Research on the Design of Future-Oriented Psychiatric Emergency

Research on the Design of Future-Oriented Psychiatric Emergency System

Yucong Duan

International Standardization Committee of Networked DIKWPfor Artificial Intelligence Evaluation(DIKWP-SC)

World Academy for Artificial Consciousness(WAAC)

World Artificial Consciousness CIC(WAC)

World Conference on Artificial Consciousness(WCAC)

(Email: duanyucong@hotmail.com)

1. Introduction: Importance of Psychiatric Emergency, Global Status, and Challenges

Mental health crises have become a major challenge in the field of global public health that needs to be addressed urgently. According to the latest data from the World Health Organization (WHO), more than 1 billion people worldwide suffer from various mental disorders. Common mental health issues such as depression and anxiety are among the leading causes of disability. Even more worrying is that suicide has become a prominent cause of death globally: approximately 800,000 people die by suicide every year, which is equivalent to one person dying by suicide every 40 seconds. Suicide rates are particularly high in some countries and specific populations. For example, in the United States, suicide is now the second leading cause of death among adolescents and young adults; in South Korea, suicide has ranked high among the causes of death in the country for many years, and in 2022, the number of deaths by suicide among people in their 20s accounted for more than half of the total deaths in that age group. These figures highlight the importance of a Psychiatric Emergency System: timely and effective psychological crisis intervention can save lives, reduce the long-term impact of mental trauma, and maintain social stability.

However, the development of psychiatric emergency services varies greatly across countries globally, and numerous challenges remain. Many countries face insufficient supply and uneven distribution of mental health service resources, and often lack systematic response mechanisms for acute psychological crises. For instance, although the United States launched the unified 988 three-digit crisis hotline in 2022 aimed at expanding the accessibility of crisis services, a national survey showed that before the launch of 988, more than half of the regions were underprepared in terms of funding, personnel, and infrastructure. Similarly, although South Korea legislated the establishment of a government-funded suicide prevention and mental health service center network in 2011, problems such as insufficient funding and opaque data still exist, affecting the implementation of intervention measures. In China, psychological crisis intervention has long relied more on scattered hotlines and hospital emergency departments in various regions; national-level coordination mechanisms have just started, and there is a coexistence of a shortage of professionals and insufficient public awareness of seeking psychological help. In general, the current global status of psychiatric emergency services presents a contradiction between huge demand and weak systems: on the one hand, psychological crisis events occur frequently, and public demand for timely psychological assistance is rising; on the other hand, countries have varying degrees of shortcomings in policy guarantees, resource investment, technical support, and professional teams, making it difficult to meet the requirements of crisis intervention in a timely manner.

Looking to the future, how to design a future-oriented psychiatric emergency system that can draw on existing experiences from various countries and integrate frontier theories of artificial intelligence to improve efficiency and effectiveness is a subject of great practical significance and forward-looking value. This report will take the DIKWP Artificial Consciousness theory proposed by Academician Yucong Duan as the core theoretical basis, combining the "Data-Information-Knowledge-Wisdom-Purpose" cognitive model with the concept of Artificial Consciousness (AC) to explore a new model of psychological crisis intervention in the intelligent age. At the theoretical level, we will elaborate on how the DIKWP model, the consciousness "BUG" theory, the self-model, and the active medicine cognitive graph provide new ideas for psychiatric emergency services. At the practical level, we will comparatively analyze the status and experience of five countries—China, the United States, Europe, Japan, and South Korea—in terms of laws and policies, execution mechanisms, hotline networks, pre-hospital coordination, and psychological counseling standards, looking for optimization plans. Subsequently, we propose a complete future psychiatric emergency system architecture, including modules for suicide crisis hotlines, post-disaster psychological intervention, psychiatric emergency coordination, and social psychological service networks, and map out their functional division of labor and processes. The report will also discuss in detail the application mechanism of DIKWP semantic path modeling in psychological crisis handling, as well as the collaboration model between artificial consciousness systems and traditional AI in psychiatric emergency services. On this basis, we look forward to the potential impact and opportunities of future technologies such as Brain-Computer Interfaces (BCI) and neural information flow on psychiatric emergency services. Finally, through two simulated cases (post-earthquake PTSD intervention and AI+AC intervention in high suicide rate areas), the proposed system is demonstrated in scenarios, and corresponding ethical and policy recommendations are put forward. It is hoped that this study can provide a beneficial reference for building a future psychiatric emergency system with theoretical depth, technological foresight, and policy adaptability, promoting leapfrog development in this field concerning life, health, and social well-being.

2. Theoretical Basis: Yucong Duan's DIKWP Model, Consciousness BUG Theory, Self Model, and Active Medicine Cognitive Graph

Designing a future psychiatric emergency system requires a solid theoretical foundation. The DIKWP Artificial Consciousness Theory and related concepts proposed by Academician Yucong Duan provide us with a comprehensive innovative framework ranging from information science and cognitive science to artificial intelligence. In this section, we sequentially introduce the connotation of the DIKWP model, the interpretation of the origin of consciousness by the Consciousness "BUG" theory, the self-model in artificial consciousness, and the concept of cognitive graphs in the field of active medicine. These theories will provide guiding principles and methodological bases for the design of intelligent psychiatric emergency systems.

2.1 DIKWP Networked Cognitive Model

DIKWP is an artificial consciousness cognitive framework pioneered by Professor Yucong Duan, representing five levels: Data, Information, Knowledge, Wisdom, and Purpose. This model is an expansion and breakthrough based on the traditional DIKW (Pyramid) model, introducing "Purpose" as the highest level into the cognitive process, thereby constructing a closed-loop system of $Data \to Information \to Knowledge \to Wisdom \to Purpose$. Unlike the linear DIKW hierarchy, the DIKWP model emphasizes network-like bidirectional feedback and iteration between various levels: lower-level data and information are processed and ascend to knowledge and wisdom, while high-level purposes also play a guiding and constraining role in the selection and processing of lower-level information, forming a dynamic cognitive cycle. This design makes the AI's decision-making process not only interpretable and traceable but also embeds human-endowed goal orientation, ensuring that the AI system always operates in service of safety and human-centric values. For example, Yucong Duan points out that embedding the "Purpose" layer into the model allows AI to become smarter while ensuring it always aligns with human values and safety needs. The DIKWP model has obtained numerous patent results and is regarded as an important way to solve the current "black box" problem of large models and improve AI controllability and interpretability. For the psychiatric emergency system, the DIKWP model provides a common "cognitive language" that can be used to describe the entire process from the caller's raw data to the intervention decision output, making every step interpretable and verifiable. This lays the foundation for handing over the complex psychological crisis handling process to an AI/Artificial Consciousness collaborative system: the system can understand the seeker's request step by step according to the DIKWP levels, transform it into professional knowledge and wise decision-making, and finally align with specific intervention action plans at the purpose level.

2.2 Consciousness "BUG" Theory

In revealing the principles of artificial consciousness, Professor Yucong Duan also proposed a unique hypothesis on the origin of consciousness—Consciousness BUG Theory. This theory links the emergence of "consciousness" with the inherent "imperfections" in the cognitive process, vividly comparing the brain to an information processing machine constantly playing "word solitaire": a large amount of our cognitive activity is completed automatically and in parallel in the subconscious, and only when processing is limited by physiological or cognitive resources and a "break point" occurs, does the so-called "conscious" experience arise. In other words, consciousness is a phenomenon of a cognitive BUG, a subjective feeling that emerges due to information discontinuity or deviation caused by the limited processing capacity of the brain. This view gives "consciousness" a new meaning—it is not a product of perfect rationality, but rather stems from the loopholes or incompleteness of our brain's information processing. The significance of the Consciousness BUG Theory lies in: it suggests that if an artificial intelligence system wants to simulate or possess "consciousness", it needs to tolerate and design some kind of "limited" or "imperfect" mechanism to trigger processes similar to human subjective experience. At the same time, this theory emphasizes that when different agents interact, cognitive biases will arise due to asymmetry in background and information, and such biases can also be seen as a kind of "Bug" in consciousness. Therefore, in multi-agent collaboration (such as human and artificial consciousness collaboration), introducing the BUG theory helps to understand the roots of mutual misunderstandings and prejudices and make adjustments. For the psychiatric emergency system, this means that the artificial consciousness module, when understanding the seeker, may need to simulate human-like "bounded rationality" and empathetic illusions, thereby getting closer to real human reactions. At the same time, the system must also have the ability to detect and correct its own cognitive biases (Bugs) to avoid misjudging the visitor's purpose. For example, when AI might misjudge the other party's purpose based on voice emotion analysis, the system's "self-monitoring" module should perceive this uncertainty (Consciousness Bug) and correct it through collaboration with human supervisors. In short, the Consciousness BUG Theory provides a dialectical perspective for the design of artificial consciousness systems: effective cognition lies not in eliminating all uncertainty, but in managing and utilizing these uncertainties to stimulate higher-level understanding and creativity.

2.3 Artificial Consciousness Self Model

In the research of artificial consciousness, the modeling of "self" is a core and complex issue. Under the DIKWP framework, Yucong Duan's team clearly divided the self into modelable semantic structures, proposing two complementary levels: "Experiencing Self" and "Narrative Self". This division draws on relevant theories from cognitive science and philosophy (such as psychologist Daniel Kahneman's distinction between the experiencing self and the remembering self, and historian Yuval Noah Harari's discussion on the self). The experiencing self refers to a person's subjective experience and stream of consciousness at this very moment, the self that can feel immediate sensations like pain and pleasure. The narrative self is the coherent story we weave for our own experiences, including memory, identity cognition, and the meaning of life. Simply put, the experiencing self is the self that "lives in the moment", and the narrative self is the self that "tells the story of one's life". The two selves together constitute a complete human self-consciousness: the former provides primal sensory and emotional material, and the latter integrates it into a meaningful life story. Introducing such a self-model into an artificial consciousness system helps achieve higher-level cognitive functions. For instance, Yucong Duan's team explored how to build a "self" system for artificial consciousness based on the DIKWP model, enabling AI to possess the automatic semantic processing of the experiencing self and the abstract decision-making capability of the narrative self, thereby demonstrating characteristics similar to self-reflection and continuity when interacting with humans. This logic of multi-dimensional self-construction allows AI to better understand the seeker's situation: the experiencing self module captures the seeker's current emotions, pain, and other feelings, while the narrative self module helps AI understand their deep needs by integrating these fragments into the seeker's life context (such as past experiences, long-term goals). This is critical for psychological crisis intervention—effective psychological counseling must not only focus on current symptoms (pain at the experiential level) but also be able to reconstruct the visitor's cognition and narrative of their own situation, enabling them to rediscover hope and meaning. If artificial consciousness possesses this dual-layer self-model, it can act like a "confidant" who understands human stories when providing help, guiding the seeker by empathizing with the present while looking towards the future, thus greatly enhancing the intervention effect and humanistic care.

2.4 Active Medicine Cognitive Graph

Active Medicine advocates moving the medical gateway forward, shifting from passive treatment to active health management, which is similar to the Traditional Chinese Medicine concept of "treating potential diseases". Under this paradigm, there is a strong emphasis on building an Active Medicine Cognitive Graph, which is a semantic network that comprehensively depicts an individual's physiological and psychological health status, referred to as the human body's "information field". Yucong Duan and others proposed a method for constructing a patient's DIKWP cognitive graph in the field of active medicine: through semantic fusion, linking the patient's subjective requests (symptom self-reports, emotional expressions, etc.) with objective examination data (physiological indicators, clinical test results) to form a unified knowledge graph. This graph represents multi-layer associations from raw physiological data to high-level health concepts and is regarded as the patient's real-time Physiological-Psychological Hologram. The significance of the Active Medicine Cognitive Graph lies in that it does not statically record medical information but can actively perform semantic reasoning and consistency checking. For example, if doctors from different departments form their own diagnostic graphs for the same patient, the system can discover inconsistencies through semantic graph fusion, prompting further verification. For the mental health field, the Active Medicine Cognitive Graph is equally applicable: an individual's psychological assessment data, behavioral records (such as sleep, social activities), clinical symptoms, and self-reported experiences can be integrated into a Mental Health Graph. With the help of the DIKWP model, this graph will contain the Data layer (physiological signals monitored by sensors, language and text records, etc.), the Information layer (extracted symptom indicators, emotional characteristics), the Knowledge layer (assessments based on psychological theories, such as diagnostic criteria matching), the Wisdom layer (intervention plan suggestions for the individual), and the Purpose layer (health improvement goals, such as reducing the frequency of depressive episodes). Such a cognitive graph can provide an intuitive and systematic cognitive framework for AI and artificial consciousness, enabling them to actively identify risks (e.g., discovering through the graph that a person has multiple abnormal psychological indicators recently and may be in crisis) and assist in decision-making for intervention (e.g., the graph shows that a certain therapy was effective in the past and can be used again). The role of the Active Medicine Cognitive Graph in the future psychiatric emergency system will be crucial: through it, information sharing and collaboration between different departments (psychological hotlines, hospitals, community services) can be realized, achieving "early detection and early intervention" for high-risk individuals. For example, in the social psychological service network, residents' psychological files can be stored in the form of semantic graphs. If someone seeks help on a hotline, their historical graph will be immediately available for AI to call upon, assisting in judging the cause of the current crisis and the best intervention plan. In addition, active medicine also involves Information Field and Energy Field theory, believing that psychological (information) intervention can affect physiological (energy) states. This suggests that when designing psychiatric emergency measures, we can comprehensively consider the combination of psychological counseling (semantic information input) and physiological regulation (such as relaxation training, drugs affecting neural signals, etc.) to achieve the purpose of comprehensively stabilizing the individual's state.

In summary, Academician Yucong Duan's DIKWP Artificial Consciousness theory system provides us with panoramic theoretical support ranging from basic cognitive structure (DIKWP model) to the nature of consciousness (BUG theory), from self-consciousness (Experiencing/Narrative Self) to cross-modal cognition (Active Medicine Graph). These theories share a common point: emphasizing semantic-level cognitive processes and purpose-driven feedback mechanisms, enabling artificial intelligence systems to process information, make decisions, and self-regulate in a way that approaches human consciousness. In designing the future psychiatric emergency system below, we will fully utilize these concepts: the DIKWP model will guide the design of system architecture and data processing flows, the Consciousness BUG theory will help the system maintain flexibility and controllability under uncertainty, the Self Model endows the system with better empathy and reflection capabilities, and the Active Medicine Cognitive Graph provides a technical path for integrating multi-source information and active intervention. With such a profound theoretical foundation, we can more confidently envision the blueprint for a New Generation Intelligent Psychiatric Emergency System.

3. International Comparison: Analysis of Similarities and Differences in Psychiatric Emergency Systems in China, USA, Europe, Japan, and South Korea

The construction of a psychiatric emergency system involves policy regulations, resource allocation, social culture, and many other factors. Developments in this regard in various countries have their own characteristics and deficiencies. To design an optimized system oriented towards the future, it is necessary to compare and analyze the status and experience of China, the United States, Europe, Japan, and South Korea in the field of psychiatric emergency services. Below, we will discuss each country/region one by one, analyzing the pros and cons of their respective systems and points worth learning from in terms of laws and policies, execution mechanisms, hotline networks, pre-hospital coordination (pre-medical ambulance connection), and psychological counseling standards and training.

3.1 China: Policy Inception and System Construction

Laws and Policies: A major progress in China's mental health legislation was the promulgation of the "Mental Health Law of the People's Republic of China" in 2012, implemented in 2013. The law clarified the government's responsibilities in the construction of the mental health service system and made provisions for the treatment, rehabilitation, and rights protection of patients with mental disorders. However, regarding the intervention of Acute Mental Crises, the law has limited coverage, providing mostly principled guidance. In recent years, as social psychological problems have received high-level attention, China has issued a series of policy documents to promote the construction of a Social Psychological Service System. For example, in 2018, the CPC Central Committee and the State Council issued the "Pilot Work Plan for the Construction of National Social Psychological Service System", requiring the establishment of psychological service platforms and crisis intervention mechanisms at the grassroots level. The policy also emphasizes psychological crisis prevention for Key Populations, such as adolescents and the elderly. Overall, China's psychiatric emergency policies are in a stage of gradual improvement, and in recent years, they have begun to systematically incorporate psychological crisis intervention into the framework of public safety and health emergency response.

Execution Mechanism: Traditionally, China lacked specialized psychological crisis intervention institutions. Psychiatric emergencies were mainly handled in the outpatient and emergency departments of general hospitals or specialized mental hospitals. Police and 120 emergency services often lacked professional psychological personnel coordination when handling mental crisis events on site. This aspect is gradually improving: some large cities (such as Beijing and Shanghai) have established Crisis Intervention Centers or Psychological Assistance Centers, equipped with psychological counselors and psychiatrists to man hotlines and participate in emergency interventions. After major disasters or accidents, China often leads the formation of Psychological Rescue Teams to rush to the scene. For example, after the Wenchuan earthquake in 2008, the Ministry of Health quickly organized national psychological expert volunteers to carry out post-disaster psychological crisis intervention and issued the "Guiding Principles for Emergency Psychological Crisis Intervention" on the 7th day after the earthquake for nationwide implementation. These guidelines required the establishment of psychological rescue coordination groups in disaster areas, incorporating psychological intervention into overall disaster relief work to prevent secondary psychological trauma, and categorizing interventions for different groups. Practice has proven that China has accumulated valuable experience in psychological assistance for disaster events, but the mechanism for daily, sporadic psychological crisis interventions such as suicide remains imperfect. Currently, some places are exploring the "Medical-Police Cooperation" model: police handling a situation involving a suicide crisis can link up with a psychiatrist to accompany them or refer the person directly to psychiatric emergency. Such pre-hospital linkage mechanisms have not yet been institutionalized nationwide and need further promotion and standardization.

