Chinese civil society activists and rights-protection lawyers are experiencing unprecedented levels of repression. The relentless pressure, as well as the acts of police violence and torture, has made many fearful of the consequences of their work. This is, inevitably, taking a toll on the mental health of activists. While psychological counselling services in China have expanded in recent years, most counsellors are reluctant to work with politically sensitive clients. This essay examines the need for the human rights community in China to develop the skills to address the mental health challenges of activism.