or pain in the chest, call 120 right away.

  • Cost: There is no cost involved. Just avoid being alone during these days and keep taking your medicine as usual.
  • In plain terms: In the first day after losing a loved one, the risk of a heart attack is about 21.1 times higher than normal, then it drops each day afterward. For people aged 60 to 89, the rate of heart attacks or strokes within 30 days of losing a spouse roughly doubles compared to the general population, then returns to normal after a month. Those already dealing with heart disease must not skip their medication. Chest pressure, shortness of breath, or weakness in one arm or leg are clear emergency signs — call 120 immediately.
  • Benefit: This conclusion comes from a study of 1,985 acute heart attack patients, comparing their health status before and after the event. Out of them, 270 individuals (13.6%) had lost someone close within six months prior, and 19 lost a loved one just one day before the attack. Within 24 hours of such a loss, the risk of a heart attack rose 21.1 times (95% CI 13.1–34.1; actual range roughly 13 to 34 times). This risk then gradually decreased day by day. To put this into perspective: among people with a baseline 5% ten-year risk of heart attack, one extra case occurs for every 1,394 people who recently lost a loved one; for those with a 20% baseline risk, the figure is one extra case per 320 people. Another UK-based study compared 30,447 widowed individuals aged 60–89 with 83,588 similar controls. Within 30 days of bereavement, 0.16% of the bereaved group suffered a heart attack or stroke, versus 0.08% of controls — an IRR of 2.20 (1.52–3.15), meaning their risk was roughly 2.2 times higher. Specifically, heart attack risk was 2.14 times higher (1.20–3.81) and stroke risk 2.40 times higher (1.22–4.71). These elevated risks faded after 30 days. Over 90 days, two other conditions also showed increased risk: acute coronary syndrome (IRR 2.20, 1.12–4.29) and pulmonary embolism (IRR 2.37, 1.18–4.75). In total, 67 people in the control group experienced such events, and the heart attack risk was 2.1 times higher for bereaved individuals.
  • Evidence grade: A
  • Notes: Practical steps are easy to follow: ask someone else to manage your medication rather than relying on memory alone. Avoid long-distance travel during this period, and do not try to cope by drinking alcohol — details on alcohol’s effects are covered in Section 2. Recognizing heart attacks and strokes, plus instructions on calling emergency services, are explained in Section 13. Both studies referenced here rely on retrospective population data, so it’s hard to determine exactly how many participants would have developed these conditions anyway. Yet both studies point to the same general trend and timeframe. For anyone unable to arrange help or who must remain alone during these days, please see point 6 in this section.
  • Sources:Mostofsky E, et al. (2012). Risk of acute myocardial infarction after the death of a significant person in one's life: the Determinants of Myocardial Infarction Onset Study. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.111.061770；Carey IM, et al. (2014). Increased risk of acute cardiovascular events after partner bereavement: a matched cohort study. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2013.14558

2. On the week you receive a cancer diagnosis, don’t go alone to pick up the results — postpone non‑treatment decisions

  • Cost: No cost at all. Simply arrange for someone to accompany you when you collect the results, and put any major decisions unrelated to treatment off for a few days.

  • In plain terms: In the first week after receiving a cancer diagnosis, the risk of suicide is roughly 12.6 times higher than among people without a diagnosis, while the risk of dying from cardiovascular disease is about 5.6 times higher. By the end of the first year this drops to roughly 3.1 times; the effect is especially pronounced for harder‑to‑treat cancers. The greatest risk exists during those first few days, after which it falls quickly. Therefore, bring a companion when picking up the results and avoid being alone at home. Decisions such as quitting your job or selling your house can wait until your next appointment.

  • Benefit: Data from Sweden’s national registers tracked over 6.07 million people (6,073,240 individuals) from 1991 to 2006. Compared with cancer‑free controls, the relative risk of suicide in the first week after diagnosis was 12.6 (95% CI 8.6–17.8), meaning roughly 12.6 times higher. The true value lies somewhere between 8.6 and 17.8. The incidence rate during that week was 2.50 per 1,000 person‑years — about 2.5 cases per 1,000 people each year. By the end of the first year this fell to 3.1 (2.7–3.5; 0.60 per 1,000 person‑years), or roughly 3.1 times higher. Cardiovascular mortality in the first week was 5.6 times higher (5.2–5.9; 116.80 per 1,000 person‑years), and over the first four weeks it remained at 3.3 times higher (3.1–3.4; 65.81 per 1,000 person‑years). This elevated risk declines rapidly within the first year; the effect is more pronounced for cancers with poorer prognoses. Comparisons of the same patients over time yielded consistent results.