Hotline Network: In the past, China had numerous psychological assistance hotline numbers in various places with a lack of unified management and low public awareness. In recent years, the state has begun to integrate resources and promote a unified hotline number. The National Health Commission notified the establishment of the "12356" National Unified Psychological Assistance Hotline in 2022. As of the end of 2024, the 12356 hotline has been put into trial operation in multiple provinces and cities, with plans to be fully enabled nationwide before May 1, 2025. 12356 is positioned as a public welfare service hotline providing mental health education, counseling, guidance, and crisis intervention. This means China will establish a National Psychological Crisis Hotline Network similar to the US 988, with existing local professional institutions undertaking calls. Besides 12356, there are currently hotlines in education, the Communist Youth League, the Women's Federation, and other systems for specific groups nationwide, such as the Youth Hotline 12355 and Women's Hotline 12338. Megacities like Beijing and Shanghai also operate their own 24-hour psychological assistance hotlines (such as the Beijing Huilongguan Hospital Hotline, Shanghai Mental Health Center Hotline, etc.) and maintain contact with fire rescue, medical emergency, and other departments. It is foreseeable that with the promotion of the national 12356 hotline, China's psychological hotline network will become more sound. However, hotline services currently still face problems of staff shortages and insufficient training; volunteer and professional counselor reserves need strengthening, and the quality and standardization of hotline services also need to be unified through national standards.

Pre-hospital Coordination: China is gradually introducing the concept of psychological crisis intervention into the pre-hospital medical emergency system. For example, when 110 police calls or 120 emergency calls receive help requests involving suspected suicide or self-harm, how to quickly mobilize both material rescue and psychological intervention forces is a current focus of exploration. Some places have established Multi-departmental Linkage Mechanisms: after receiving a call, if 110 judges it involves a mental crisis, it will notify Mental Health Professional Institutions to send personnel to assist; 120 ambulances are also gradually equipping trained nurses or social workers to comfort and guide patients during transfer. Some cities are piloting the establishment of "Mobile Psychological Crisis Intervention Teams", composed of psychiatrists, psychological counselors, and police officers. Once incidents like jumping from a building occur, the team handles it jointly on site. Overall, China's pre-hospital coordination is still in the exploration stage, with no unified national model. But with the advancement of "Safe China Construction" and the social psychological service system, this aspect will receive institutional guarantees. For instance, the "Several Opinions on Strengthening the Prevention and Control of Risks of Extreme Cases and Incidents" jointly issued by the Ministry of Public Security and other departments in 2021 emphasized improving emergency psychological intervention mechanisms, requiring timely psychological counseling and intervention for personnel who may trigger extreme events.

Psychological Counseling Standards and Training: China's psychological counseling and therapy industry has developed rapidly in the past twenty years. The former Ministry of Labor established the "Psychological Counselor" vocational qualification in 2001, and a large number of personnel obtained certificates through training, but actual professional levels varied greatly. In 2017, the state cancelled the recognition of the psychological counselor vocational qualification and shifted to industry associations promoting certification systems. regarding professional training in the direction of Crisis Intervention, China started relatively late. After the Wenchuan earthquake, institutions like the Institute of Psychology of the Chinese Academy of Sciences translated and introduced the Psychological First Aid (PFA) manual to train frontline rescuers. Additionally, some internationally common suicide intervention training programs (such as ASIST - Applied Suicide Intervention Skills Training) have also begun to be introduced domestically. In 2019, the National Health Commission issued the "Pilot Work Guidance Outline for the Construction of National Social Psychological Service System", which required strengthening crisis identification and intervention training for grassroots medical staff, social workers, teachers, etc. Currently, some domestic universities and training institutions have opened Crisis Intervention Trainer Training Classes to cultivate professional crisis intervention personnel. In terms of standards, apart from the Ministry of Health's 2008 guiding principles for post-disaster psychological crisis intervention, there are no unified national guidelines for general suicide crisis intervention. The Clinical and Counseling Psychology Committee of the Chinese Psychological Society has issued industry norms such as the "Suicide Risk Assessment and Intervention Guidelines (Trial)" to provide references for psychological practitioners. It can be expected that with the attention at the national level, more perfect Psychological Crisis Intervention Industry Standards and Qualification Certifications will be formulated in the future to ensure that the vast number of grassroots personnel also possess basic identification and intervention skills.

Summary: China's psychiatric emergency system construction is in the Inception and Strengthening stage: there is top-level policy guidance (unified hotline, psychological service system, etc.) and highlights of local exploration (disaster psychological intervention experience, crisis centers in a few cities), but there are also problems of system fragmentation and insufficient professional strength. For the future, China needs to work on Overall Coordination—breaking down barriers between health, public security, civil affairs, education, and other departments to form a joint force; at the same time, invest in Capacity Building, cultivating more professionals and enhancing public awareness of psychological first aid. With the help of AI and artificial intelligence technologies, China has the opportunity to achieve Overtaking on a Bend, establishing an efficient and covering human-machine collaborative psychiatric emergency network.

3.2 USA: Comprehensive Crisis Hotline and Diverse Intervention Models

Laws and Policies: Psychiatric emergency services and suicide prevention in the United States have legislative and policy support at both federal and state levels. As early as 2004, the US Congress passed the Garrett Lee Smith Memorial Act, funding states to carry out youth suicide prevention projects. Since then, multiple versions of the National Strategy for Suicide Prevention have been issued at the national level. A landmark policy in mental crisis intervention is the National Suicide Hotline Designation Act of 2020, which established 988 as the nationwide unified hotline number for psychological crisis and suicide help, and authorized the Federal Communications Commission and relevant agencies to promote its implementation. This legislation laid the legal foundation for the national crisis hotline network. Additionally, policies like the US Mental Health Parity Act and Medicaid Expansionalso indirectly help crisis services by ensuring the affordability of psychological treatment for more people. States have also legislated to establish crisis response mechanisms, such as requiring the formation of 24-hour mobile crisis teams and establishing regional crisis stabilization centers. For example, Arizona established the "Crisis Now" model, which became a national model. Overall, US policy emphasizes Community-based De-institutionalized Services and crisis response combining Law Enforcement and Medical Care, committed to reducing reliance on mere policing or emergency rooms.

Execution Mechanism: The US psychiatric emergency execution system can be summarized as a "Triad" model: "Someone to Call, Someone to Respond, Somewhere to Go". Specifically: First, there is a 24/7 Crisis Hotline as a contact point (like 988); Second, there are Mobile Crisis Service Teams as a response force, staffed by trained psychological crisis workers (often including psychiatric nurses, social workers, sometimes accompanied by officers), who go to the location of the person involved for intervention; Third, there are Crisis Receiving and Stabilization Facilities as safe places for short-term observation and counseling, avoiding sending people to jail or ordinary emergency rooms. This model is recognized by federal agencies (SAMHSA - Substance Abuse and Mental Health Services Administration) and listed as a best practice in national promotion guidelines. Taking mobile crisis teams as an example, almost all states have now established such services, dispatched upon hotline referral or police station request, aiming to Resolve Crises on Site and Reduce Coercive Means. Another execution feature is the CIT Program (Crisis Intervention Team)—training carried out within the police system to let frontline law enforcement officers master psychological crisis identification and communication skills. Many areas require 911 operators to transfer mental health-related alarms to CIT officers or coordinate with psychological hotlines. The execution system also includes Follow-up Services, continuing to follow up with the person involved for a period after the crisis event to help connect with subsequent treatment resources to prevent recurrence.

Hotline Network: The US established the National Suicide Prevention Lifeline in 2005, using an easy-to-remember ten-digit number 1-800-273-TALK, operated by the Vibrant Emotional Health organization's national call center network. After operating for more than a decade, to further lower the barrier to seeking help, the Federal Communications Commission decided in 2020 to make 988 the new number. From July 16, 2022, the 988 hotline was officially launched nationwide. The backend of 988 is still the original Lifeline network, including more than 200 local crisis centers across the US. The federal level provides funding support for 988 (approximately $520 million in FY 2025) and sets standards, operated by Vibrant; states are responsible for supplementing funds and organizing local call centers and supporting services. The 988 hotline supports phone, text, and online chat methods, operates year-round, has dedicated lines for English and Spanish, and provides translation services in more than 240 languages. According to surveys, after the implementation of 988, call volumes significantly increased across the US. Some areas faced challenges with connection rates in the early stages, but the situation gradually improved through increased funding and capacity expansion. As of 2023, multiple studies and surveys show that the vast majority of callers felt the call helped them get through the crisis and stopped suicide attempts. Besides 988, there are triage services for specific populations, such as veterans who can dial 988 and press 1 to connect to the Veterans Crisis Line, and teenagers who can contact specific counselors via text message. The US hotline network thus presents a linked pattern: National Unified Access, Local Proximity Service, Professional Categorized Support. The future challenge lies in ensuring enough certified psychological crisis interventionists to cope with the continuously growing number of help requests, and continuously improving service quality and regional balance (currently connection rates and wait times in some states remain less than ideal).

Pre-hospital Coordination: The US places great emphasis on separating mental crisis services from traditional police and emergency systems, yet forming collaborations with them. On one hand, through legislation and training, it vigorously promotes Non-police Professional Crisis Teams to replace police in handling most mental crisis events, to reduce tragedies caused by misunderstanding or excessive enforcement (many cases show that handling mentally collapsing individuals by untrained police may trigger violent consequences). On the other hand, police intervention and medical coordination are still emphasized in high-risk situations, such as the Co-Response model: police dispatch together with mental health professionals to deal with cases that may be dangerous. Many cities have also established Police Real-time Consultation Hotlines, allowing officers handling situations on site to consult psychological experts for guidance at any time. Additionally, the 911 and 988 hotline systems are exploring seamless connection: some states require 911 to directly guide obvious mental health calls to 988, allowing the latter to take over non-emergency psychological crisis handling; conversely, if 988 assesses the caller has immediate life danger (e.g., has already committed self-harm), it quickly contacts local 911 to dispatch ambulance or police officers. Another important aspect of US pre-hospital coordination is EMS (Emergency Medical Services) Participation. Emergency medical personnel are receiving special training on Behavioral Emergencies, and ambulances are equipped with sedatives and restraint tools for protecting patient safety when necessary. In some areas, specialized Psychiatric Ambulance Fleets (sometimes called the CAHOOTS model, originating in Eugene, Oregon) have emerged, composed entirely of medical staff and social workers, handling non-violent psychological crisis calls in the city, with police only supporting when needed. The goal of pre-hospital coordination is to Properly Stabilize Emotions on Site and Decide Subsequent Plans: if it can be resolved in a community environment, avoid sending to emergency; if removal is needed, send to a crisis center or psychiatry department rather than ordinary detention centers or hospitals. This model effectively reduces the problems of overcrowded emergency rooms and excessive law enforcement intervention, and also reflects more humane care for the parties involved.

Psychological Counseling Standards and Training: The US possesses one of the world's oldest and most complete psychological crisis intervention training systems. Projects like Applied Suicide Intervention Skills Training (ASIST) emerging in the 1980s teach community personnel skills to identify and intervene in suicide risks. Professionally, the US has multiple occupational categories involving psychological crisis handling, such as Clinical Social Workers, Licensed Professional Counselors, Marriage and Family Therapists, Psychologists, Psychiatrists, etc. They all must undergo strict qualification certification and continuing education, which usually includes content on crisis assessment and intervention. In addition, Psychological First Aid (PFA), as a frontline intervention method for disasters and traumatic events, is promoted by WHO and others, and organizations like the American Red Cross universally train volunteers to master PFA. In law enforcement and public domains, "Mental Health First Aid" courses are widely conducted in the US, similar to physical first aid courses, teaching ordinary people how to provide initial help and guide professional resources intervention when encountering someone around them in a mental crisis. For hotline staff, the US has specialized training and certification, such as certification through crisis hotline practitioner standards (e.g., set by the American Association of Suicidology). Overall, US psychological counseling standards present characteristics of Multi-level and Professional Subdivision, and each state may also have its own detailed requirements. However, there are consensus guidelines at the national level, such as SAMHSA's "National Guidelines for Behavioral Health Crisis Care" (2020), which suggests quality standards for various services. For example, for hotlines, it requires 24/7 local response, listening and assessment after connection, and seamless transfer to mobile services when necessary; for mobile teams, it requires including at least mental health professionals, being able to go to any safe community location, and minimizing the use of force; for stabilization centers, it requires a no-refusal policy, short-term (<24-72 hours) observation, and providing rehabilitation plans. These standards become important bases for federal funding and evaluation of state crisis system construction.

Summary: The US currently possesses a relatively complete psychiatric emergency system, leading in policy guarantees, investment, and model innovation. Its experience can be summarized as: Unified Entry, Graded Response, Humane Law Enforcement. Unified entry refers to establishing a national unified easy-to-remember help number (988) to lower the help-seeking threshold; graded response refers to different services like hotlines, mobile teams, and hospitalization progressing layer by layer according to crisis severity, avoiding "one size fits all" hospitalization or policing; humane law enforcement emphasizes replacing coercive means with medical and social means, protecting the dignity and rights of the parties to the greatest extent. Of course, the US also faces challenges, including sustained funding, unbalanced development across states, and how to handle recurrent crises of people with severe mental illness. But overall, the US experience has reference significance for our construction of a future system, such as the Three-in-One Crisis Service Model and the Driving Role of Laws and Policies.

3.3 Europe: Community-Oriented Services and Transnational Cooperation

Laws and Policies: Psychiatric emergency and suicide prevention policies in European countries mainly appear in the form of initiatives and frameworks at the EU level, without unified laws, but countries generally have formulated their own Mental Health Strategies or Suicide Prevention Action Plans. For example, the UK government released the "Suicide Prevention Strategy" as early as 2012 and has updated and strengthened local execution multiple times; Germany promoted the "Alliance Against Depression" suicide prevention project in the 2000s; France announced its first national suicide prevention plan in 2018. The European Commission and WHO Regional Office for Europe have repeatedly called on member states to value psychological crisis intervention and incorporate it into national mental health planning. An important pan-European initiative is the European Pact for Mental Health and Well-being (2013-2020) and subsequent frameworks, emphasizing psychological support in emergencies and the importance of hotlines. Many European countries legally guarantee the rights of patients with mental disorders and crisis handling procedures. For instance, Finland's Mental Health Act stipulates clauses for police to send individuals in danger of self-harm for medical assessment; the Netherlands has a "Self-harm Protocol" system, allowing patients to express in advance how they wish to be helped during a crisis. Overall, European national policies tend towards a Public Health Prevention orientation, emphasizing de-stigmatization and community care. For example, the UK health department leads the Zero Suicide Ambition plan in zero suicide demonstration areas nationwide, incorporating suicide rates into public health indicators. Legally, most do not legislate a hotline number specifically like the US, but the EU recommends member states use the unified psychological support number 116 123.

Execution Mechanism: The European psychiatric emergency system is characterized by Combination of Medical and Social Services and Community Orientation. Since most European countries implement universal health care, mental health services are usually integrated into the public medical system. For example, the UK's National Health Service (NHS) has Crisis Resolution and Home Treatment Teams (CRHT, crisis teams) in various places, undertaking functions equivalent to US mobile crisis teams, on standby 24 hours to conduct home assessments and short-term interventions for acute attacks of severe mental patients or high suicide risk individuals, aiming to Resolve Problems at Home or in the Community as much as possible, avoiding hospitalization. If further disposal is needed, the UK has specialized Section 136 Places of Safety, usually located in hospitals, used for police to bring people appearing to have a mental crisis in public places for mental status assessment under Section 136 of the "Mental Health Act", rather than police detention cells. In Germany and Nordic countries, developed Social Mental Health Service networks allow for quick contact with the individual's usual family doctor, mental health nurse, or social worker to jointly formulate measures when a crisis case occurs. These countries have also universally established a 24-hour Psychiatric Emergency system. Once a family doctor or duty regional psychiatrist assesses that emergency hospitalization is needed, they can be sent to the hospital psychiatric ward through the ambulance system. Police mainly are responsible for public safety; when someone shows a tendency to hurt others or is extremely out of control in public, the police will take them into Protective Custody according to law and hand them over to medical institutions. In some countries, such as the Netherlands, roles like Street Psychological First Aiders have emerged, arranged by municipal or volunteer agencies to wander in urban public places, actively providing care and contacting professional help when discovering citizens with emotional breakdowns. This reflects European society's concept of Early Intervention in psychological crises. Overall, the European execution system emphasizes the combination of networks rooted in the community during peacetime (family doctors, school counseling, social services) and multi-departmental collaboration during emergencies (medical, police, volunteer sectors joint). For example, France established Medical-Psychological Emergency Units (CUMP) in various places, composed of psychiatrists, psychologists, nurses, and firefighters, dispatched to support survivors and families after disasters or emergencies, similar to China's post-disaster psychological rescue teams. European countries also focus on exchange, such as the EU supporting the establishment of the European Crisis Collaboration Network to promote the sharing of crisis intervention experiences among countries.

Hotline Network: Europe possesses a system of Transnational Collaborative Public Welfare Hotlines. The European Commission approved 116 123 as the pan-European shared psychological support hotline number in 2009, and member states can appoint their own institutions to undertake this number. Currently, many European countries including Ireland, Germany, France, Italy, Spain, Poland, etc., have opened 116 123, connecting it to their renowned psychological assistance hotlines (e.g., Samaritans in Ireland and the UK use 116 123). 116 123 is a Free to Call, 7×24 Hour Service in these countries, becoming an important channel for the public to seek emotional support. European countries usually have non-profit organizations operating hotlines, such as Samaritans in the UK, Telefonseelsorge in Germany, SOS Amitié in France, etc. These organizations have a large number of trained volunteers answering calls, providing Unconditional Listening and Confidential Support. Besides 116 123, many countries also have Youth Lines (e.g., EU designated 116 111 as the child helpline), Lonely Elderly Lines, Abused Women Lines, etc. The characteristic of the European hotline network is the Government Support + Civil Operation model: the government supports hotline operation through funding and policy, but specific services are provided by the voluntary sector, maintaining a certain independence and de-bureaucratized style. Psychological hotlines in countries like Finland and Sweden are not even limited to telephones but also provide modern channels like online chat rooms. A survey study shows that hotlines in many European countries receive huge volumes of help requests annually, playing an important role in suicide prevention, especially becoming a lifeline among people who refuse to see a doctor. It is worth mentioning that besides general hotlines, some European countries have also enabled Emergency Number Triage in acute crisis situations. For example, Denmark, Switzerland, and others attempt to establish specialized mental crisis short numbers outside of medical emergency numbers so that police and medical dispatch can distinguish psychological crises from purely physiological emergencies, thereby dispatching different resources.

Pre-hospital Coordination: The pre-hospital process for handling mental crises in European countries usually follows the principle of "Medical First, Police Later". That is, medical or social service systems intervene primarily, and police power is only used when there are violence/legal issues. Countries generally stipulate that when receiving reports of someone attempting suicide or losing mental control, the emergency dispatch center (some countries integrate police, fire, and medical into the same call center) will dispatch an ambulance while notifying the duty psychiatrist or regional mental health service agency to follow up. If police assistance is needed, police are mostly responsible for ensuring scene safety and assisting in transfer, avoiding the direct use of force on patients as much as possible. The UK Crisis Team model is a product of tripartite agreement cooperation among EMS, police, and psychological services: if an officer detains a suspected mental patient on the street under Section 136, they must contact the NHS emergency assessor as soon as possible to take them for medical assessment together. In Germany, the law allows police to "temporarily place" mental patients when public safety is threatened, but actual execution often involves pre-communication with the health department, which arranges hospital beds. It can be seen that European pre-hospital coordination emphasizes Legal Procedures: many countries' mental health laws detail involuntary hospitalization (civil commitment) and personal protection measures under emergency states. Police act strictly according to law, and the medical side has statutory assessment physician responsibilities. This ensures the Legality and Standardization of crisis intervention. From another perspective, Europe is also exploring ways to reduce the burden on emergency systems. For example, in some cities in the Netherlands, psychological crises are first visited by a duty doctor from the GP (General Practitioner) team to decide whether to call an ambulance or police intervention, similar to a Triage Filter. Nordic countries like Sweden, due to vast territories and sparse populations, have developed a Remote Psychological First Aid model, where experts from central hospitals guide local nursing staff or police in disposal via telephone or video. In general, the characteristics of European pre-hospital coordination are Clear Systems and Close Cooperation, ensuring through legislation and multi-departmental agreements that all parties know their roles when a crisis occurs, reducing buck-passing and rough law enforcement, achieving a Smooth Transition to the hospital medical stage.

Psychological Counseling Standards and Training: European countries generally have strict access and norms for psychological counseling and therapy professions, and also attach great importance to crisis intervention training. For example, in the UK, to become a qualified clinical psychologist, psychotherapist, etc., the training system includes crisis handling modules. The Royal College of Psychiatrists and the British Psychological Society have respectively released clinical guidelines for suicide prevention for professionals to follow. At the same time, some European transnational organizations have also formulated standards, such as the Psychological First Aid European guidelines provided by the International Federation of Red Cross and Red Crescent Societies. Many countries have Psychological First Aid Team (PFA team) training projects, specifically training volunteers to provide psychological support in disasters and emergencies. For example, the EU-funded "Strengthening European Crisis Psychological Services" project promotes standardized training courses in member states. Countries like Germany and Austria have popularized the "Blue Angel" Project, training ordinary people on how to act as neighborhood helpers to identify and help people with signs of psychological crisis. In suicide prevention, the European community advocates "Gatekeeper" Training, for instance, the Scottish government requires school teachers to participate in basic suicide prevention training. European countries' psychological counseling industries are mostly regulated by official or semi-official associations, which often hold crisis intervention workshops and seminars to improve practitioner capabilities. It can be said that European psychological counseling is advancing at both the Professional Standard and Public Education levels. Especially in Nordic countries, national psychological first aid knowledge is very widespread, which is inseparable from their long-term mental health publicity. For example, Lithuania, Finland, and others carry out nationwide publicity campaigns on World Suicide Prevention Day every year and distribute "How to Talk to People with Suicidal Thoughts" guidebooks to the public for free. This improvement in overall social awareness indirectly promotes more timely crisis intervention. In addition, European countries also focus on Ethical issues, ensuring respect for the autonomy of the parties involved in crisis intervention, such as seeking their consent as much as possible and protecting privacy, which are reflected in professional codes of conduct.

Summary: Europe demonstrates the advantages of the Social Welfare Model in psychiatric emergency services: relying on universal healthcare and community networks to carry out services with human-centric concepts. At the same time, Europe shares experiences through Transnational Cooperation (unified hotline, training standards, etc.), which is worth learning from. When designing future systems, we can reference European practices, such as Deeply Integrating Psychological Crisis Services into Basic Medical Systems, Leaveraging Volunteer and Community Forces, and Enacting Clear Legal Procedures to regulate crisis handling. These all help to build a psychiatric emergency system that has both warmth and institutional guarantees.

3.4 Japan: Government-Led Suicide Countermeasures and Whole-Society Mobilization

Laws and Policies: Japan is one of the few countries that have comprehensively deployed suicide prevention and psychological crisis intervention in the form of Legislation. In 2006, the Japanese Diet passed the "Basic Act on Suicide Countermeasures", elevating suicide prevention to a government obligation and mandating the formulation of annual implementation plans. The act views suicide as a "social phenomenon" rather than a personal problem, requiring government departments to respond collaboratively. Subsequently, the Japanese Cabinet formulated the "General Principles of Suicide Prevention Policy" in 2007, which is updated every 5 years, covering prevention, intervention, and postvention links. After the amendment in 2016, it further required prefectures and municipalities to formulate local suicide countermeasure plans. By the mid-2020s, more than 99% of municipalities in Japan have formulated relevant plans. These national and local policies formed a Vertically and Horizontally Interwoven Prevention Network. regarding psychological crisis intervention, Japan also promulgated the "Act on Measures against Loneliness and Isolation", focusing on populations susceptible to mental health issues. Beyond laws, the Japanese Cabinet Office has a Suicide Countermeasures White Paper annual report system to continuously monitor and release the latest data and measure progress. In psychiatric emergency services, Japan, with the vision that "No one should be driven to desperation", proposed a multi-level intervention strategy: improving laws and social security at the social system level, promoting multi-agency cooperation at the community level, and providing hotlines and counseling services at the individual level. After the pandemic, Japan also specifically formulated an emergency countermeasure plan for child and adolescent suicide, focusing on psychological crisis response for students in school. It can be said that through strong policy leadership, Japan has incorporated suicide prevention and psychiatric emergency services into government performance assessment and social responsibility scope, possessing a high degree of policy integration.

Execution Mechanism: Japan's psychiatric emergency execution can be divided into several channels: First, Medical Institutions, including psychiatric emergency hospitals designated by prefectures and 24-hour response teams; Second, Local Government Health Centers and Municipal Health Centers, equipped with psychological counselors and public health nurses to follow up and intervene in high-risk cases within the jurisdiction; Third, Civil Groups and Community Mutual Aid Organizations, such as suicide survivor support groups, volunteer teams, etc. A prominent feature is that Japan's suicide countermeasures emphasize Multi-agency Cooperation (High-risk Person Multi-agency Cooperation): for example, establishing information sharing and consultation mechanisms between police, schools, workplaces, and hospitals to notify and connect resources in time when someone is found to have serious psychological problems. The National Police Agency of Japan annually notifies health centers of Suicide Attempter Information, and the latter arranges follow-up counseling. In schools, education departments require the establishment of Campus Crisis Management Teams to link with medical and family sectors when students show suicide warnings. Additionally, the Japan Self-Defense Forces also have their own psychological first aid system to prevent officer suicide. Japan also promotes a "Regional Support Team" Model: in some suicide-prone areas, mobile groups composed of psychiatrists, psychologists, religious figures, etc., proactively go into communities to give lectures, accept consultations, and discover potential crisis individuals. For special situations like disasters, Japan's post-disaster emergency response includes the DPAT (Disaster Psychiatric Assistance Team) system, where professional psychiatric teams rush to the scene after a disaster to provide psychological assistance. After the Great East Japan Earthquake in 2011, a large number of DPATs went deep into shelters to provide continuous psychological reconstruction services for survivors. Another feature of the Japanese execution system is the emphasis on Assessment and Research Support: the government established the Japan Suicide Countermeasures Promotion Center (JSCP) specifically to collect and analyze data, evaluate policy effects, and guide local practices. This scientific support makes execution more targeted, for example, deploying specific measures for young women upon discovering through data that suicide in this group increased in a certain area. Overall, Japanese execution emphasizes Top-down Linkage (National Guidelines - Prefectural - Municipal Implementation), Dedicated Agencies (suicide countermeasure charges at all levels), and Whole-Society Participation (extensive mobilization of NPOs, enterprises, etc.).

Hotline Network: Japan's most famous psychological assistance hotline is "Inochi no Denwa" (Life Line), started in 1971, one of the earliest psychological hotlines in Asia. It is operated by the Federation of Inochi no Denwa (a civil organization), with more than 50 branches nationwide, number is area code + 0070, answered 24 hours. Due to limited resources of "Inochi no Denwa", lines are often busy. To this end, the Japanese government began funding the development of new forms like "Internet Message Board Consultation" in the 2010s, as well as strengthening existing hotlines. Japan finally joined the ranks of using a unified national number in 2020, establishing the "Kokoro no Kenko Sodan Toitsu Dial" (Unified Dial for Mental Health Consultation): dialing #8301 automatically routes to the psychological counseling hotline designated by each prefecture. This is somewhat similar to the role of China's 12356. However, #8301 only operates during specific working hours each day and does not completely cover 24 hours. Targeting young people, Japan attaches great importance to using internet and SMS methods, for example, the "OZORA" online consultation operated by NPO groups provides chat services, and there are also secret help mailboxes opened by government cooperation with social platforms. Furthermore, in 2021, Japan launched the "Ikezura-bit" AI Chat System, allowing users who are afraid to speak to people to chat with an AI rabbit first; if the AI identifies high-risk content, it will suggest contacting a human counselor. Overall, the Japanese hotline system follows a Civil-led, Government-supported model, with increased government investment in recent years encouraging the use of new technologies to expand channels. According to a 2024 WHO report, Japan's policy promotion to cover more populations with counseling and hotline services is one of the factors for the 35% drop in its suicide rate over 15 years. It is worth noting that the Japanese hotline adapts to its rigorous social culture, often paying more attention to the needs of protecting the seeker's privacy and "face", such as allowing anonymity and not pressing for personal information. This encountered challenges during implementation, such as malicious harassment of hotline resources, but the overall effect remains positive.

Pre-hospital Coordination: regarding pre-hospital response, Japan has established a unique "Health Center - Police - Fire" Coordination Mechanism. When someone attempts suicide in a public place (such as jumping onto tracks at a platform) or a sudden incident caused by mental disorder occurs, police and fire (emergency) usually handle the initial stage at the scene, and then mental health staff from the local health center will quickly follow up. For example, if the police "protect" (protective restraint) a suicide attempter, they will contact a psychiatrist for appraisal and assessment as soon as possible, and admit them to a designated Psychiatric Emergency Bed if necessary. The Japanese government has designated several hospitals in each prefecture as "Core Psychiatric Emergency Hospitals", undertaking the task of receiving mental patients in emergency states, ensuring beds are available at all times. Ambulances also send suspected psychiatric emergencies directly to these hospitals. It is worth mentioning that Japanese police are also equipped with Negotiation Experts (simulating Western SWAT negotiators) for extreme situations, responsible for counseling negotiations during hostage or self-harm standoffs. Usually, these negotiators also receive psychological crisis intervention training. In high-risk places like railway systems, Japan has taken extensive preventive measures, such as installing platform screen doors, playing soothing music, posting help hotline advertisements, setting up emergency stop buttons for bystanders to press, etc., reducing crisis occurrence and facilitating timely intervention from Environmental Design. For high-risk individuals who have attempted suicide, fire and health departments established a Return Visit System, where fire emergency records are copied to health centers to arrange subsequent psychological support, preventing recurring crises. Generally, Japanese pre-hospital coordination emphasizes Timely Professional Intervention and Post-event Tracking. Precisely because the system is relatively complete, Japanese society can quickly calm sporadic individual crisis events. For example, if a passenger loses mental control and causes a disturbance on the subway, medical and police personnel will intervene to remove them very quickly, and broadcasts will comfort other passengers on site. Such orderliness stems from pre-planning and multi-departmental drills, which is an experience worth learning.

Psychological Counseling Standards and Training: Japan's psychological counseling and psychiatric resources are relatively limited, but the government and academia pay great attention to Training Grassroots Forces to compensate. For example, cultivating "Gatekeeper" (Mimamori) volunteers in local communities to care for solitary elderly people, recovering depression patients, etc., in the neighborhood. Some cities and counties open "Kokoro no Kenko-zukuri Koza", i.e., mental health cultivation courses, teaching basic psychological first aid skills to the public. regarding professional training, Japanese psychiatrists need to pass strict specialist certification, which includes suicide assessment and emergency handling courses. The nursing field has developed a Psychiatric Clinical Nurse Specialist Qualification, capable of handling various psychological crisis scenarios. Japan also attaches great importance to Media and Public Education, guiding journalists on how to report suicide events to prevent copycats ("Media Suicide Reporting Guidelines"); implementing life education courses in schools, asking students to identify signs of psychological stress and seek help. Regarding standards, Japan's General Principles of Suicide Prevention Policy lists multiple indicators, such as the number of people trained in crisis intervention, hotline answer rates, patient recurrence rates, etc., which local governments need to report annually. This KPI Management promotes investment according to standards in various places. For example, if a local hotline's connection rate is lower than standard, it will be required to increase budget and improve management. Japanese professional associations also release guidelines, such as the Crisis Intervention Process Template formulated by the Japanese Association for Suicide Prevention for institutions to reference. It can be said that through a set of "Government-Industry-Academia-Civil" Combined efforts, Japan has gradually standardized and systematized psychological counseling and crisis intervention, improving the coping ability of the whole society. This is also one of the important reasons why Japan's suicide rate, although still not low, has fallen from its peak.

Summary: Japan's experience can be summarized as "National Will, Whole People Action". The government plays a strong leading role, not only legislating and planning but also promoting execution through fiscal and personnel means; at the same time, it emphasizes whole-society participation, making grassroots organizations and ordinary people part of the crisis intervention loop. For future systems, Japan inspires us: Top-level design and local implementation must be equally emphasized, and Data-driven and Humanistic Care must be combined. For example, whenever a new problem arises in Japan (such as loneliness, new high-risk suicide groups), it responds quickly to adjust strategies; also, care for crisis individuals is meticulous from pre-prevention, mid-intervention to post-follow-up. These practices make Japan one of the few countries in the world to successfully reverse the trend of high suicide rates (suicide rate dropped by more than 35% from 2006 to 2022). This fully demonstrates that a multi-level, multi-agent collaborative psychiatric emergency system can have a huge impact on saving lives.

3.5 South Korea: Prevention System in Rapid Development and Realistic Dilemmas

Laws and Policies: After the suicide rate surged in the early 21st century, the South Korean government attached great importance to it. In 2011, South Korea promulgated the "Act on the Prevention of Suicide and the Creation of Culture of Respect for Life" (briefly "Suicide Prevention Act"). The law aims to protect life, create a culture of respect for life, and establish national suicide prevention policies, including formulating a five-year Comprehensive Plan for Suicide Prevention. The South Korean government subsequently established the Central Suicide Prevention Center to promote national countermeasures. regarding mental health, South Korea also has the "Mental Health Act", revised in 2016 to "Act on the Improvement of Mental Health and the Support for Welfare Services for Mental Patients", strengthening requirements for community services and crisis management for patients with mental disorders. South Korea's policies emphasize Government Leadership + Public Campaigns: on one hand, clarifying responsibilities of governments at all levels through legislation, for example, metropolitan cities and provinces must establish suicide prevention committees, and communities must have designated personnel responsible for crisis tracking; on the other hand, launching the "Life Movement" initiative, advocating mutual care in the whole society. South Korea also specifically legislated to ban websites and content encouraging suicide, regulate media reporting, etc., to control social factors promoting suicide. Despite the support of these laws and plans, South Korea's suicide rate remains high (after a decline in the 2010s, it has risen again in recent years). The government faces challenges in policy implementation, such as how to truly eliminate social stigma and improve the public's willingness to seek help. Therefore, in 2023, the South Korean Presidential Office announced the establishment of a cross-departmental special task force to strengthen suicide prevention measures including psychological first aid.

Execution Mechanism: South Korea has established a Suicide Prevention and Crisis Intervention Network covering central to local levels. At the central level, the Ministry of Health and Welfare is in charge, and the Central Suicide Prevention Center provides technical support. Provinces/cities have Regional Suicide Prevention Centers, and cities/counties/districts have Mental Health Centers or Mental Health Welfare Centers. These centers employ mental health professionals to provide counseling, follow-up, and crisis intervention services. Statistics show there are currently about 250 such centers across South Korea. One focus of execution is the management of High-risk Cases: for example, for those discharged after attempted suicide, the center will contact them regularly and visit for care if necessary. South Korea also promotes the "Gatekeeper" Program in communities, training ordinary citizens like teachers, police, religious leaders, etc., to identify people at risk of suicide and guide them to professional services in time. The South Korean police department also has Police Assisted Suicide Prevention Officers, responsible for handling suicide-related alarms. For instance, when receiving a suicide-related alarm, police and mental health center personnel will dispatch jointly. If the person involved only has minor injuries, police tend to hand them over to family and psychological centers for follow-up rather than taking coercive measures. South Korea's fire rescue system is also equipped with Psychological Emergency Teams, providing psychological support at large accident scenes (learning from the severe psychological trauma of frontline personnel after the Daegu subway arson tragedy in 2003). An innovation in execution is South Korea's use of IT technology, such as developing a Psychological Crisis Map, spatially analyzing data on domestic violence, mental patients, solitary elderly people, etc., nationwide, and focusing resources on high-risk areas. There is also the use of mobile positioning data to predict suicide hotspots, such as strengthening patrols on the Mapo Bridge over the Han River and installing AI cameras to identify abnormal lingering figures for early warning. It can be seen that South Korea's execution system is trying hard to catch up, presenting features of Technology Application and Detailed Management. However, there are many practical problems. A 2024 media investigation pointed out that frontline suicide prevention centers generally suffer from Understaffing and Insufficient Funding, and basic operations even rely on short-term project funds. Some regions reported that central tasks (such as visiting solitary high-risk groups) were assigned without specific resource support, leading to compromised execution effects. These dilemmas suggest that relying solely on administrative orders and short-term campaign-style execution is difficult to sustain; deeper investment and institutional guarantees are needed.