  • Evidence grade: A

  • Notes: These figures apply specifically to cancer patients. No comparable data exist for other serious diagnoses. The actual number of people affected remains low: a total of 6,073,240 individuals were included in the study, and the first‑week suicide rate is 2.50 per 1,000 person‑years, i.e., only 2.5 cases per 1,000 people each year. This information is provided not to frighten, but to emphasize the importance of having someone present during those initial days. Long‑term management, insurance coverage, and follow‑up care are discussed in Sections 16 and 24. For those unable to find a companion, see point 6 in this section, which suggests enlisting neighbours or community contacts instead.

  • Sources:Fang F, et al. (2012). Suicide and cardiovascular death after a cancer diagnosis. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa1110307

3. After losing a job, it’s important to set a regular sleep schedule, keep yibao (basic medical insurance) active, and plan job searches methodically — don’t just stay at home all day.

  • Cost: There’s no expense involved. First, register as unemployed and apply for unemployment benefits; then schedule job searches at set times. The real challenge is waking up on time when no one is there to push you.

  • In plain terms: People who are unemployed have a roughly 60% higher chance of dying in the years that follow compared to those still employed. This effect is stronger among younger men and peaks during the first decade after job loss. Some of this risk can be controlled: studies that also accounted for smoking and drinking showed a 25% smaller increase in mortality. Registering as unemployed and claiming benefits also ensures that employee medical insurance stays active (see Section 7).

  • Benefit: Data from 42 studies involving over 20 million participants and 235 mortality risk estimates show that, after adjusting for age and other factors, unemployed individuals face an average HR of 1.63 for all causes of death — meaning their risk is about 63% higher than that of employed people. This effect is more pronounced in men and in people early or midway through their careers; it diminishes after the first ten years. When lifestyle factors like smoking and drinking are included in the analysis, the average HR drops by 24%, reflecting a similar reduction in overall risk.

  • Evidence grade: A

  • Notes: These findings come from observational studies, so a direct cause‑and‑effect relationship cannot be proven; it’s also possible that poorer health contributes to unemployment. Nevertheless, the 24% reduction in risk after adjusting for health behaviors offers a useful direction for intervention. Details on eligibility for unemployment benefits, how to apply, and how to maintain social insurance coverage are provided in Section 7. Information on severance pay and why you should avoid voluntarily resigning can be found in Section 19.

  • Sources:Roelfs DJ, et al. (2011). Losing life and livelihood: a systematic review and meta-analysis of unemployment and all-cause mortality. Social Science & Medicine. https://doi.org/10.1016/j.socscimed.2011.01.005

4. People who lose a loved one to suicide, accident, or homicide should seek professional help rather than trying to cope alone