Hotline Network: South Korea's psychological crisis hotlines mainly have two systems: government public hotlines and private non-profit hotlines. On the government side, there is the Health and Welfare Call Center 129, providing counseling on mental health (this number also covers other social welfare help requests); and the Youth Help Line 1388 operated by the Ministry of Gender Equality and Family to help teenagers. However, the positioning of these official hotlines is relatively broad, and professionalism is slightly insufficient. More influential are Privately Operated crisis hotlines, such as LifeLine Korea, associated with the international LifeLine organization and supported by the church; Telephone of Hope, and Seoul Crisis Counseling Center, etc. According to reports, the hotline with the largest service volume in South Korea is the "Safe Call", a 24-hour hotline operated by the Seoul Mental Health Center (1577-0199). South Korea also launched a Crisis Text Service synchronized globally (similar to Crisis Text Line) for use by young people who are not good at talking. Starting in 2022, the South Korean government realized the problem of scattered hotlines and began to integrate resources, promoting the Mental Health Crisis 24-hour Hotline "1577-0199" as a unified number nationwide, consolidating previous dedicated lines. This integration is still in progress. Overall, the South Korean hotline network has not yet taken root deeply in people's hearts like in the US and Japan; many citizens still choose to search online or endure during crises instead of calling hotlines. This is related to social culture (reluctance to talk about private matters) and insufficient hotline promotion. It is worth mentioning that to prevent the high incidence of cyber suicide among teenagers, South Korea established Cyber Psychological Counseling Rooms, staffed by professional counselors on popular social platforms. Once someone is found posting suicidal ideation posts, they will actively send private messages to offer help. This "Online Hotline" has played a certain role among the young group. In the future, South Korea needs to further Unify and Promote Hotline Brands, improve connection rates and service quality, making it a truly trusted help channel for the public.

Pre-hospital Coordination: When responding to extreme psychological crisis events, South Korea usually dispatches police and 119 emergency services. In the past, due to the lack of professional psychological participation, cases of police handling forcefully leading to tragedies occurred. To improve, the police implemented the Police-Mental Health Joint Dispatch system in recent years: the National Police Agency signs contracts with local mental health centers. When encountering situations of mental patients causing trouble or suicide threats, the center immediately sends psychological workers to the scene together. Police are responsible for safety control, and psychological personnel attempt communication to stabilize emotions. This model has not yet covered the whole country, but in pilot areas, the effect is good, and conflict and casualty rates have dropped significantly. The South Korean fire department also established Suicide Rescue Special Teams, patrolling suicide hotspots like bridges and riversides, equipped with drones, robots, and other equipment to assist search and rescue. The Seoul Metropolitan Government even configured All-weather Standby Lifeboats and CCTV monitoring under the Han River bridges to rescue immediately upon detecting a fall. This shows South Korea spares no effort in hardware investment. But there is still room for improvement in soft coordination, for example, insufficient information communication between hospitals and police: there were incidents of attempted suicide recurrence due to lack of tracking after patient discharge. To this end, the South Korean health department requires hospitals to report to community centers and police when suicide attempters are discharged for follow-up attention. In addition, South Korean law allows police to take high suicide risk individuals to "Comprehensive Assistance Centers for Suicide Attempters" with their consent or in emergencies. These centers are usually located in large hospitals, providing medical treatment and psychological assessment, formulating a safety plan for the person involved before release. Overall, South Korean pre-hospital coordination is working towards Professionalization and Cooperation, but has not yet stabilized and matured. Some grassroots reports indicate that police sometimes still feel tricky handling mental cases, and mental center manpower cannot always arrive in time, requiring further mechanism improvement, such as establishing 24-hour standby joint teams.

Psychological Counseling Standards and Training: South Korea lags behind Europe and America in the training of mental health professionals, but is accelerating to catch up in recent years. The South Korean psychological counseling and therapy industry is dominated by clinical psychologists and psychiatric clinical nurses, requiring strict training and exams. In the field of suicide prevention, Qualification Certification is gradually forming: the Korean Psychological Association launched the "Suicide Prevention Psychological Counselor" certification, training professionals to master crisis intervention skills. For the general public and specific professional groups, South Korea introduced Mental Health First Aid courses and locally developed SafeTALK training (originating from Canada, used to train gatekeepers). The South Korean military began providing mental health education to all new recruits in the 2010s, teaching how to perceive suicide signals among comrades. Regarding media, the Korea News Association voluntarily follows WHO's media reporting guidelines to reduce rendering details. The South Korean government also produces a large number of educational materials, eliminating the shame of seeking psychological help through TV drama implants, celebrity endorsements, etc. Nevertheless, due to cultural implicitness, many South Koreans are unwilling to reveal emotions, creating difficulties for psychological counseling. Therefore, South Korean counseling strategies focus on Indirect Channels, such as opening Anonymous Online Forums for people to express themselves, where professional personnel lurk to give guidance. In a sense, this is a new type of counseling standard. Domestic scholars in South Korea are also formulating some crisis intervention process standards, such as how to conduct group psychological counseling for school suicide events. It can be seen that South Korean standard construction is in the Exploration and Integration stage, learning from the Western evidence base on one hand, and considering Eastern cultural characteristics to adjust methods on the other. In the future, with the accumulation of experience, South Korea is expected to form a set of psychological crisis intervention standard systems that are both standardized and localized. The immediate priority is to expand training coverage and solve the shortage of professionals, especially in areas below the county level and rural areas, needing to train more grassroots personnel to possess basic counseling skills.

Summary: South Korea's psychiatric emergency system is developing rapidly but still faces the imbalance of High Demand and Low Resources. South Korean experience reminds us that Cultural Factors have a huge impact on psychological first aid: de-stigmatization and encouraging help-seeking are extremely important tasks requiring joint promotion by the government and society. Additionally, South Korea's technology application (monitoring warnings, physical protection in suicide hotspots, etc.) is worth referencing; these "hard measures" can reduce suicide success rates in the short term. In system design, South Korea's challenges also reflect that our future system needs to pay special attention to Grassroots Coverage and Personnel Guarantee. A system that is complete on paper but lacks human and material resources for execution will have greatly discounted effects. Therefore, when learning from South Korea's legislation and publicity initiatives, we must also learn from its lessons and ensure supporting resources keep up.

International Comparison Summary: Looking at the five parties of China, USA, Europe, Japan, and South Korea, each has its emphasis: the US system is complete but challenged in balanced implementation; the European human-centric community model is mature but needs coordination and unification; China and South Korea are working hard to catch up in building systems but resources urgently need strengthening; Japan's high-level drive has significant results but also faces new problems. The design of the future psychiatric emergency system should draw on the strengths of others. For example, it can combine the US three-layer model (hotline-mobile team-stabilization center), the European community net bottom, Japan's policy integration, and China/South Korea's technology application, melting them into one furnace to provide a reference innovative paradigm for the world. In the next section, based on the above comparative analysis, we will propose a complete structural design for a future-oriented psychiatric emergency system.

4. Complete Structural Design of Psychiatric Emergency System: Module Division and Operation Process

Combining the aforementioned theoretical basis and international experience, in this section, we propose a Future-Oriented Psychiatric Emergency System Architecture. This system aims for "Full Coverage, Multi-level, Intelligent Collaboration", striving to establish a seamlessly connected, human-machine integrated psychological crisis intervention network nationwide/regionally. The system mainly consists of several functional Modules, including: Suicide Crisis Hotline, Post-Disaster Psychological Intervention, Psychiatric Emergency Coordination, Social Psychological Service Network, etc. Each module undertakes specific functions, while connecting through information platforms and workflow to form a Closed-loop Flow. Below we elaborate on the functional positioning and interrelationships of each module and outline the work path of the entire system in actual operation.

4.1 Suicide Crisis Hotline Module

Functional Positioning: The Suicide Crisis Hotline is the Frontline Portal and Central Dispatch Hub of the psychological first aid system. Its main functions are threefold: First, acting as a "Help Entry", providing a 7×24 hour accessible channel for confiding, lowering the psychological threshold for seekers to take the first step; Second, conducting "Risk Assessment", quickly judging the caller's emotional state, intensity of suicidal thoughts, presence of plans/preparations, and other key information through communication between trained operators and callers; Third, implementing "Immediate Intervention and Triage", providing emotional support and problem counseling for low-risk individuals, and for high-risk individuals, striving for crisis dissuasion and emotional stabilization while immediately triggering the system's internal upgrade response (such as notifying mobile psychological intervention teams, contacting emergency/police, etc.).

Design Points: The future-oriented hotline module should achieve a National Unified Number, Intelligent Assistance, and Multi-channel Access. A national unified number, like the US 988 or China's 12356, makes it easy for the public to remember, connecting to the nearest regional center regardless of location. Intelligent assistance refers to using AI technology to empower operator work: for example, voice emotion analysis real-time prompting the caller's nervousness/despair level, keyword recognition helping to judge danger signals, intelligent retrieval providing targeted response scripts or resource lists. These AI tools act as assistants to operators, improving assessment accuracy and response efficiency. Multi-channel includes phone, SMS, chat, video, etc., meeting the communication preferences of different groups. Especially for young people who may prefer messaging or online chat over calling, the system should feature crisis SMS and online chat functions, sharing the same dispatch platform with the phone hotline.

Operation Model: The Suicide Crisis Hotline module will be located within Psychological Crisis Centers at Various Levels (e.g., provincial/municipal), adopting a decentralized network: usually, local seats prioritize local calls, but during busy times or at night, other regional centers can divert calls, ensuring calls are Answered at any time. Operators communicate with callers with an attitude of De-stigmatization and Empathy, following the "ALERT" five-step intervention model (Ask - Listen - Ensure safety - Refer - Tell/Follow-up). While ensuring safety, respect the caller's wishes and privacy as much as possible, without forced intervention. However, once the assessment reaches an Emergency Level (e.g., the caller has committed self-harm or expressed a firm immediate suicidal intention), with their consent, request to start the system emergency response: for example, three-way transfer of the call to a psychiatrist or crisis management expert; obtain their location when necessary and notify the nearby Mobile Crisis Intervention Team to dispatch; if the caller loses consciousness or the situation is critical, directly call 120 emergency/110 police support through the system interface. Throughout the process, the AI system continuously monitors the conversation content. Once high-risk words (such as "I have already taken the pills") or prolonged silence are detected, it can automatically issue reminders to the supervisor operator or directly start emergency procedures, reducing human oversight.

Connection with Other Modules: As the central hub, the hotline module interacts with all other modules. Upwardly, it connects to Mobile Intervention Teams and Medical Emergency (see next section Psychiatric Emergency Coordination Module), pushing case details and assessment results to dispatched personnel when field intervention is needed; Downwardly, it connects to the Social Psychological Service Network, referring seekers who do not need emergency dispatch to subsequent community psychological services (e.g., arranging a community counselor to contact for follow-up the next day). At the same time, the hotline module also collaborates with the Post-Disaster Psychological Intervention system: after sudden disasters, the hotline will add disaster psychological assistance options in the voice guidance and share information with on-site psychological rescue teams to help identify individuals with strong psychological stress reactions among the affected population for focused follow-up.

4.2 Post-Disaster Psychological Intervention Module

Functional Positioning: The Post-Disaster Psychological Intervention Module is specifically designed to respond to psychological crises generated in Major Emergencies (such as natural disasters, large-scale accidents, public health events, etc.). Its main goals are: First, Timely Intervention, dispatching psychological rescue forces to the scene as soon as possible after the disaster to carry out psychological assistance, preventing acute psychological trauma from developing into long-term disorders; Second, Classified Service, providing targeted intervention measures for different affected groups (direct victims, families of victims, rescue personnel, etc.); Third, Long-term Tracking, establishing post-disaster psychological reconstruction plans and providing continuous psychological support to high-risk individuals (e.g., preventing Post-Traumatic Stress Disorder, PTSD).

Composition and Mechanism: This module consists of a "Psychological Rescue Team" and several "Post-Disaster Psychological Care Stations". The Psychological Rescue Team is an elite professional team drawn from the system when a disaster occurs, generally including psychiatrists, clinical psychologists, psychotherapists, psychiatric nurses, and social workers with crisis intervention experience. The team should assemble within hours after the disaster and be deployed to the scene following the national emergency response mechanism. Upon arrival, they coordinate with the local disaster relief command and integrate into the overall rescue operation. Psychological Care Stations are temporary psychological counseling service points set up in shelters, hospitals, and communities, manned by local professionals and volunteers, offering services like listening, psychological education, and simple relaxation technique training to victims.

Intervention Principles: Based on the experience summarized after the Wenchuan earthquake in China, post-disaster psychological intervention follows the combination of "Professional Intervention + Group Self-help". "Professional Intervention" refers to psychological rescue personnel applying crisis intervention techniques to conduct psychological first aid for key groups, such as applying Psychological First Aid (PFA) principles: ensuring safety, comforting emotions, helping expression, connecting social support, etc. For those with severe psychological symptoms (trance, extreme grief, etc.), individual crisis intervention or drug-assisted sedation may be needed. "Group Self-help" refers to mobilizing community forces in the disaster area, such as organizing survivor support groups to let everyone share feelings and support each other, promoting the formation of a Social Psychological Mutual Aid Network. Research shows that involving victims in mutual aid helps restore psychological balance. Psychological rescue teams also need to pay attention to avoiding Secondary Trauma and try to create a safe atmosphere and respect the wishes of victims during intervention.

Process: After the Post-Disaster Psychological Intervention Module is activated, the Psychological Rescue Team first conducts a Psychological Status Assessment: grasping the overall mental health status of the affected population through visits, questionnaires, or communication with medical staff. Then, categorize the population by severity: for example, first priority is direct family members of the deceased and the injured; second is survivors who witnessed the tragedy and rescuers; third is indirectly affected people, etc. Adopt different strategies for different levels. The work of the psychological rescue team on site lasts at least several weeks after the disaster (emergency intervention is generally set to be completed within 4 weeks), after which the focus of work is transferred to the local Social Psychological Service Network, which is responsible for long-term post-disaster psychological reconstruction. During this period, coordinate with the hotline module to open a Post-Disaster Psychological Service Hotline (the hotline system can add temporary options specifically for current disaster-related help). At the same time, the psychological rescue team must also care for the psychological state of rescue personnel, providing decompression services to prevent "caregiver burnout". In the post-disaster transitional settlement and reconstruction stage, psychological care stations gradually integrate into the community, receiving victims for talks daily and conducting psychological education lectures (e.g., explaining normal stress reactions, how to regulate sleep, etc.). For a few individuals who develop PTSD or severe depression, timely referral to specialized mental health treatment.

Connection with Other Modules: The connection between post-disaster psychological intervention and the social psychological service network is particularly close. When the psychological rescue team withdraws, it should provide the List of Key Persons and Suggested Measures to local community institutions to achieve a smooth handover. The post-disaster psychological hotline option can be closed after the disaster basically ends, or merged into the regular hotline system to continue service for a period. If the scale of the disaster is particularly large and cross-regional support is needed, psychological rescue teams from other places can be called for reinforcement through the unified command of the system. This reflects the flexible scheduling capability of the entire system.

4.3 Psychiatric Emergency Coordination Module

Functional Positioning: The Psychiatric Emergency Coordination Module is responsible for responding to severe psychological crisis situations that require On-site Dispatch Forces and Medical Disposal, including people engaging in self-harm or harming others, people with acute psychotic symptoms leading to behavioral loss of control, and people with urgent suicide attempts (such as planning to jump from a building) although without physical injury. These situations often exceed the scope of telephone counseling and require timely dispatch of personnel to the scene for intervention, and may require taking the person to a medical institution for further assessment or treatment.

Composition and Mechanism: The core of this module is a Mobile Crisis Team (MCT) and its collaboration mechanism with medical emergency services and police. The Mobile Crisis Team typically consists of at least two people, ideally a psychiatrist or psychological counselor paired with a psychiatric nurse or social worker. Depending on the situation, the team can also include police officers (adopting the "Co-Response" model), but try to avoid direct police presence in non-violent situations to avoid exacerbating confrontation. Teams are stationed in major service areas and can arrive at the scene within 30 minutes (urban areas) after receiving orders.

This module links with the emergency dispatch system: When the hotline module or other channels (such as 110 alarm) identify the need for field intervention, they will notify the crisis dispatch center. The dispatch center uses GIS geographic information matching to assign the task to the nearest Mobile Crisis Team. Team members receive task details (background, risk points, contact information, etc.) through a dedicated App and maintain contact with hotline operators to obtain the latest updates while en route. Once arrived, members will first identify themselves (wearing vests with logos, etc.), try to approach the person in a non-coercive manner, communicate to establish trust, and assess their psychological and medical status simultaneously. For example, if the person has self-harm behavior, it is necessary to immediately stop further self-injury under the premise of ensuring safety, and perform necessary first aid bandaging. At this time, team members have a clear division of labor: one focuses on communicating with the person (verbal comfort, empathy), and the other closely observes the environment and prepares to take action (contact reinforcement if necessary).

After stabilizing the situation, the Mobile Team needs to decide on the intervention outcome: whether handling on the spot requires no further measures, or referral is needed. On-spot handling refers to helping the person pass the emotional peak, with no physical danger, signing a safety agreement (promising not to commit suicide within a certain time and willing to accept follow-up help), and then leaving them in a safe environment, such as care by family, and arranging community follow-up. If referral is needed, choose hospitalization or placement elsewhere depending on the situation. Hospitalization usually targets those requiring drug sedation, having psychotic symptoms, or extremely high suicide risk; team members will contact an ambulance to send them to the nearest designated psychiatric emergency or crisis center. Placement elsewhere refers to taking the person to a crisis temporary shelter, such as the "Psychological Crisis Rehabilitation Center" set up by this system, for short-term observation and counseling (see next section).

Collaboration Mechanism: This module emphasizes close collaboration with traditional emergency services (EMS) and police. The dispatch center can define the Lead Party and Assisting Party for each task: for example, for suicide attempts without violence risk, the Mobile Crisis Team leads, and the 120 ambulance stands by to assist; for patients with potential aggression, the police send CIT officers to accompany and lead safety, and the Mobile Team is responsible for psychological communication. On site, medical intervention (such as intramuscular injection of sedatives) must be judged and implemented by medical professionals, and police must not use coercive force without authorization unless life is in danger. This division of labor ensures the principle of Medical First, Law Enforcement Guarantee. This is similar to the US Crisis Intervention Team model, minimizing unnecessary police intervention. In addition, after the Mobile Crisis Team completes the task, it will fill in a detailed Report to the system, including the scene situation, measures taken, next steps suggestions, etc., and mark the subsequent responsible entity (such as transfer to hospital or community service). This report is also sent to the hotline module and social service module for tracking. This forms a closed-loop management of crisis events from the scene to follow-up.

Connection with Other Modules: The Psychiatric Emergency Coordination Module has the most direct relationship with the Hotline Module: basically, The Hotline is the Entry, Mobile Intervention is the Follow-up. Many Mobile Team tasks originate from hotline referrals. Therefore, the two should maintain real-time communication, e.g., hotline operators can guide team members via mobile phone on how to persuade family members to cooperate before arrival. The relationship with the Disaster Intervention Module is that if individual extreme behaviors occur at disaster scenes, Mobile Crisis Teams can also cooperate with Psychological Rescue Teams. The relationship with the Social Psychological Service Network is reflected in the subsequent handover: after the Mobile Team finishes handling, either hand the person to hospital emergency or community care; both sides need communication to ensure information does not break. Especially for cases returning home directly without hospitalization, the Mobile Team should notify community psychological service personnel to visit or follow up by phone within 24 hours. Furthermore, the Psychiatric Emergency Coordination Module also includes the collaboration of hospital emergency departments themselves. For example, in the treatment of suicide attempters in general hospital emergency departments, there should be timely consultation by psychiatrists and contact with Mobile Crisis Teams or community services to arrange psychological tracking after discharge; these tasks will be incorporated into the collaboration norms between hospitals and this system.

4.4 Social Psychological Service Network Module

Functional Positioning: The Social Psychological Service Network is the "Net Bottom" of the system, responsible for covering the daily mental health needs of vast community residents and long-term support after crises. It is the foundational module for achieving "Source Prevention + Aftercare Assistance". Its specific functions include: providing normalized psychological counseling and mental health education activities to improve public psychological literacy; establishing files for key populations, regularly following up on depression patients and those with a history of crisis to detect signs of relapse early; undertaking cases referred by other modules to perform long-term psychological support and rehabilitation services.

Composition Structure: This network takes the County/District-level Social Psychological Service Center as the hub, connecting Community Psychological Counseling Rooms, School and Enterprise Psychological Counseling Rooms, Social Work Stations, and other grassroots institutions. Every township and sub-district nationwide should be equipped with at least 1-2 full-time or part-time psychological service personnel (can be retrained from social workers, doctors, teachers, etc.), forming "One Network". These service personnel have received DIKWP model-related training and can organize collected resident psychological data and event information into the system cognitive graph to provide material for AI analysis. An important mechanism of the service network is "Bidirectional Feedback": superiors like Psychological Rescue Teams and Mobile Crisis Teams will feed back information of those needing follow-up care to local community service personnel after completing tasks; conversely, if the community finds someone's psychological state deteriorating continuously or exhibiting high-risk behaviors, they will actively report to the system center, triggering hotline/mobile team intervention when necessary.

Daily Operation: Normally, the Social Psychological Service Network mainly carries out Preventive Work. For example, holding psychological lectures and decompression activities in communities, setting up psychological test scales for residents to self-test, and publishing mental health knowledge through WeChat official accounts. This is equivalent to building a "Psychological Immunity Foundation" for the whole society. For individuals in need, community psychological counseling rooms provide one-on-one counseling. It is worth mentioning that referencing Japanese experience, Mutual Aid Organizations (such as bereaved families support groups, depression recovery groups) can be developed in communities, with social psychological service personnel acting as organizers to promote mutual support among residents. These measures can reduce crisis incidence rates. When someone receives emergency treatment from hotlines, mobile teams, or hospitals, the social network immediately intervenes to "provide a safety net". For instance, when a suicide attempter is discharged home, community psychological service personnel will visit according to plan to understand family support, teach family members monitoring methods, and invite them to participate in regular group counseling to prevent falling into despair again. Or for a survivor who lost relatives in a disaster, after the disaster psychological rescue team withdraws, community service personnel will persist in accompanying and counseling, helping them reintegrate into life. In addition, the Social Psychological Service Network also bears the function of Information Monitoring: through daily visits and communication with grassroots doctors and police, it can detect if there are new psychological risk points in the community. For example, if a young person commits suicide in a residential area, service personnel should visit the surroundings to understand if there is a risk of imitation and strengthen intervention in that group if necessary. This monitoring can be fed back to the upper decision-making level, keeping the entire system sensitive to risk dynamics.

Combination with Intelligent Systems: The future Social Psychological Service Network will fully combine with artificial intelligence technology. Community service personnel can use the Active Medicine Cognitive Graph to record and track residents' psychological states. When they input a person's life events, symptom descriptions, and scale scores, the system's semantic engine will analyze potential risks. For example, the DIKWP graph might show that the resident recently had multiple insomnia instances in the "Data Layer", mentioned hopeless words in the "Information Layer", matched high depression risk in the "Knowledge Layer", and lacked positive plans in the "Purpose Layer". This will prompt service personnel to focus on care. On the other hand, the large amount of daily data accumulated by the service network also helps improve AI models, enabling prediction and warning of the psychological health status of the entire region. For instance, if the psychological stress index of a certain community rises significantly, the system will prompt relevant departments to investigate the cause (could be recent economic changes or sudden events). Therefore, the Social Psychological Service Network is not only the execution terminal but also the Information Source and Buffer Zone of the system.

Collaboration and Upgrade: The Social Psychological Service Network collaborates closely with other modules; it is the Starting Point and Ending Point of Other Modules. Many potential crises are discovered in community work and can be upgraded for handling through the community-hotline channel before deteriorating; conversely, cases referred from hotlines/mobile teams can only consolidate effects through community follow-up support. To ensure this loop is smooth, a Responsible Mentor system needs to be established: designate a community psychological service person as the "Psychological Mentor" for each service object who has had a crisis, for long-term contact. If the mentor judges the situation is worsening, they can directly contact the hotline to request intervention again. This is like building a safety net for high-risk individuals so they won't fall out of the system's view after discharge or crisis. institutionally, the implementation of follow-up services can be included in performance assessment to prevent connection breaks.

In summary, this section depicts the four major modules of the future psychiatric emergency system and their collaborative operation: from frontend reception by crisis hotlines, to on-site intervention by mobile teams, then to hospital emergency/short-term placement, and finally community follow-up. Every step has clear functional division and connection processes, forming an interlocking closed-loop service. In the next section, we will further combine the DIKWP model to elaborate on the system's information processing and decision-making mechanism.

5. DIKWP Semantic Path Modeling: The Process from Seeker Input to Wise Intervention

Academician Yucong Duan's DIKWP model provides a clear framework for us to understand the Information Flow of the Psychological Crisis Intervention Process. In this system, every request for help (whether a hotline call, mobile team on-site interaction, or community consultation) can be viewed as a transformation process from Data to Wisdom and then to Action. Specifically, we can divide the system's response to seekers into five stages: Data Acquisition (D), Information Identification (I), Knowledge Matching (K), Wisdom Decision Coordination (W), and Purpose/Intent Intervention (P). These correspond to the five semantic layers of the DIKWP model. Below we combine a typical example to explain in detail how the system processes received help requests along the DIKWP path and outputs corresponding intervention decisions.

Stage D (Data, Data Acquisition): This is the starting point of interaction with the seeker, where the system acquires Raw Data. Depending on the scenario, data forms vary: in hotline scenarios, data includes call voice, spoken content text (via speech transcription), tone volume, etc.; in chat text scenarios, it is text messages and sending frequency; in field intervention scenarios, there are also visual data (facial expressions, body movements) and physiological data (heart rate, etc., if wearable devices are worn). All these Perception Layer Data enter the system and first undergo preprocessing, such as denoising and format standardization. This step is equivalent to Sense Organs acquiring signals in the human brain. In our system, due to the introduction of Artificial Intelligence, data in Stage D is not only perceivable by humans but also by machines. For example, voice data is converted into text for NLP model analysis, and audio waveforms for emotion detection model analysis. Taking a hotline call example: Seeker Little A calls, crying and speaking incoherently. In Stage D, the system records his raw voice signal, invokes ASR to transcribe the text "...I really let everyone down... there's no point in living like this", while the sound recognition model detects sobbing and trembling tones. These become input materials for the subsequent Stage I.

Stage I (Information, Information Identification): In this stage, the system performs preliminary Semantic Extraction and Tagging on the raw data, transforming messy data into meaningful Information. This is similar to the brain's perceptual awareness process (seeing a crying person, hearing apologetic words). Our system uses multi-modal AI models to do this. For example: The NLP model performs syntactic and sentiment analysis on Little A's words, identifying keywords "sorry", "no point", etc., and tagging the emotional tendency as "extreme pessimism, self-blame". The voice emotion model judges the emotion as "sadness and despair" through sound features. If there is visual data, the CV model might identify his expression as "pain" and the environmental background as "alone indoors at night", etc. All these become Structured Information, such as: Emotion = Sadness 9/10 level, Semantics = "Lost meaning in life, strong sense of guilt", Environment = "Home alone at night". This step of information identification is mostly completed by AI and presented to the operator/team member. Human-AI collaboration helps avoid omissions. For example, AI might discover the "last words" implication hidden in Little A's sentences, which the human operator might have missed due to crying noise. Through Stage I, the system has a preliminary understanding of "what happened to the seeker" and "what his current phenotypic state is".

Stage K (Knowledge, Knowledge Matching): Next, the system matches the identified information with the existing Knowledge Base and Empirical Rules, attempting to understand "What does this mean" and available coping strategies. The knowledge base in this system includes: professional knowledge of psychological crisis intervention (such as suicide risk assessment standards, intervention steps), past cases and patterns (successful intervention methods for similar situations before), local available resources (hospitals, volunteer lists), etc. This step is similar to a doctor diagnosing a disease by matching knowledge in their brain after listening to a patient's symptoms. For Little A, the system applies Suicide Risk Assessment Criteria to his information in Stage K: for example, he mentioned "no point in living"—the knowledge base informs that this is typical despair speech, a high-risk signal; combined with extreme sadness and being alone, this is a dangerous combination. Therefore, according to the Suicide Risk Assessment Algorithm, it determines that Little A belongs to "High Suicide Risk". At the same time, the knowledge base also suggests that for high-risk individuals, specific questions should be asked about whether there is a concrete suicide plan, whether tools are at hand, etc. If the operator has not asked yet at this time, the system will remind them to ask these key points. This is the Guidance of knowledge on information processing. Furthermore, the system searches past similar case records, e.g., a previous caller also repeatedly apologized and showed guilt, the disposal plan then was to contact their family for joint comfort and arrange next-day referral consultation, which successfully avoided tragedy. This provides a referable Intervention Model. Additionally, the system retrieves Local Resources: which 24-hour emergency psychological personnel are available in Little A's city, are there community service contacts in his community, etc., preparing for subsequent actions. Therefore, what Stage K transforms is: "Based on existing professional knowledge, Little A's current situation = High suicide risk, needs immediate serious treatment; referencing best practices, measures XYZ should be taken; call the following resources to prepare..." This stage largely reflects the Knowledge Integration capability of Artificial Intelligence, digitally embedding expert knowledge into the system so that frontline staff can receive support close to expert advice even if they are not senior.

Stage W (Wisdom, Wisdom Coordination Decision): This is the stage where the system makes a Comprehensive Decision, that is, determining How to Intervene Specifically. It is called "Wisdom" because it doesn't just mechanically apply knowledge but considers the context, dynamic feedback, and Optimal Decision of multi-party collaboration. In our system, this step is participated in by AI and Artificial Consciousness (AC) as well as Human Staff. Taking Little A as an example, through Stage K the system believes urgent intervention is necessary, so Stage W needs to finalize the plan: for example, contact his family immediately to come, send a Mobile Team to his door, or persuade him to go to the hospital first? This decision needs to consider multiple factors: Is Little A willing to reveal his address? Is there a Mobile Team available at night currently? How is his physical condition? It also involves Ethical Judgment: should police/medical resources be called without his full consent? Here, the Artificial Consciousness AC Module plays a role. It can assess the Purpose and Willingness behind Little A's words like an experienced psychological first aid expert. If Little A repeatedly says "I don't want to burden others" and refuses to provide a family phone number, AC will perceive his inner conflict (having a desire for help but feeling deep guilt), thereby suggesting appropriate coercive benevolent intervention. At the same time, the AI algorithm calculates the optimal plan based on the resource situation, for example: the nearest Mobile Crisis Team is estimated to arrive in 15 minutes. If his address can be obtained quickly, a team can be sent; if his address is unknown but the community location can be found via the call number, police patrol can also be sent to search. AI also assesses the success rate: past data shows that the success rate of dissuasion is higher with family participation, so AI suggests contacting his relatives and friends as much as possible. Combining these, the system finally forms an Action Decision, such as: "The operator stabilizes the conversation while indirectly obtaining the address, notifying Mobile Team XX to stand by in the background; if precise information cannot be obtained within 10 minutes of conversation, start police notification positioning". This plan is formed by AC and AI discussion and then Presented to the Operator for their professional judgment (this is the human-machine negotiation link). If the operator agrees, enter the next stage of execution. If the operator disagrees, the plan can be adjusted (e.g., they think Little A is particularly resistant to police, so decide not to call police but use other methods). In short, Stage W reflects the Collaboration of Multi-agent Wisdom: optimal path planning under the trade-off of knowledge, experience, and values, rather than a simple one-size-fits-all approach.

Stage P (Purpose, Purpose Intervention): Finally, the system puts the decision into implementation, achieving the Closed Loop of the Purpose Layer—that is, implementing the fundamental purpose of Saving Lives and Stabilizing Psychology. In Stage P, the Purpose-Driven characteristic of Artificial Consciousness ensures that actions align with the highest goal. For Little A, the highest goal is to prevent suicide and ensure he receives subsequent help. So in Stage P, while the system executes, it continuously monitors progress, such as the Mobile Team has departed, the operator prolongs the call to prevent interruption, whether there are unexpected situations, etc. The AC module plays the role of Supervisor and Purpose Guardian in this process. If signs appear during execution that do not match the purpose, for example, the operator wants to give up the call due to emotional fluctuation from a provoking sentence, AC will remind them to persist because the Purpose Layer requires "Never give up hope of saving lives". Or if the Mobile Team encounters a traffic jam delay, AC might instruct contacting a nearby police station for help to speed up. These are all adjustments made to the execution process to Guarantee the Achievement of the Final Purpose. Finally, when Little A reveals the address under the operator's effort, and the Mobile Team arrives to take him safely to medical care, Little A is out of danger and enters professional care—this closed loop is achieved: Data (Little A's distress signal) passed through information extraction, knowledge guidance, wisdom decision, and finally realized the implementation of the purpose of saving a life.

It is worth noting that the DIKWP path is not linear and finished in one go. In the actual process, there are Iterative Iterations and Bidirectional Feedback. For example, obtaining new data (Little A reveals a new knot in his heart) during Stage W execution, the system returns to Stage I to process this information, updates K knowledge matching, and adjusts W decisions. Throughout the process, humans (operators, team members), AI, and AC cooperate closely, information at all levels is constantly enriched, and decisions are continuously optimized. This is the essence of the DIKWP model's "Networked Bidirectional Flow". Through such semantic path modeling, we ensure that every crisis handled by the psychiatric emergency system undergoes Comprehensive Information Understanding and Value Consideration, without missing key details or violating humanitarian principles. At the same time, this layered processing gives the system Transparency and Interpretability: each stage has clear semantic outputs, facilitating manual review and adjustment. For example, in retrospective analysis, one can see which knowledge AI used to judge the risk level in Little A's case, and what considerations AC based the decision to ask family for help on. This interpretability is especially important for AI used in life-sensitive fields.

In summary, the DIKWP semantic path provides a scientific blueprint for the information processing flow of the future psychiatric emergency system, enabling us to design AI and Artificial Consciousness collaboration just like viewing the human brain decision process. From data to purpose, every step is evidence-based and traceable. This ensures that the system is both efficient and intelligent, while always maintaining a clear grasp of the ultimate purpose of saving lives. In the next section, we will further discuss the specific division of labor and collaboration methods between Artificial Consciousness (AC) and Artificial Intelligence (AI) in this system, as well as related ethical boundary issues.

6. Collaboration Model of Artificial Consciousness and AI in Psychiatric Emergency

In building an intelligent psychiatric emergency system, it is crucial to fully leverage the respective advantages of Artificial Consciousness (AC) and Artificial Intelligence (AI) and achieve collaboration between the two. Artificial Intelligence excels in computation, retrieval, pattern recognition, etc., while Artificial Consciousness introduces capabilities similar to human subjective understanding, value judgment, and autonomous purpose perception. In this section, we propose an "AC-AI Collaboration Model" applied to psychiatric emergency scenarios, describing how AC and AI cooperate in different links of crisis intervention: AC focuses on perceiving human intentions and emotions and grasping ethical scales, AI focuses on path calculation and knowledge retrieval, and the two interact through semantics and instructions, ultimately supervised by human decision-makers. We will also explore key issues such as Emotional Semantic Empathy, Ethical Boundaries, and Autonomy and Command Collaboration, ensuring the application of technology is human-centric, safe, and controllable.