  • Cost: Calling 12356 is free of charge. Visiting a doctor and attending a psychological clinic costs the same as any other outpatient visit. The hard part is mustering the courage to reach out.
  • In plain terms: Within five years after losing a spouse to suicide, men are about 80% more likely to develop a mental disorder compared to the general population, while women are about 70% more likely. Compared to those whose spouses died from other causes, this risk is still 70% to 100% higher. Such bereaved individuals also tend to feel isolated and ashamed. This is precisely why they should actively seek help rather than waiting for things to get better on their own.
  • Benefit: A nationwide Danish registry tracked 6.7 million adults from 1980 to 2014, totaling over 136 million person-years of observation. For bereaved individuals whose spouses died by suicide, the relative risk of being newly diagnosed with a mental disorder within five years was as follows: for men, the IRR was 1.8 (95% CI 1.6–2.0), meaning a roughly 80% higher risk; for women, the IRR was 1.7 (1.6–1.8), representing a roughly 70% higher risk. Compared to those whose spouses died from other causes, the IRR for men was 1.7 (1.5–1.9) and for women 2.0 (1.9–2.2), again indicating a 70% to 100% higher risk. This group also showed higher rates of suicidal behavior, mortality, and need for municipal social assistance. Physical health risks such as cirrhosis and sleep disorders were also elevated. An additional 57 separate studies were reviewed without pooling their results. Bereavement due to suicide is linked to four key outcomes: a higher risk of suicide among surviving partners; a higher likelihood of parents being admitted to psychiatric care after their child’s suicide; a higher suicide risk among mothers after their adult child’s death; and a higher depression risk among children after their parents’ suicide. Compared to those grieving after violent deaths from other causes, people bereaved by suicide report feeling isolated and ashamed more often.
  • Evidence grade: A
  • Notes: Sudden, violent deaths refer to accidents, homicides, or disasters. After such events, rates of PTSD, depression, and prolonged grief are higher than after deaths from natural causes, and recovery tends to be slower. Guidance on handling suicidal thoughts is provided in Section 1, Item 25.
  • Sources:Erlangsen A, et al. (2017). Association Between Spousal Suicide and Mental, Physical, and Social Health Outcomes: A Longitudinal and Nationwide Register-Based Study. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2017.0226；Pitman A, et al. (2014). Effects of suicide bereavement on mental health and suicide risk. The Lancet Psychiatry. https://doi.org/10.1016/S2215-0366(14)70224-X；Kristensen P 等 (2012). Bereavement and mental health after sudden and violent losses: a review. Psychiatry. https://doi.org/10.1521/psyc.2012.75.1.76（备注里那份综述）

5. In the first six months after losing a spouse, assign one trusted person to oversee meals, sleep, medication for chronic conditions, and follow‑up appointments

  • Cost: No expense at all. Simply choose someone — a child, sibling, or friend — and ask them to visit regularly or call you. The hard part is actually asking them to take on this responsibility.
  • In plain terms: Within the first six months after a spouse passes away, the risk of dying is roughly 40% higher than for people who haven’t lost a spouse. After six months it drops to about 15% higher. For men the increase is roughly 23%; for women the difference is so small it may well be a coincidence. This extra risk cannot be offset simply by staying positive. The practical step is to hand off medication, meals, and medical check‑ups to a specific person rather than relying on your own memory.
  • Benefit: Data from 15 studies that were registered beforehand and later tracked a total of 2,263,888 participants show that within six months of losing a spouse the relative risk of death is 1.41 (95% CI 1.26–1.57), meaning the death probability is about 40% higher than for non‑bereaved individuals. After six months this drops to 1.14 (1.10–1.18), a 15% increase. For men the relative risk is 1.23 (1.18–1.28), a 23% rise; for women it is 1.04 (1.00–1.08), a difference that is not statistically significant and may simply be a fluke. No notable difference was found between people under 65 and those 65 or older. Another analysis combining 123 publications, 1,377 risk estimates, and over 500 million people yielded a hazard ratio of 1.23 (1.19–1.28), indicating a 23% overall increase in mortality. Men again face a higher risk than women: their hazard ratio is 1.27 (1.19–1.35), a 27% rise, while for women it is 1.15 (1.08–1.22), a 15% increase.
  • Evidence grade: A
  • Notes: These findings come from retrospective analyses of population data; other confounding factors cannot be completely ruled out because spouses naturally share similar lifestyles and health patterns. Nevertheless, the consistent pattern — a markedly higher risk in the first half‑year compared to later periods — observed in two independent meta‑analyses makes this period a worthwhile window for extra care. Men tend to have higher risk and are less likely to ask for help. Families with bereaved elders should follow Section 17 to sort out accounts, guardianship, and wills. For those who cannot find such a person — whether living alone, having no surviving children, or lacking any close relatives — they should turn to community resources and mobile tools as described in Section 6.
  • Sources:Moon JR, et al. (2011). Widowhood and mortality: a meta-analysis. PLoS ONE. https://doi.org/10.1371/journal.pone.0023465；Shor E, et al. (2012). Widowhood and mortality: a meta-analysis and meta-regression. Demography. https://doi.org/10.1007/s13524-012-0096-x

6. For those with no relatives or friends, replace “someone watching over you” with three simple things: a neighbor who can enter your home, a list of community outreach services, and emergency contacts saved on your phone.

  • Cost: No expense at all. The hard part is simply reaching out — telling a neighbor or a member of the Residents’ Committee, “I live alone and have just experienced a crisis.”
  • In plain terms: When you have no family or friends, the phrase “finding someone to help” is essentially meaningless. In reality, it refers to two separate goals: first, ensuring that if something happens, someone will notice and intervene; second, making sure you take your medication and eat regularly on your own. To achieve the first goal, you need three things: leave a spare key with a neighbor, sign up for community outreach programs through the Civil Affairs Bureau, and set up reliable emergency contacts on your phone.
  • Benefit: This study tracked 44,573 outpatients diagnosed with atherosclerosis or at high risk for blood clots — conditions where plaque buildup can easily lead to blockages. Enrolled between December 2003 and December 2004, these patients were followed for four years as part of the international REACH project. Of these, 8,594 individuals (19%) lived completely alone. Over the four-year period, the overall mortality rate among solitary residents was 14.1%, compared to 11.1% among those living with others. Cardiovascular-related deaths also proved higher: 8.6% versus 6.8%. Both figures showed statistically significant differences (log-rank P<0.01). The effect varied by age: for people aged 45–65, solitary living raised mortality from 5.7% to 7.7%; after adjusting for other factors, the hazard ratio was 1.24 (95% CI 1.01–1.51). Among those aged 66–80, the rate rose from 12.3% to 13.2%, with a hazard ratio of 1.12 (1.01–1.26). Conversely, for individuals over 80, solitary living actually lowered mortality from 28.4% to 24.6 (hazard ratio 0.92). In 2022, China’s Ministry of Civil Affairs issued guidelines mandating regular outreach services for vulnerable seniors — including those living alone, disabled, or without family support. These services involve home visits, phone check-ins, video calls, and remote monitoring, all coordinated through local neighborhood committees. By the end of 2025, the goal is to ensure that every at-risk senior receives at least one monthly visit. The policy also encourages households to install smart emergency call devices, water meters, and health monitors capable of alerting designated contacts instantly. Community workers are required to respond immediately to any emergency signals. It is important to note that the absolute risk increase for mortality in this group is 0.03, while the absolute risk reduction is 0.79, and the absolute risk difference is 1.06. Additionally, 79.2% of cardiac arrests occur at home, making it vital to have someone nearby.
  • Evidence grade: B
  • Notes: Here is exactly how to implement these three measures. First, give a spare key or temporary lock code to a trusted neighbor or property manager, and let them know you’ll be alone for a few days. No deep friendship is necessary — just ensure someone knows you’re inside. Second, visit your local Residents’ Committee and request inclusion on the outreach registry; elderly individuals living alone or without family are explicitly covered by this program, and you can also ask whether free smart alarms or water meters are available locally. Third, program emergency contacts and a medical ID card into your phone, and keep it on and unmuted during this period. This recommendation earned a B grade for two reasons. First, while the link between solitary living and higher mortality is well-documented, it remains possible that people in poorer health or with fewer resources are more likely to live alone — a reverse causation that the study itself acknowledges as needing further validation. Second, the outreach policy currently applies only to seniors; younger adults lack comparable support systems. However, the same directive does require community workers to identify individuals facing sudden hardships such as job loss or emotional distress (see Section 11 regarding the 12356 counseling hotline). Why does having someone nearby matter so much? As shown in Section 13, when cardiac arrest occurs outside a hospital, survival rates jump dramatically when bystanders perform CPR: 16.1% of victims survive when help is present, versus just 3.9% when no one is around. Living alone essentially places you in that lower survival bracket. Additionally, arranging these steps can double as a practical daily routine: funeral arrangements often require multiple visits to cemeteries, health clinics, police stations, and the Housing Provident Fund office (see Section 25), so scheduling these errands each day provides structure during a difficult time. Finally, remember that the 12356 helpline is available for repeated use, not just a single call (see Section 11). While living alone remains a long-term risk factor — with a hazard ratio of 1.32 for overall mortality, as discussed in Section 22 — this advice specifically targets immediate safety during a temporary crisis.
  • Sources:Udell JA, et al. (2012). Living alone and cardiovascular risk in outpatients at risk of or with atherothrombosis. Archives of Internal Medicine. https://doi.org/10.1001/archinternmed.2012.2782；民政部等十部门 (2022). 关于开展特殊困难老年人探访关爱服务的指导意见（民发〔2022〕73 号）. https://www.gov.cn/zhengce/zhengceku/2022-10/13/content_5718017.htm

7. After a parent dies, tell the child the truth, let him attend the funeral, and don’t send him to another environment

  • Cost: There is no monetary cost. The difficulty lies in the fact that you yourself are grieving, yet you must still explain things clearly to your child.