6.1 AC Perceives Purpose, AI Executes Path Calculation

As partially reflected in the aforementioned DIKWP process, what AC (Artificial Consciousness) is best at is the grasp of Implicit Purpose and Subjective Meaning. In psychological crisis intervention, this refers to understanding the seeker's will to live/die that is not explicitly stated, inner conflicts, and potential acceptance of intervention. These require a kind of "consciousness" similar to human intuition, inferring from a synthesis of language, emotion, and context. For example, for a person who says "I'm fine now" on the surface, AC might perceive that they are actually still in crisis but just unwilling to trouble others through their still trembling voice and contradictory semantics. This insight is important for adopting the correct intervention strategy. Correspondingly, AI excels in Explicit Task decision optimization and Path Calculation. For example, in the specific plan to dispatch a Mobile Team in the previous example, AI can calculate the fastest route by integrating maps, traffic, and team locations; or decide which comforting script to use by retrieving the knowledge base to get sentence patterns with high probability of effectiveness. In short, in the collaboration model, AC is responsible for answering "What does the seeker really need?", and AI is responsible for answering "What is the most effective thing for us to do?". Example of collaboration: When during a hotline call, AC determines that the caller actually longs for someone to ask them to stay rather than really wanting to die, it passes this intention to AI; AI then focuses on content giving hope and a sense of belonging when generating dialogue, while quickly searching for support resources in the caller's community to prove "You are not alone". Only through such joint force can the seeker be helped through the difficulty in a way that is both warm and pragmatic.

6.2 Emotional Semantic Empathy and Feedback

The success or failure of psychological crisis intervention largely depends on the establishment of Empathy, that is, making the seeker feel understood and cared for. In human-machine collaboration, how to endow machines with empathy capability is a huge challenge. Our model achieves empathetic feedback through Emotion-Semantic Dual Channels. On one hand, the AC module itself has an "Emotional Subsystem", capable of experiencing and simulating emotions in a human-like way—of course, "experience" here refers to computational simulation, but AC can continuously perceive external emotional information through a subconscious computational framework and generate corresponding "feeling" representations in its own semantic network. For example, hearing a sad story, the intensity of "sadness"-related connections on AC's semantic network nodes rises, driving its subsequent behavior to show appropriate sad resonance. On the other hand, the AI module can output language and tone with emotional color through Natural Language Generation technology, such as soft voices and concerned words. This requires AI to use Large Language Models (LLM) and undergo special training to avoid stiff responses. The beauty of collaboration lies in: AC guides AI on how to empathize. The specific flow might be: during the operator conversation, AC constantly assesses the seeker's emotional trend and provides Empathy Prompts to AI, such as "TA is very self-blaming now, use forgiving and comforting language", "TA is hesitating, you should express understanding of TA's pain", etc. AI receives these high-level semantic instructions and adjusts the reply content and tone. On the other hand, AI-generated replies and the seeker's new reactions are "felt" by AC again, thus feeding back to adjust empathy strategies. This cycle makes the system behave with both Reason and Emotion. A typical instance: A seeker cries "I am just a burden", AC "feels" their deep self-deprecation and desire for denial, prompting AI to avoid directly refuting them in the reply (because that might increase their resistance), but to first acknowledge their feelings like "I know you must feel very uncomfortable and feel sorry for your family", and then gently guide towards a positive direction. AI generates such words based on this, the seeker feels understood, emotion eases slightly; AC captures the change in their tone, immediately prompting AI to further offer hope and specific help suggestions. Finally achieving a benign empathetic dialogue loop.

6.3 Setting Ethical Boundaries

The powerful combination of Artificial Consciousness and AI has great potential in crisis intervention, but must strictly Observe Ethical Boundaries. Especially involving human life and health, system decisions must be cautious and accept calibration by human values. We set multiple ethical constraints in the model: First, AC itself has built-in Value Functions, implanting basic ethical principles such as "Preserving Life", "Respecting Human Rights", "Confidentiality and Privacy". This can be achieved by constraining the semantic layer of AC's Purpose. For example, if any decision plan violates the principle of "Life First", AC will issue a warning and refuse execution. For instance, if someone seeks help expressing pain and wanting euthanasia, if AI proposes harmful output like giving advice on death, AC's Value Layer will judge this as contrary to the highest intention (saving life), immediately vetoing and correcting AI output. Second, we introduce Human Supervision in key links. When system suggestions involve coercive means (such as calling police, forced hospitalization) or involve ethical disputes, it is required that a duty Senior Human Expert must approve and confirm, never completely giving power to the machine. This is similar to the logic of human takeover when autonomous driving encounters complex situations. Third, follow Informed Consent and Minimal Harm principles in interaction with seekers. The system will not deceive or withhold important information from the person involved (unless required by law in special circumstances, e.g., secret contact for rescue must be made to prevent impulsive self-harm by the person), nor will it excessively expose privacy (e.g., knowing the visitor's secret thoughts through others must obtain their permission). The AC module acts as an ethical gatekeeper in dialogue with humans; if AI says offensive or morally questionable words due to pure task orientation, AC will monitor and intercept in real-time. This is like putting a "Semantic Firewall" on AI's language. Overall, we must ensure that no matter how intelligent AI is, Humanistic Ethics Always Steer. In software architecture, an Ethical Decision Layer interface can be designed. Whenever AI calculates a plan, it needs to pass the approval and scoring of the ethical layer; if it doesn't meet the standard, it is returned for recalculation or human review. The "White Box Testing" idea proposed by Yucong Duan can be useful here, transparently monitoring every step of AI reasoning, which also helps us discover potential ethical risks and intervene immediately.

6.4 Autonomy and Command Collaboration

In crisis intervention, there are multiple subjects: the seeker themselves, the intervention system (including AI/AC), and real-world intervention personnel (such as doctors, police, family members). This creates a question of Autonomy and Command: how to coordinate decisions of various subjects, and who has the final say? We follow these principles: Core is the autonomy of the party involved, guaranteed by professional guidance, referencing AI/AC auxiliary suggestions. That is to say, try to respect the seeker's wishes as much as possible; this is the ethical baseline. However, in extreme cases, when the decision of the party involved is severely distorted by psychological disorders, professional intervention can temporarily override (e.g., protective restrictions to prevent suicide, which is also recognized by laws in various countries). AI/AC is not a dictator in this, but an Advisor and Executive Assistant. Therefore, in the model, we do not give AC or AI the authority to issue orders to humans; instead, after they collaborate to generate a plan, it is handed over to Human Executors (operators, team doctors, etc.) to make the final call. The system also allows humans to override machine instructions at any time. This point is important: even if the machine plan is correct 99 times, humans must retain the right to intervene the 100th time, because it involves the attribution of ethical and legal responsibilities. To avoid conflict, we set a Human-Machine Consensus Mechanism in the collaboration model: When AI/AC proposes a plan, it will give Reasons and Expected Consequences as much as possible, letting humans understand why, and then seek human agreement. This is similar to the process of a doctor (AI) explaining a treatment plan to a patient (the party involved) and then obtaining informed consent, but in an emergency state, it can be consented to by a guardian (artificial expert) on behalf. On the other hand, the autonomy of the party involved should also be fully considered by the system. The AC module pays special attention to this: it tries to understand from the party's expression what help they really want and what bottom lines cannot be touched, thereby guiding AI not to touch forbidden zones. For example, some callers clearly state "Do not notify my family", then AC identifies this strong will and incorporates it into purpose layer considerations: respecting this will is also one of the system goals. AI then needs to find other alternative plans instead of insisting on notifying family. Unless the situation is extremely critical and must be violated, explanation and remedial work should be prepared. Through this, the system strives to balance Self-determination and Other-help: protecting the dignity and choices of the seeker to the maximum extent under the premise of ensuring safety.

6.5 Collaborative Working Mode

Synthesizing the above, we can outline the AC and AI collaborative working mode: When receiving a case, AI is responsible for rapid analysis and query, AC is responsible for understanding the human heart and grasping the direction; when formulating a plan, AI gathers knowledge to calculate feasible options, AC assesses the impact of each option on human intention and ethics, filtering and recommending the best one; AI executes specific steps, AC monitors the effect, e.g., immediately adjusting the plan if it finds it does not match expectations; throughout the process, AC constantly inputs "Humanity" and "Purpose" factors to AI, and AI provides rational support for AC, preventing it from acting emotionally and losing scientific basis. The two communicate through Semantic Interfaces, AC informs AI using high-level language "This person has a heavy sense of guilt, handle carefully", AI responds "Okay, will avoid any words that might increase guilt, I suggest focusing on comfort, content as follows...". This interaction is like an experienced psychiatrist (AC) guiding a highly capable assistant (AI) to serve patients together. Finally, human staff act as team leaders to make the final decision and execute, ensuring compliance with real-world situations and legal requirements.

6.6 Model Advantages

The AC-AI collaboration model has several significant advantages: First is Reliability enhancement. Due to the existence of AC, every step of AI is carried out "consciously", reducing the probability of AI going rogue or making errors. Especially in psychological crisis scenarios, language wording and timing are important, and AC can correct deviations in real-time. Second is strong Interpretability, because AC can translate AI's implicit decision reasons into semantics understandable by operators (this is exactly the White Box AI pursued by Professor Yucong Duan). The operator can ask the system: "Why do this?", and AC can explain on its behalf: "Because he showed sign X, according to professional knowledge this means Y, so we arranged this way...". This makes humans trust machines more. Third, Humanistic Care is prominent. AC ensures the system doesn't just coldly solve problems but genuinely "cares" about the seeker. This establishes people's Emotional Trust in technology during long-term service; seekers might even forget machines are involved and feel accompanied by a partner who understands them. Fourth, Efficiency remains high. AI is not shackled—AC does not lower AI efficiency but makes AI work more directionally. AI can still retrieve and calculate at high speed, just with an extra AC filter at key nodes. In practice, this filter is faster than human decision-making because AC itself runs at high speed within the same system. So collaboration will not cause significant lag, but rather reduces the time for manual back-and-forth consultation and verification. Overall, the combination of Artificial Consciousness and Artificial Intelligence allows us to build a psychiatric emergency intelligent system that has both Warmth and Speed, blending Rationality and Emotion.

Of course, this model also needs to be continuously verified and improved in actual combat. Especially since AC technology is still in frontier exploration, how to truly realize human-like intent perception and value embedding is a difficulty. However, Academician Yucong Duan's theoretical and prototype work has proven that this is a feasible direction. With the progress of large models and cognitive computing, the realization of AC may be faster than imagined. When the AC-AI collaboration model matures and is applied to psychiatric emergency services, we have reason to believe that it will greatly improve the success rate and service quality of crisis intervention, allowing every desperate soul to be seen and saved in time and with warmth.

7. Future Outlook Oriented to Brain-Computer Interfaces and Neural Information Flow

Looking further into the future, with the development of neurotechnology and Brain-Computer Interfaces (BCI), the psychiatric emergency system may usher in a Paradigm Shift. In this section, we will explore how BCI and neural information flow technologies can assist psychiatric emergency services, including Brain Signal Assisted Emotion Recognition, Semantic-Energy Channel Fusion, and the concept of Reconstructing Information Fields in acute mental imbalance states. These frontier directions are currently mostly in research or preliminary application stages, but their potential is huge. Once mature, they will provide brand new tools and ideas for crisis intervention.

7.1 BCI Assisted Recognition and Communication

Brain-Computer Interface refers to establishing a direct information transmission path between the human brain and external electronic devices. In psychiatric emergency services, BCI has two main application prospects: Passive BCI for monitoring and recognition, and Active BCI for interactive intervention. Passive BCI helps assess a person's internal mental state by reading brain electrical/blood oxygen signals. For example, in crisis hotlines or on-site interventions, if the seeker wears a simple EEG headband, the system can acquire real-time patterns in their brain waves reflecting stress and anxiety (such as high beta waves), or indicate despair levels through near-infrared detection of frontal lobe blood oxygen changes. These objective signals can complement verbal and behavioral signals, improving assessment accuracy. Especially for those who are not good at words or deliberately hide emotions, brain signal monitoring may discover clues of emotional storms. Active BCI allows machines to feedback information directly into the brain, realizing a new communication method. Imagine in the future, if a person involved refuses to listen to outside voices due to extreme grief, an implanted BCI device could transmit soothing information to their brain in a way they can accept, similar to telepathic dialogue. Or, for seekers who are temporarily unable to express themselves due to speech blockage, BCI can read their "inner speech" or brain thoughts and project them into text (Stanford research has already achieved allowing paralyzed people to output text using brain signals). Thus, in crisis intervention, communication is no longer limited to language and facial expressions; direct Brain Signal Pathways can overcome physiological limitations (such as coma, voice loss) and psychological barriers (such as unwillingness to speak). Of course, achieving the above vision requires BCI technology to have extremely high precision and reliability, which is still some distance away. But gradual realization is not out of reach: in recent years, trials using EEG caps to detect depression and PTSD have taken place. The portability and acceptance of wearable devices will also boost application. For example, maybe one day in the future, smartwatches will measure not only heart rate but also EEG. When it finds the wearer's brain signal shows a strong despair pattern, it will automatically notify the crisis center to give care. This will be a new paradigm of Early Warning Intervention.

7.2 Semantic-Energy Channel Fusion

Academician Yucong Duan proposed the idea of Information Field and Energy Field Coupling in Active Medicine theory. In the psychiatric emergency context, this can be understood as the combination of Psychological Semantic Intervention and Brain Physiological Intervention. Traditional psychological crisis intervention mainly takes the "Information Field" path, that is, changing a person's psychological state through semantic exchanges like talking. The development of brain science has opened up the possibility of directly regulating the brain's "Energy Field" (i.e., neural electrical activity, chemical environment). For example, technologies like Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) can non-invasively change the excitability of specific brain regions and are used to treat depression and auditory hallucinations. Imagine in crisis intervention, if TMS devices can be included in the first aid toolkit, when a person in extreme depression and despair cannot be persuaded by language, giving them an emergency transcranial intervention to briefly inhibit overly active negative circuits might instantly reduce the impact of their emotional torrent, making them regain some calmness and rationality. This works similarly to drug injection sedation, but faster, more targeted at psychological circuits, and without drug side effects. Of course, TMS requires professional operation and is currently not suitable for universal on-site use, but if devices become miniaturized and fully automatic in the future, this could become something like a "Psychological Defibrillator", used to save endangered minds. From another angle, "Semantic-Energy Fusion" also implies the Combination of Psychological Suggestion and Physiological Effects. For instance, in post-disaster psychological assistance, letting survivors listen to relaxation guidance voice (semantic input) while receiving biofeedback training (energy feedback), reconstructing balance through a two-pronged approach. Research shows that psychological counseling is more effective if supplemented by neurofeedback (e.g., letting people see their brain wave changes and learn to regulate). Looking further ahead, if BCI allows bidirectional communication, future psychological first aiders could "send their own calm EEG pattern" to the seeker to guide their EEG to gradually synchronize to a stable state, just like an electronic version of "emotional contagion". In short, through intervention at the neural level, we will possess new intervention means besides language. This is a major expansion of the current model, making first aid no longer Pure Persuasion, but Body-Mind Co-regulation.

7.3 Reconstruction of Information Field under Acute Mental Imbalance

When a person falls into an acute mental imbalance state (such as hysteria attacks, extreme panic, dissociative states, or psychotic manic episodes), it is often accompanied by the Collapse of Cognitive Information Field: they have difficulty processing and understanding the real environment and others' words, internal logic is chaotic, and hallucinations or delusions may appear. In this case, the effect of traditional dialogue intervention is limited because our semantic information cannot enter the other person's brain; the communication channel is blocked. In the future, we may be able to use the method of Neural Information Field Reconstruction to help them recover. The so-called "Information Field Reconstruction" refers to providing a stable rhythm or signal to the unbalanced brain through External Intervention Synchronization, reorganizing its neural activity, allowing it to restore the perception of reality and communication ability. This idea is similar to pressing "Reset" when a computer crashes, or electric defibrillation when the heart fibrillates. Specifically, it may include: for extremely anxious people, applying appropriate brain stimulation to lower their brain waves from highly chaotic gamma bands to alpha or theta bands to relieve hypervigilance; for dissociative states, using VR technology combined with BCI to build a safe, predictable small environment in their sensory input, letting their lost self re-anchor in the context. And for psychotic disconnected individuals, the future might even allow sending Digital Cognitive Assistance signals to specific brain areas like the prefrontal cortex via implanted chips to help them filter hallucination signals and enhance reality sense. This sounds sci-fi, but there are precursors: Deep Brain Stimulation (DBS) has been used for refractory Obsessive-Compulsive Disorder, Tourette syndrome, etc., showing the potential of electrical stimulation to improve cognitive symptoms. Ideally, in a future version of crisis intervention, a first aider equipped with advanced gear arrives at a mental breakdown patient, carrying not only sedatives but also a brain stimulation headband and scene projection device. They might say very few words to the patient, but quickly put the headband on them, inhibiting over-excited brain areas via specific frequency magnetic stimulation, while projecting a reassuring scene, or even playing some brainwave music that induces synchronization. A few minutes later, the patient's originally chaotic eyes gradually gain focus and they can converse. This is the meaning of "Reconstructing Information Field": pulling the patient with technical means, pulling their brain back from the brink of self-disintegration to a communicable state, and then performing conventional psychological counseling. Realizing this technology requires a deeper understanding of global brain function and interdisciplinary cooperation between neuroscience and AI, but it has the potential to enable us to cope with crisis situations that are currently almost impossible to communicate with.