  • In plain terms: Children who lose a father or mother before age 18 have a mortality rate in early adulthood that is roughly 50% higher than those who have not experienced such a loss. If the death was due to unnatural causes such as accidents or suicide, the risk rises by about 80%. If it was due to illness or other natural causes, the risk is about 30% higher. This is not something a child simply forgets after a few days; the effects can last many years. What you can do is tell the truth, let him attend the funeral, keep him in school, and avoid sending him to relatives’ homes to “change his environment.”

  • Benefit: This data includes the entire populations born in Denmark from 1968 to 2008 and in Sweden from 1973 to 2006, plus 89.3% of those born in Finland from 1987 to 2007 — a total of over 7.3 million people. Among them, 189,094 lost one or both parents before age 18. Their overall mortality rate is 50% higher than that of peers who have not experienced such a loss (mortality ratio 1.50, 95% CI 1.43–1.58, roughly 1.5 times higher). For deaths caused by unnatural reasons, the ratio is 1.84 (1.71–2.00), an increase of about 80%. For deaths due to natural causes, it is 1.33 (1.24–1.41), a rise of about 30%. The risk is highest when the child’s cause of death matches that of the parent.

  • Evidence grade: B

  • Notes: When speaking to your child, do not make up stories such as “Mom or Dad has gone away on a trip.” Any arrangements regarding guardianship and upbringing must be put in writing. This recommendation is graded B not because the figures lack solidity; these statistics come from longitudinal studies of entire populations in three countries, which would merit an A rating on their own. The lower grade reflects the absence of direct experimental evidence linking these mortality figures to specific ways of communicating with children or involving them in funerals. The authors also point out that data on parent-child relationships and children’s lifestyles after such a loss are lacking. Both genetic factors and long-term effects of bereavement contribute to these elevated mortality rates. Details on designated guardians and property arrangements can be found in Section 17, while information on child support and schooling is covered in Section 18.

  • Sources:Li J, et al. (2014). Mortality after parental death in childhood: a nationwide cohort study from three Nordic countries. PLoS Medicine. https://doi.org/10.1371/journal.pmed.1001679

8. Still stuck in grief after half a year, unable to move on — when to see a psychiatrist or clinical psychologist

  • Cost: This includes registration fees and treatment costs. Treatment is delivered in sessions; on average, 16 sessions are given over 19 weeks in clinical trials. The main challenge is simply mustering the courage to make that first appointment.

  • In plain terms: Roughly 1 out of every 10 adults who lose a loved one gets stuck in prolonged grief: after more than six months they still miss the deceased so much they can’t eat, work, or care for their children. They feel numb and see no point in living. This isn’t a sign of personal weakness — it meets specific diagnostic criteria and has dedicated treatments. Targeted therapy achieves a success rate of 51%, while standard psychotherapy reaches only 28% and takes longer to show results.

  • Benefit: Fourteen studies involving adults whose loved ones died of non‑violent causes and who had not previously sought mental‑health care reveal that prolonged grief disorder affects 9.8% of this group (95% CI 6.8–14.0), meaning about 10 out of every 100 bereaved adults are impacted. The rate rises with age. Another study tested the diagnostic criteria on 291 bereaved individuals through interviews at 0–6, 6–12, and 12–24 months after loss. The core symptom is intense longing for the deceased; at least five of nine additional criteria must also be present. The first five criteria are emotional numbness, shock, feeling life lacks meaning, distrust of others, and distress caused by the loss. The remaining four are difficulty accepting the loss, trouble defining one’s own identity, avoidance of reality, and an inability to carry on daily life. All these symptoms must appear daily or be severe enough to impair functioning, and they must persist for at least six months after the death. A randomized trial of 95 participants receiving 16 therapy sessions over 19 weeks found a 51% success rate for specialized treatment versus 28% for standard interpersonal psychotherapy (P = 0.02, a statistically significant difference). Consequently, only 4.3 patients need to be treated for one additional person to experience improvement.

  • Evidence grade: A

  • Notes: Don’t fixate on exact time limits. The real indicator is whether grief interferes with eating, sleeping, work, or childcare — if so, it’s time to seek help. The appropriate clinics are psychiatry, psychology, or clinical psychology departments, all of which are available at public psychiatric hospitals. This condition is known as prolonged grief disorder or complex grief in various sources; required duration varies from six to twelve months across different guidelines. The 9.8% prevalence figure stems from 14 studies with differing methodologies, so authors caution that it may not apply universally to all populations.

  • Sources:Lundorff M, et al. (2017). Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2017.01.030；Prigerson HG, et al. (2009). Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Medicine. https://doi.org/10.1371/journal.pmed.1000121；Shear MK, et al. (2005). Treatment of complicated grief: a randomized controlled trial. JAMA. https://doi.org/10.1001/jama.293.21.2601

9. Don’t spend money on grief counseling right away — first check whether your grief is truly stuck (see the symptoms listed in item 8).

  • Cost: No cost at all; in fact, this approach saves you the expense of counseling.
  • In plain terms: Offering psychological counseling to every bereaved person right after their loss yields little benefit at first, and over time those benefits disappear entirely. The reason is that most people without any intervention would have recovered on their own anyway. However, for those who clearly struggle to adapt, such counseling works just as well as treatment for other mental health issues. So the proper sequence is: first check whether your grief fits the criteria in item 8 (meaning it’s stuck and warrants a visit to a psychiatrist); only if it does should you spend the money on counseling.
  • Benefit: Data from 61 comparative studies confirm this pattern. General psychological intervention for all bereaved individuals shows minimal benefits right after treatment, which fade further over time. When counseling is limited to those who clearly cannot adapt, its effectiveness matches that of treatment for other mental health conditions. Poor results from studies without prior screening stem from the fact that the control group would have recovered on its own over time. Another 14 randomized controlled trials also show consistent results: treatment for people already experiencing difficulties brings significantly better outcomes than controls both immediately after treatment and during follow-ups, with benefits growing over time. Preventive intervention for people without any issues, however, proves ineffective. One study tracked 205 individuals from before and after the loss of a spouse at 6 and 18 months, identifying five possible trajectories: normal grief, prolonged grief, chronic depression, improvement following the loss, and resilience. The most common path is resilience, while normal grief is relatively rare.
  • Evidence grade: A
  • Notes: This recommendation means “not everyone needs it” rather than “no one should get it.” Those in high-risk groups per item 4 (bereaved after suicide, accidents or violent deaths) and those meeting the criteria in item 8 (grief that has become stuck and warrants psychiatric evaluation) are precisely the individuals for whom such counseling is supported by evidence. This same conclusion appears in a review published in The Lancet. Grief itself is not a disease, and most people do not require professional intervention. Resources should instead be directed toward high-risk individuals and those already suffering from complicated grief, post-loss depression or post-traumatic stress disorder.
  • Sources:Currier JM, et al. (2008). The effectiveness of psychotherapeutic interventions for bereaved persons: a comprehensive quantitative review. Psychological Bulletin. https://doi.org/10.1037/0033-2909.134.5.648；Wittouck C, et al. (2011). The prevention and treatment of complicated grief: a meta-analysis. Clinical Psychology Review. https://doi.org/10.1016/j.cpr.2010.09.005；Bonanno GA, et al. (2002). Resilience to loss and chronic grief: a prospective study from preloss to 18-months postloss. Journal of Personality and Social Psychology. https://doi.org/10.1037/0022-3514.83.5.1150；Stroebe M 等 (2007). Health outcomes of bereavement. Lancet. https://doi.org/10.1016/S0140-6736(07)61816-9（备注里那份综述）