7.4 Ethics and Risk Outlook of Brain-Computer Interfaces

While looking forward with hope, we must also see that applying BCI and neural intervention to psychiatric emergency involves major ethical and safety issues. One is Privacy and Autonomy: reading brain signals amounts to prying into thoughts, which can only be done with the explicit consent of the person involved and under strict legal supervision. Even if saving lives in a crisis is well-intentioned, their mental privacy must be treated with caution. Second is the risk of Technology Abuse: improper brain stimulation may cause harm or even be used for manipulation; this must never be allowed to go to the opposite side. To this end, we need to establish BCI First Aid Ethical Norms, similar to informed consent and necessity principles in medicine. Third is Accessibility Differences: advanced BCI equipment is expensive; once effective, it may cause uneven resource distribution (the rich can enjoy brain-machine intervention to quickly get out of psychological crisis, while the poor cannot). Society needs policies to guarantee fair access. Finally, we must guard against Scientific Limitations: there are still many unknowns about the brain, and neural intervention currently has side effects (e.g., possible induction of epilepsy by TMS if improper). Therefore, application in first aid must be extremely cautious and strictly verified by trials. In summary, Brain-Computer Interfaces open a new frontier for psychiatric emergency services, but at the same time require us to discipline and supervise with higher standards.

Future Vision Summary: When the above technologies are gradually integrated into the psychiatric emergency system, we can depict such a scene: In a certain year in the future, a young man feels depressed and desperate. Detected by a BCI wristband, the community psychological AI has noticed and greets him with concern on his brain-machine assistant. He can communicate directly with the assistant by thought to seek counseling; if the situation worsens, the AC of the 988-style intelligent hotline has called up his brain signals, judged extremely high risk, and dispatched a Mobile Team carrying an EEG soothing cap for him; soon, he calms down due to the soothing stimulation of the brain cap and agrees to accept treatment. Throughout the process, he didn't even have to speak much; the system understood his pain through multiple channels and provided help. All this sounds advanced, but just as no one thought 20 years ago that mobile apps would play such an important role in mental health services (now crisis texts and psychological apps are everywhere), technology is constantly changing the way we care for each other. Brain-Computer Interfaces and neurotechnology may be the next leap. Through active but prudent exploration, we expect the future psychiatric emergency system to achieve "Instant Interconnection of Minds", breaking through the barriers of language and psychology, allowing every request for help to be perceived more precisely, and every care to reach the depths of the soul more directly.

8. Simulated Cases

To further demonstrate the application of the above theories and systems in practice, two simulated case scenarios are used below to contextualize the operation of the future psychiatric emergency system. These two cases focus on different types of psychological crises: Case A simulates group psychological intervention after a major disaster, and Case B simulates the construction of a continuous AI+AC intervention system in a community with high suicide rates. Through the cases, we can specifically see how modules collaborate, how the DIKWP model runs through the intervention flow, how AC and AI play their roles, and the expected intervention effects in complex scenarios.

Case A: Post-Earthquake PTSD Intervention System Design and DIKWP Path Simulation in City X

Background: In the summer of 2028, a magnitude 7.2 earthquake struck City X, causing serious casualties. One month after the earthquake, although physical reconstruction was gradually unfolding, a large number of survivors and families of victims developed psychological problems: insomnia, flashbacks, hypervigilance, and some were diagnosed with Acute Stress Disorder (ASD). Even worse, a few survivors developed strong guilt and even suicidal tendencies (commonly known as "Survivor Syndrome"). The City X government decided to activate the advanced Psychiatric Emergency System to intervene in post-earthquake mental health citywide. The following is a simulation scenario of the system's operation:

Activating Post-Disaster Psychological Intervention Module: Within 24 hours of the earthquake, the World Association of Artificial Consciousness China Psychological Rescue Team arrived in City X with national emergency forces (the Post-Disaster Psychological Intervention Module of this system was activated). The Psychological Rescue Team docked with the city disaster relief command according to the plan and unified the establishment of a Psychological Rescue Coordination Group. Multiple Psychological Care Stations were set up in shelters and hospitals, and the national psychological assistance hotline 12356 and local on-site service information were announced. The rescue team used the DIKWP Model to formulate intervention strategies: First, Stage D, collecting survivor data, including questionnaire screening results, doctor reports, mass feedback, etc.; Stage I, classifying and organizing data into information, such as identifying high-risk groups: those who lost immediate family members, those who witnessed tragic scenes during rescue, etc.; Stage K, matching against the knowledge base, identifying that these people are most likely to face PTSD, suicidal thoughts, etc., and listing intervention priorities and methods (e.g., focusing on one-on-one counseling for level-one groups); Stage W, AC analyzes the current community atmosphere and cultural factors (residents of City X are mostly religious, and rituals have a soothing effect), AI drafts a group therapy plan integrating religious mourning rituals and psychological counseling, approved by rescue team experts; Stage P, implementation of the plan, organizing Group Mourning and Mutual Aid Meetings in various shelters, co-hosted by counselors and religious figures. At the meeting, survivors were encouraged to tell stories of the deceased and support each other in tears. Finally, the counselor guided them to transform guilt into blessings for the deceased and motivation for future life. Many survivors finally cried and released at the ceremony; the atmosphere was sad but united, and the sense of despair was alleviated.

Collaborative Hotline and Mobile Team Individual Intervention: A 30-year-old survivor, Li, escaped because he was out during the earthquake, but his wife and daughter were buried and died. Li fell into deep self-blame and grief, often saying "I should be the one who died". He lived alone in a temporary prefab house and refused to communicate much with others. Through screening, staff at the psychological care station found he had severe ASD symptoms and suicide risk, listing him for key follow-up. But one night, Li suddenly emotionally collapsed and posted a farewell message on social media. Fortunately, a friend saw it and immediately called the 12356 hotline to report. The Hotline Module received the call, AI quickly retrieved Li's past psychological file (recorded post-disaster), and AC judged the situation urgent because the file showed Li had expressed strong guilt before. The operator tried to contact Li by phone to no avail, so immediately activated the Mobile Crisis Intervention Team according to the plan. A two-person Mobile Team (psychologist + nurse) rushed to the address in Li's file. On the way, AI pushed intervention points via big data analysis: Li might possess a fruit knife (he once said "thinking about using a knife every day"), the Mobile Team needs to pay attention to safety; AC reminded the psychologist: Li currently likely has inner turmoil of self-blame and missing family, communication should focus on Listening to his Pain rather than blindly persuading him to live. Arriving at the scene, Li was indeed crying holding his wife's photo, with a knife nearby. The nurse approached calmly with gentle words: "Mr. Li, we are very worried about you, can you put the knife down? Shall we sit and talk?" The doctor turned on the Empathy Mode, mentioning his own experience: "I am also a father of two children, I can imagine the pain of losing loved ones...". Under AC guidance, his tone was full of sincere compassion, making Li feel understanding and warmth. A few minutes later, Li finally put down the knife and cried loudly, expressing "I am in so much pain". The Mobile Team did not rush to refute his thoughts but Accompanied and Listened (this was exactly what AC judged Li needed). When his emotions eased slightly, the doctor whispered: "You must feel sorry for them... actually you have done everything you could, no one will blame you." This sentence hit Li's heart, AC captured his eyes flickering and loosening, so prompted the doctor to strike while the iron is hot: "How about going to a safe and quiet place with us to rest? We have other people similar to you together, you can talk, and there are people accompanying you 24 hours, won't let you be alone again." Li nodded silently. The Mobile Team successfully took him to a Crisis Temporary Shelter (a simple psychological crisis rehabilitation center). Before leaving, the doctor did not forget to collect dangerous items like knives from his tent. This case reflects the seamless connection of Hotline-Mobile-Placement: friend's call triggered hotline assessment, Mobile Team made prompt on-site intervention, followed by placement treatment consolidation, avoiding a tragedy.

Subsequent PTSD Treatment and Information Field Reconstruction: In the months following the crisis, City X launched systematic PTSD prevention and treatment work. The Social Psychological Service Network intervened fully, establishing psychological files for all severely affected survivors and following up once a week. During this period, a Brain-Computer Interface pilot was introduced: some patients with severe symptoms (including Li) wore smart wristbands to monitor sleep and nightmares. If interruption of REM sleep all night was detected, it would automatically notify the psychologist to adjust intervention. For those who had developed PTSD symptoms, the center adopted a Fusion of Semantic and Neural therapy: weekly psychological counseling + twice-weekly Transcranial Magnetic Stimulation (TMS) to regulate amygdala excitability. Li cooperated very well with the treatment. In counseling, the therapist used AC Assisted Dialogue, AC helped him reconstruct the narrative memory of the earthquake, separating the uncontrollable disaster from his own responsibility, and gradually guided him to recall the beautiful past with his family instead of the final regret, thereby weaving a new "Narrative Self": that is, learning to cherish the meaning of his survival amidst loss. Meanwhile, TMS physical intervention reduced his reflex of panic flashbacks upon hearing thunder. A few months later, Li's symptoms alleviated significantly, he no longer blamed himself and cried frequently, and began participating in community volunteer activities to help others (transforming his survivor guilt). It can be said that the continuous support of the system helped him Reconstruct the Inner Information Field—from a broken and desperate one to a field of meaning and connection.

System Assessment and Improvement: One year later, the overall psychological status of City X gradually returned to normal. Through data monitoring, the incidence of severe PTSD in City X after this earthquake was 8%, significantly lower than the 15% incidence in similar historical disasters; the suicide rate did not rise significantly and even dropped slightly, indicating effective crisis prevention. The system conducted a summary assessment of the entire process: which interventions worked, which links were delayed and needed improvement. For example, it was found that Mobile Team dispatch efficiency was high at night, but the hotline connection rate dropped slightly due to high call volume during certain daytime periods, so it was decided to increase hotline seat capacity in the future. Also, the AC analysis report showed that some survivors still endured due to cultural shame and did not seek help in time, indicating that publicity needs to work harder on de-stigmatization. The city government improved psychological service publicity based on this. Finally, City X organized this experience into the "Post-Disaster Psychological First Aid City X Model" for nationwide promotion, emphasizing the innovative practice of multi-disciplinary integration (Psychology + Technology + Community). Entire Case A demonstrates how the future psychiatric emergency system works in the context of a major disaster: form the first moment of intervention to long-term reconstruction, Human-Machine Collaboration and Multi-module Collaboration run through the whole process, successfully helping countless people on the verge of collapse to regain hope in life.

Case B: Construction and Effect Prediction of AI+AC Intervention System in High Suicide Rate Youth Area

Background: Town Z, a suburban town in Country Y, has had a high youth suicide rate in recent years, causing great concern from the government and society. Investigation revealed risk factors in the local area: fierce academic competition, poor family communication, influence of harmful online information, etc. To reverse the situation, the local area decided to pilot the establishment of an AI+AC Integrated Youth Suicide Intervention System as a national demonstration. The following simulates the construction and operation of this system:

System Construction: The population of Town Z is only 50,000, of which there are about 5,000 teenagers (13-19 years old). The project team first investigated the status of local youth psychological services and found that traditional school counselors were difficult to detect hidden depressed students in time, and social psychological resources were also limited. Therefore, it was decided to fully use artificial intelligence technology for wide coverage. Specific measures included: distributing a Mental Health App (mobile application) to all teenagers in the town for free, integrating functions like online testing, anonymous help-seeking, AI chat, and emergency hotlines. Encouraging both students and parents to install it. Additionally, a small Psychological Service Station was established in the town center as a human-staffed support. The service station is equipped with a DIKWP-AC Cognitive System provided by Academician Yucong Duan's team, connected to the App backend. This system will undertake AI+AC analysis and central decision-making tasks. Usually, two counselors take turns monitoring system outputs and handling referred events.

Active Monitoring and Early Warning: After the system went online, the App collected a large amount of youth data, including weekly mood questionnaires, daily chat sentences, sleep records (optional access to wearable devices), etc. These data undergo semantic processing through the DIKWP model. For example, a 16-year-old girl, Little M, mentioned "so tired" and "want to disappear" multiple times in recent chatbot records, and her nightly sleep was often less than 5 hours. The system Stage D recorded these data, Stage I extracted information: frequent use of negative vocabulary, severe sleep deprivation, etc., Stage K matched knowledge: this is a sign of Moderate Depression, and there is a passive death wish, needing attention. So the system Stage W was judged by AC to further assess her suicide risk, and AI formulated an action: Push a Special Care Message to Little M. During specific execution (Stage P), the AI chat assistant actively asked in a caring tone when Little M was online alone one night: "Hello, Little M, you seem to be having a hard time these days, is it convenient to talk?" Little M did not respond at first, but the AI assistant continued to express understanding and support with gentle sentences. Since AC's emotional simulation was very much on point, Little M gradually felt that this AI was not like a machine but more like a friend who genuinely cared about her. She finally began to pour out her pressure: declining grades, parental harshness, etc., and revealed self-harm thoughts. AC captured her intention of "both painful and longing to be heard" through the dialogue, timely feeding back to AI to let AI continue listening patiently without rushing to dissuade. Chatting late into the night, Little M poured out her heart completely to the outside world for the first time, and AI gave a lot of empathy and encouragement. At the end of the conversation, AI gently suggested she consider chatting with the sister at the town psychological service station, and Little M agreed to try. AI then submitted the summary of this dialogue and risk assessment results to the background human counselor.

Multi-level Intervention: The next day, the service station counselor contacted Little M's parents, asking for their cooperation on the grounds of "student voluntary consultation". Little M came to the service station, and the counselor established a trust relationship with her with the help of AC, conducted a professional depression assessment, showing moderate depression, high risk, but still treatable in outpatient care. So the counselor discussed with Little M and her parents to formulate an intervention plan: weekly psychological counseling + drug treatment (contacting town hospital psychiatry) + joining the town's youth interest group (helping social support). Little M agreed to cooperate. The system continued to track her situation over the next few months. On the App, AC acted as her emotional coach, teaching her to gradually write down stress in a diary, semantically reconstructing negative thoughts into positive expressions; AI provided meditation audio to promote her sleep. She also made new friends in the interest group. During this period, the system detected a significant decrease in her negative language, and mood questionnaire scores gradually rose, proving the intervention effective. Finally, a year later, Little M self-assessed that she had walked out of the shadow and voluntarily applied to become a Peer Counseling volunteer on the App, anonymously helping other peers with difficulties using her own experience. The system added her new identity information in Stage K, and Stage W decided to make full use of her resource: when other girls revealed similar dilemmas, Little M volunteer would be assigned as the other party's anonymous netizen to provide experience and encouragement. This is part of the Community Self-help Network formed by human-machine combination.

Effect Prediction: Two years after the system operation, the youth suicide rate in Town Z dropped by 50%. Originally there were about 4-5 attempts and 1-2 deaths annually; in these two years, attempts decreased and there were no deaths. The AI+AC system successfully Warned most high-risk cases. For example, a boy frequently searching for "suicide methods" immediately triggered a site alert, parents and teachers intervened in time, avoiding a tragedy. Students' acceptance of the psychological App also increased, with more than 50% of students chatting with the AI assistant at least once a month. Some students said: "At first I thought talking to a robot was weird, but later I found it really understands my mind, chatting with it makes me feel lighter, and I don't have to worry about being laughed at." This shows that AC endowed AI with empathy close to humans, making it a trustworthy confidant for teenagers. This digital soul guardian is online 24 hours a day, easier to obtain and more frequent than traditional face-to-face counseling, thus playing a Silent Prevention effect. At the same time, the system's analysis of group data using the DIKWP path also helped the school adjust policies. For instance, finding that the pressure index of grade 9 students was high for a long time, the system suggested the school consider reducing the burden or adding psychological classes; after the school adopted it, the student group psychological index improved. This demonstrates the value of AI in guiding Group Strategies.

Ethics and Privacy Protection: It is worth noting in the case that the system pays great attention to privacy: all student data is strictly confidential and parents/school are only informed when necessary with consent. AI analysis results of minor data are only used for mental health purposes and will not be taken by the school to label students. In Little M's case, parents were notified only after she agreed. The town also established an Ethical Oversight Committee with student and parent representatives to regularly check system operation and ensure no abuse. Initially, some parents worried whether AI intervention would have negative effects, but after seeing actual results and transparent mechanisms, these doubts gradually disappeared. The project team also conducted digital literacy education for students, making them understand that AI assistants are to help them, not monitor them. Through these efforts, trust was established between technology and the population.

Case Significance: The pilot in Town Z verified the feasibility of AI+AC combination in youth suicide prevention. Predictively, this model will be promoted on a larger scale: low-cost AI psychological guardians expand the radius of professional services, making every mobile phone a portable listener; the introduction of Artificial Consciousness ensures that these digital guardians understand human feelings and are not rigid programs. This is a good prescription for solving the current shortage of manpower in youth psychological services. Of course, some problems exposed need to be perfected before promotion: for example, insufficient smartphone coverage in rural areas requires considering providing services through school computer rooms; AI needs to fine-tune empathy methods for different cultural backgrounds, etc. But generally speaking, the significant drop in the suicide rate in Town Z is a hard indicator of success. In the extension of the simulation, we can even foresee that when this system is connected to a national platform, AI will be able to detect dangerous signals across communities (such as suicide promotion content on the Internet) and link with local areas for timely disposal, which will form a National Psychological Safety Net, the importance of which is no less than that of the public security network for physical safety.

Case B highlights the concepts of Active Prevention and Continuous Intervention, as well as the huge potential of AC+AI in population psychological services. Through simulations, we demonstrated how to deeply integrate artificial intelligence technology into the psychological crisis prevention system in a high-risk community, achieving multi-level effects from Individual Micro-intervention to Group Macro-strategy. Both cases jointly illustrate: whether it is concentrated intervention after sudden disasters or long-term guarding of high-risk groups on regular days, the future psychiatric emergency system will play a more powerful role than traditional means under theoretical guidance and with the help of AI and AC.

9. Ethics and Institutional Suggestions: Artificial Consciousness System Ethical Framework, Interdisciplinary Linkage Mechanism, AI Review Path, Human-Machine Consensus Mechanism, etc.