10. Don’t drop yibao or turn to alcohol after separating or divorcing

  • Cost: Zero. Simply keep your yibao active and quit drinking. The hard part is resisting the urge to use alcohol as a crutch during this transition period.
  • In plain terms: An analysis of 6.5 million people across 11 countries shows that separated or divorced individuals face a significantly higher risk of premature death than those still married. This effect is stronger among men and younger adults. The original text does not claim a direct causal link, as divorced people may already differ in health and income. Of the four proposed reasons, two are within personal control: maintaining yibao and regular health check‑ups, and avoiding reliance on tobacco and alcohol.
  • Benefit: Data from 32 longitudinal studies involving over 6.5 million participants, 160,000 deaths, and more than 755,000 divorces across 11 countries confirm that separated or divorced adults have a markedly higher risk of early death compared with married peers. The increase is especially pronounced for men and younger individuals. Four possible mechanisms are discussed: selection bias (healthier or better‑off people may be less likely to divorce), loss of financial and insurance support, deterioration of health‑related habits such as smoking and drinking, and chronic psychological stress from ongoing tension.
  • Evidence grade: A
  • Notes: The source only notes a “significant rise” and provides group comparisons without specific risk‑ratio figures, so no exact numbers are reported here. Given that the evidence points to a clear direction but lacks a quantifiable threshold, the overall benefit is rated as moderate. Issues related to property, debts, and betrothal gifts at the time of divorce are covered in Sections 8 and 10; child‑custody arrangements are discussed in 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

11. Call 12356 for general support, 12355 for minors and teens; for medical care, book a psychology clinic appointment

  • Cost: No cost involved. Both hotlines are free to call. Psychology clinic visits are billed at standard outpatient rates.
  • In plain terms: If you need someone to talk to, dial 12356 — this is the national mental health helpline, and it’s completely free. Minors and teenagers can call 12355, the dedicated youth support service. If you need professional medical care, you can book an appointment at a psychiatry, psychology, or clinical psychology clinic. Community grid workers and social workers are also expected to proactively identify people facing family issues, job loss, or school dropout.
  • Benefit: A 2026 plan jointly issued by 25 government departments including the National Health Commission calls for improving operational rules for the 12356 mental health helpline. Goals include ensuring stable service delivery, raising call connection rates, developing a provincial-level digital platform for 12356, and strengthening coordination between 12356 and other emergency hotlines such as 110. The plan also aims to expand and optimize the 12355 youth support service, integrating it with 12356. By 2030, three key targets must be met: over 80% of administrative villages and urban communities must have mental health counseling rooms or social service centers offering relevant services; every county-level area must have at least one public psychiatric hospital or medical facility providing psychology clinic services; and all provinces must have their own provincial 12356 platforms. The mental health crisis response and support workforce includes psychiatrists, psychotherapists, counselors, social workers, and volunteers. The plan also specifies three groups who must stay alert to early warning signs of mental health risks: community grid workers, social workers, and volunteers. They are tasked with promptly identifying situations such as family crises, job loss, or school dropout. (Source: National policy document issued March 2026)
  • Evidence grade: B
  • Notes: This grade is assigned because the establishment of counseling rooms in villages and communities and psychology clinics at county level are only planned targets for 2030, not yet universally available nationwide. Both 12356 and 12355 are already operational. Details on the launch date and daily operating hours of 12356 can be found in Section 1, Article 25. It is also important to note that psychological counseling and psychotherapy are distinct services: only licensed psychiatrists can make diagnoses and prescribe medication, and psychotherapy must be delivered at qualified medical institutions. Private, hourly-fee “healing” or “spiritual counseling” services fall outside this official framework.
  • Sources:国家卫生健康委等 25 部门 (2026). 关于印发健全社会心理服务体系和危机干预机制实施方案的通知（国卫医政发〔2026〕8 号）. https://www.gov.cn/zhengce/zhengceku/202604/content_7065035.htm