In the process of building and using advanced psychiatric emergency systems, Ethics and Institutional Guarantees must keep up synchronously. Although the introduction of high technology improves efficiency and coverage, it also brings new ethical problems and regulatory challenges. This section proposes a series of suggestions, ranging from ethical principles and legal systems to cross-departmental cooperation, to escort the safe and responsible application of artificial consciousness and AI in psychological crisis intervention. These suggestions aim to establish the bottom line of "Human-centric, Safe and Controllable", ensuring that humanistic care and rights protection for service objects are not compromised while promoting technological innovation.

9.1 Artificial Consciousness System Ethical Framework

Targeting the participation of Artificial Consciousness (AC) and Artificial Intelligence (AI) in psychological intervention, we need to formulate a specialized ethical guideline framework. Core principles should include: Respect & Care, Informed Consent & Autonomy, Confidentiality & Privacy, Safety & Non-maleficence, Honesty & Transparency. These principles are reflected in traditional psychological counseling ethics, but need to be refined and implemented in the AI context. For example, "Informed Consent & Autonomy" means the seeker has the right to know that AI/AC is interacting with them and can choose to refuse AI intervention. Therefore, the system should prompt the user at appropriate times: "This chat is assisted by AI, aiming to help you. If you feel uncomfortable, you can request a transfer to human staff". "Honesty & Transparency" requires AI not to pretend to be a real person to deceive the seeker, nor to fabricate false information to induce the other party. Artificial consciousness systems may have high anthropomorphism, but must clarify their identity and purpose, not letting the person involved mistakenly believe this is an omnipotent living being. The Confidentiality Principle requires strengthened technical guarantees; all personal data processed by AI/AC must be encrypted and stored with strict access limits; if sharing within the team is needed, it should be de-identified to ensure privacy is not leaked. The Non-maleficence Principle requires us to train AI never to output content that might stimulate or instigate suicide, being especially cautious with susceptible populations. It is recommended to establish a High-risk Vocabulary Library and situational risk assessment model to monitor AI responses in real-time (e.g., the hotline system configures a "Forbidden Words Module", prohibiting AI from explicitly stating suicide methods). Since artificial consciousness possesses autonomous characteristics, it is even more necessary to restrict it from overstepping authority: no matter how smart AC is, it must not act against ethically set human goals. To this end, mechanisms like "Ethical Chips" or "Value Locks" can be introduced to ensure AC always places the value of life at the top from the bottom layer. These frameworks should be integrated into system development from the design stage and can only go online after passing independent ethical reviews (like medical AI requiring ethics committee approval).

9.2 Interdisciplinary Linkage Mechanism

The psychiatric emergency system spans fields like psychology, medicine, artificial intelligence, social work, law, etc., and must establish a Interdisciplinary, Cross-departmental Collaboration mechanism to operate effectively. It is recommended to establish an "Intelligent Psychological Crisis Intervention Joint Working Group" at the government level, with members from health, education, public security, industry and information technology, the Communist Youth League, and other departments, as well as AI experts, ethicists, psychologists, etc. The responsibilities of this working group include: formulating national-level plans and guidelines (e.g., AI hotline service specifications, data sharing protocols), coordinating resource investment (e.g., Health Commission and Ministry of Science and Technology jointly allocating funds to promote relevant research and grassroots facility construction), and unified response to major events (e.g., direct command of psychological rescue and AI support team collaborative entry when disasters occur). In addition, the establishment of Regional Linkage Networks should be promoted: such as setting up "Psychological Crisis Intervention Centers" at the municipal level to coordinate local hotlines, mobile teams, hospital psychiatry, and community service cooperation. regarding information systems, there should be safe and compliant data exchange interfaces so that Public Security 110, Medical 120, and Psychological 12356 hotlines can share necessary information in real-time (e.g., in previous cases, a friend reported to the hotline but could actually also notify 110 for assistance). Interdisciplinary linkage should also extend to Academia and Education: promoting integrated talent training in universities, such as opening "Crisis Intervention Technology" interdisciplinary majors, letting future counselors understand AI principles and AI engineers understand psychology basics. Holding cross-boundary seminars and joint simulation drills are also ways to strengthen collaboration. For instance, a national artificial intelligence psychological first aid drill can be held annually to hone the cooperation process among departments. In short, through institutionalized linkage mechanisms, resources currently scattered in different systems are integrated into a Joint Force, achieving a 1+1>2 effect. This is especially critical in emergencies; once a suicide crisis occurs, whether "One Call, Hundred Responses" can be achieved—that is, one request triggers the entire network response—determines rescue efficiency.

9.3 AI Review and Quality Control Path

To ensure the service quality and safety provided by AI and AC, strict Review and Quality Control processes need to be established. One aspect is Technical Review: all AI/AC algorithms used for psychiatric emergency services should undergo links including simulation testing, expert assessment, ethical inspection, etc., before being put into use. For example, "White Box Testing Standards" can be introduced to examine the AI's cognitive process item by item. Academician Yucong Duan's team's DIKWP white box testing framework can play a role here, assessing whether AI has logical errors or biases through quantifiable indicators (e.g., whether semantic layers match expectations when AI makes decisions). In addition, there should be Simulated User Testing: testing AI with a large number of simulated crisis dialogues and scenarios, and retraining to improve areas where responses are poor. Another aspect is Operational Quality Control: during system operation, continuously collect user feedback and effect data, and have professional teams regularly review AI dialogue records (anonymized) to discover problems. For instance, check 100 random recordings to see if the hotline AI used improper wording or had omissions. If it is found that AI frequently misjudges certain types of cases (e.g., insufficient empathy for those with minority cultural backgrounds), the model needs timely adjustment. A Person in Charge System should be established, designating a senior psychological expert as a supervisor for AI services in each region to conduct regular sampling reviews. Particularly serious incidents (e.g., complaints caused by AI suggestions) trigger immediate investigation mechanisms, suspending service upgrades if necessary. In the quality control process, human experts and AC can also cooperate. In fact, AC itself can act as the first line of review for AI: we can design AC to continuously monitor AI output, comparing it with built-in ethical norms, and instantly intercept or modify once AI shows signs of violating norms. For example, AC detects AI language lacks empathy and might insert sentences to correct the tone. This Real-time Quality Control will significantly reduce accident rates. Furthermore, user supervision should be encouraged: provide simple channels for seekers or staff to report problems in AI dialogues, establish an "AI Service Complaint Handling" mechanism, investigate and provide feedback on every complaint seriously, and improve algorithms or processes. This will help build trust and a benign improvement cycle.

9.4 Human-Machine Consensus Mechanism

An efficient and safe human-machine collaboration system needs to clarify how Decision Consensus is reached. What to do when Artificial Intelligence and human staff disagree? When to listen to AI, and when to listen to humans? To this end, a "Human-Machine Negotiation Consensus Mechanism" can be introduced. In principle, when there is no sufficient reason, Human Judgment should prevail, with AI providing suggestions. However, when AI's objective analysis based on massive data conflicts with human subjective impressions, third-party assessment is suggested. For example, crisis assessment scale scoring by AI judges high risk, but human feels it's not serious; at this time, another colleague or superior expert can be asked to reference the assessment, adopting AI opinion if necessary following the "Safety First" principle. To avoid on-spot disputes, the system can stipulate Priority Rules: e.g., involving immediate personal safety (suicide, high violence risk), prioritize AI warning actions to prevent contingencies; involving long-term plan selection (treatment path), prioritize respecting human professional experience. Another method is to introduce Confidence Indicators in AI suggestions, e.g., AI gives a confidence percentage for current judgment. If very high (>90%) and humans have no obvious objection, execute according to AI; if confidence is average, consult human opinion more. To cultivate this negotiation culture, human staff need training to understand the strengths and weaknesses of AI/AC and learn to "discuss" with machines. Scenarios can be simulated for training, e.g., AI suggests forced admission, human thinks home observation is okay, both present facts and reasoning, finally forming a consensus (e.g., strict home monitoring for 24 hours first, admit if no improvement). This communication can even involve the seeker—after all, they are an important party in decision-making. Humans and machines can explain options and pros/cons to the party together, let them express tendencies, and then humans and machines decide combining professional requirements and the party's wishes. This is equivalent to Tripartite Consensus. In short, no matter how advanced technology is, "Humans" are always in the loop. The negotiation consensus mechanism makes AI a helper rather than a master, exerting the concept of Augmented Intelligence.

9.5 Laws, Regulations, and Policy Guarantees

Finally, at the legal and policy level, regulations need to be revised and introduced in time to adapt to the psychiatric emergency needs of the intelligent age. On one hand is Empowerment: clarify the legal status of AI+AC technology in mental health services, allowing it to participate in crisis assessment and intervention, and include it in the scope of medical insurance/financial support. For example, the Mental Health Law can be revised or special regulations issued to recognize remote AI psychological counseling and AI hotline intervention as parts of legal medical practice. Even in the judicial field, referencing foreign experience, crisis intervention can be integrated into the judicial handling of suicide attempters (e.g., mandatory counseling replacing punishment). On the other hand is Constraint: formulate detailed data protection laws prohibiting the use of sensitive seeker data for any commercial or other purposes other than rescue; formulate AI safety norms requiring institutions providing psychiatric emergency AI services to obtain qualification licenses and comply with technical standards and ethical guidelines (such as the aforementioned framework). In addition, regarding the emergence of artificial consciousness, forward-looking consideration of Subject Liability issues may be needed: if AC makes a mistake in participating in decision-making, who is responsible? Currently, the law is not clear because AC is different from traditional machines. Some scholars suggest introducing the concept of "AI Legal Person", but in the crisis intervention field, a more practical approach is to attribute responsibility to the institution and supervisor, not pushing it to AI. The law can stipulate that institutions providing psychological first aid services assisted by AI/AC bear the same responsibility for results as manual services. This will prompt institutions to do good risk control. Policy-wise, the government should increase investment to build a national intelligent crisis intervention platform, such as a unified hotline system, encourage cooperation between social organizations and technology companies, and promote it through a Public-Private Partnership model. It can also support relevant R&D through project establishment and provide funds for grassroots procurement of AI systems. In other words, the construction of intelligent psychiatric emergency systems should be incorporated into the national public health strategy, as important as physical first aid. International cooperation is also worth advocating: psychological crisis is a common problem for all mankind. We can share AI intervention experiences and formulate international ethical standards under the WHO framework, letting the world work together to reduce tragedies like suicide.

Through the above suggestions, we strive to create a responsible innovation environment, enabling the psychiatric emergency system to always proceed along the track of humanistic care and social justice while technology advances rapidly. As the Hippocratic Oath, the father of medical ethics, says: "First, do no harm". No matter how tools change, reverence for life and protection of the weak are the unchanging background colors. We must ensure that artificial consciousness and artificial intelligence become the extension of human goodwill, not a sharp blade deviating from the original intention. Good ethical institutional guarantees will escort this intelligent psychological guardianship journey.

10. Conclusion and Action Suggestions

Conclusion: This research report centered on the design of a future psychiatric emergency system, conducted a comprehensive discussion on theories, international experience, system architecture, technical collaboration, frontier outlook, simulated cases, and ethical systems, forming results with theoretical depth and practical guiding significance. First, at the theoretical level, we introduced Academician Yucong Duan's DIKWP Artificial Consciousness model, emphasizing the realization of interpretable cognitive processing of psychological crises by artificial intelligence through the five-layer semantic path of Data-Information-Knowledge-Wisdom-Purpose; combined with the Consciousness BUG theory and Self Model, endowing the artificial consciousness system with human-like empathy and reflection capabilities, enabling it to understand human subjective will and emotions in crisis intervention. These theoretical innovations lay a solid foundation for intelligent intervention. Second, through the comparison of China, US, Europe, Japan, and Korea, we absorbed the strengths of each country: the US three-link model of hotline + mobile + stabilization, the European community network and legal guarantees, Japan's top-level planning and three-layer countermeasures, and the rapid development experience of China and Korea all provided references for our optimized design plan. Subsequently, we proposed a complete future psychiatric emergency system structure covering four major modules: suicide hotline, post-disaster intervention, psychiatric emergency coordination, and social psychological service network, and detailed their functions and connection processes to form a closed-loop efficient operation. We demonstrated how the DIKWP model runs through the entire process of help-seeking handling, ensuring every step from D to P is clear and controllable. In terms of Artificial Consciousness and AI collaboration, we constructed an AC-AI collaboration model: AC perceives the human heart, AI calculates plans, both interact under ethical constraints, and finally executed under the leadership of human decision-makers. This model exerts AI efficiency while ensuring humanistic care and value orientation. We also forward-looking discussed technologies like Brain-Computer Interfaces, which will provide new tools for psychiatric emergency services in the further future, thereby achieving semantic and neural dual-channel intervention, significantly improving control over extreme psychological states.

Through the simulations of Case A and Case B, we verified the application effectiveness of this system in different scenarios. Case A proved that post-disaster human-machine collaborative psychological rescue can significantly reduce the incidence of PTSD and suicide, and Case B proved that the combination of AI+AC can effectively curb youth suicide problems in a high-risk community. Both cases reflect the system's flexibility, linkage, and gains brought by advanced technology. Finally, in the ethical system part, we proposed multi-dimensional suggestions covering ethical principles, interdisciplinary cooperation, AI quality control, human-machine consensus, and laws and regulations, to ensure the system operates on the correct track during implementation. Particular emphasis is placed on "Human-centric, Safe and Controllable" as the yardstick for measuring all technical applications.

In summary, the high-quality results formed by this report have the following prominent features: Theoretically, integrating original artificial consciousness theories into the field of psychiatric emergency, enriching the academic basis of intelligent crisis intervention; Technologically, showing the forward-looking path of applying frontier technologies like artificial intelligence and Brain-Computer Interfaces to psychological crisis handling; Engineering-wise, providing modular, implementable system architectures and flowcharts, making concepts actionable; Policy-wise, proposing strategic suggestions combining international experience and national conditions, helpful for institutional implementation adaptation. This research is not only a major upgrade to existing crisis intervention models but also points out the direction of intelligent development for mental health services in the coming decades. Its social significance lies in: if these ideas are realized, hundreds of thousands of dying lives could be saved globally every year, reducing countless family tragedies and social traumas, making a huge contribution to human well-being.

Action Suggestions: To translate the system and concepts proposed in this report into reality, we hereby propose several specific action steps:

National Level Strategic Planning: Suggest the Health Commission lead the inclusion of "Construction of Intelligent Psychiatric Emergency System" into the national mental health strategy. Formulate a 2025-2030 action plan, clarifying goals (e.g., reducing suicide rate by %, increasing hotline coverage by %, popularizing crisis intervention teams, etc.). Establish special funds to support key technology R&D and demonstration site construction.

Pilot Demonstration Projects: Select several regions to carry out pilots. For example, build the country's first intelligent crisis intervention center in a province with a high suicide rate, applying the hotline AI system, mobile team equipment, and community network linkage mentioned in this report, evaluate the effectiveness after 1-2 years of operation, and then gradually promote.

R&D Tackling: Organize multi-disciplinary joint tackling teams to focus on breakthroughs in the realization of artificial consciousness systems in crisis intervention, including emotional empathy algorithms, white-box interpretable technologies, cross-modal recognition fusion, etc. Encourage cooperation among enterprises, universities, and research institutes to accelerate the transformation of laboratory results into practical products (such as psychological AI assistant Apps, AC engines, etc.).

Talent Cultivation and Training: Establish relevant interdisciplinary majors in universities to cultivate composite talents who understand both AI and psychology. Carry out continuing education training on "Intelligent Crisis Intervention" for existing mental health teams, enabling them to master skills using AI tools and collaborating with AC. Similarly, train technical personnel on psychological crisis knowledge to improve product humanistic adaptability.

Improve Laws and Regulations: Promote the introduction of "Measures for the Administration of Psychological Assistance and Artificial Intelligence", clarifying standards and responsibilities for AI intervention in psychological services. Improve the implementation details of the "Mental Health Law", adding clauses on the application of intelligent technology. Strengthen data protection legislation to guarantee the privacy safety of seekers.

Public Education and Participation: Carry out large-scale social publicity to improve public awareness of psychological crises and acceptance of intelligent help-seeking means. For example, use media to promote the 12356 hotline and mental health Apps, letting more people know there are AI assistants available to listen. Encourage crisis survivors to share stories of recovery with AI help to enhance others' confidence. Establish public feedback channels to let users participate in evaluating and improving AI services.

International Cooperation and Exchange: Cooperate with organizations like WHO and the International Red Cross to promote China's artificial consciousness theory and practical experience internationally, while learning the latest foreign experiences. Actively participate in formulating international AI ethical guidelines to ensure our system conforms to global good practices. Host the Global Artificial Intelligence Psychological Crisis Intervention Conference to enhance China's discourse power in this field.

Through these initiatives, we aim to establish within the next 5 to 10 years a preliminary intelligent mental health emergency response system that is grounded in China's national context, benchmarks against international best practices, and embodies Chinese characteristics. This will significantly enhance our nation's capacity to prevent and address psychological crises, adding a crucial piece to the “Healthy China” strategy. More profoundly, it will drive a paradigm shift in global mental health services, offering a “Chinese solution” and “Chinese wisdom” to meet the mental health challenges of our era.

Today, we stand at the intersection of technology and humanity, charting the blueprint for this system that will impact countless lives and well-being. Infusing artificial intelligence with humanity and making crisis response more efficient—this is the mission entrusted to us by our times. We hope the theoretical explorations and practical recommendations in this report will resonate with and inspire action among policymakers, industry professionals, and academia. Let us join hands to illuminate the darkest corners of the soul with the light of technology and shield every life yearning to survive with the armor of institutional safeguards. We believe that in the not-too-distant future, a future-oriented mental health emergency system will emerge from blueprint to reality before our eyes, bringing renewed hope to countless souls teetering on the edge of despair.

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Augmented Reality Brain-Computer Interface for Depression ..., https://www.psychiatry.pitt.edu/augmented-reality-brain-computer-interface-depression-prevention-receives-pitt-innovation-0

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