12. In the first three months after a tragedy, postpone any irreversible major decisions

  • Cost: There is no monetary cost — you simply delay decisions, which may cause you to miss certain opportunities. It can be hard to accept at the time, since opportunities often seem to vanish quickly.
  • In plain terms: During this period, your ability to judge what truly counts as an “opportunity” is at its weakest. People will approach you with offers — some claiming to let you contact the deceased, others promising to multiply your money, some urging you to quit your job and start anew elsewhere, and still others seeking a business partnership. Set a strict rule for yourself: any decision involving an amount greater than one month’s income, or any choice that would be costly to reverse, must be postponed for three months. First, discuss it with someone who has no personal stake in the matter; you simply need someone to listen so you won’t have to decide on the spot.
  • Benefit: This rule helps you avoid making irreversible financial moves when you’re still reeling from a loss and your judgment is impaired. Such moves include selling your home, quitting your job, investing a lump sum of bereavement or compensation payouts, rushing into a new marriage, or acting as a guarantor for someone else. These decisions often involve sums ranging from tens of thousands of yuan up to the value of a house, which is why the benefit level is rated as moderate. Official documents also list “family tragedy, job loss, or dropping out of school” as risk factors for psychological distress that communities should monitor — meaning this period is already recognized as one where outside support is needed.
  • Evidence grade: C
  • Notes: If you have no such neutral third party nearby, call 12356 and explain your situation (see item 11 in this section on using this line to talk to someone). You can also write down your thoughts and reread them after three days. The “three‑month” timeframe is an author‑set guideline with no scholarly backing, which is why the evidence grade is C. Common scams targeting bereaved individuals and seniors are covered in sections 17 (investment and housing schemes) and 6 (fortune‑telling). Pitfalls related to guarantees and promissory notes are discussed in section 8. A few financial actions must be handled promptly and cannot be postponed: withdrawing your housing provident fund balance, claiming social insurance benefits, and receiving compensation for a work‑related death — details are provided in sections 25 and 19.
  • Sources:作者经验，无直接文献；「家庭变故、失业、失学」作为心理危机风险的表述见国家卫生健康委等 25 部门 (2026). 健全社会心理服务体系和危机干预机制实施方案（国卫医政发〔2026〕8 号）. https://www.gov.cn/zhengce/zhengceku/202604/content_7065035.htm

13. Don’t treat death as a way to settle debts: life insurance won’t pay out for suicides within two years, workplace injuries won’t be recognized, and debts are still deducted from your estate first.

  • Cost: There’s no direct expense — you just need to run the numbers.

  • In plain terms: Life insurance policies that pay out upon death won’t cover suicides committed within two years of purchase. Only the cash value of the policy is returned. Workplace injuries are also not covered, so any benefits for death on the job are forfeited entirely. Debts don’t disappear with death; they’re deducted from your estate first, leaving your family with whatever remains. This creates a financial shortfall for them, plus the health consequences outlined in Section 4 (relatives of suicide victims face a 7–8 times higher risk of developing mental disorders within five years). The total amount of life insurance payouts typically reaches 100,000 yuan, which is why this benefit is classified as significant.

  • Benefit: Article 44 of the Insurance Law governs contracts where death is the condition for payout. Within two years of the contract’s effective date, if the insured commits suicide, the insurer is not obligated to pay the full benefit amount. However, the insurer must return the policy’s cash value — essentially the amount that can be refunded — rather than the full coverage sum. Life insurance payouts typically reach 100,000 yuan, which is why this benefit is classified as significant. Article 16, Paragraph 3 of the Work Injury Insurance Regulations states that self-harm or suicide does not qualify as a workplace injury, thereby disqualifying victims from receiving any of the three types of compensation outlined in Article 39: a funeral subsidy equal to six months of local average monthly wages, survivor’s allowances, and a one-time death benefit equal to 20 times the previous year’s national per capita disposable income for urban residents. Meanwhile, Article 1159 of the Civil Code mandates that estate distribution must first settle any legally required taxes and debts, meaning those obligations are deducted from the estate before any shares are allocated. Article 1161 further clarifies that heirs are only responsible for debts up to the actual value of the inherited assets; they aren’t personally liable beyond that, and those who decline inheritance bear no such obligations.

  • Evidence grade: A

  • Notes: This entry focuses solely on the financial implications. Other sections and Section 1 emphasize avoiding such scenarios altogether. Article 44 of the Insurance Law applies only to the first two years post-policy issuance; it is included here for completeness, not as a strict timeline. The health impacts on family members are detailed in Section 4. For coping strategies when suicidal thoughts arise, refer to Sections 1, Items 25 and 32; information on post-recovery complications can be found in Section 1, Item 33. The exact amounts for the three types of work injury benefits are specified in Section 19, Item 16. Procedures for accessing housing provident fund and social insurance payouts from an estate are outlined in Section 25, Item 9.

  • Sources:全国人大常委会 (2015 修正). 中华人民共和国保险法第四十四条. https://flk.npc.gov.cn/detail?id=2c909fdd678bf17901678bf7c4060811；国务院 (2010 修订). 工伤保险条例（国务院令第 586 号）第十六条、第三十九条. https://www.gov.cn/gongbao/content/2011/content_1778064.htm；全国人大 (2020). 中华人民共和国民法典第一千一百五十九条、第一千一百六十一条. https://flk.npc.gov.cn/detail?id=ff808081729d1efe01729d50b5c500bf