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People attend a seminar organised by the district office on how to deal with negative emotions caused by social tragedies, at the Sham Shui Po Kaifong Welfare Advancement Association, on June 7. Photo: Elson Li
Opinion
Paul Yip
Paul Yip

To deal with Hong Kong’s mental health struggles, increasing manpower is not enough

  • The city must review and adjust health and social services, especially for ethnic minorities, and increase mental health education in schools and counselling in communities
  • Importantly, we all have a part to play in creating a caring and empathetic society
Paul Yip
Paul Yip
Why you can trust SCMP
After the recent tragic events involving people who appeared to be struggling with mental health issues, the Hong Kong government has taken prompt action, asking the Health Bureau’s Advisory Committee on Mental Health to look at issues related to the model for psychiatric, rehabilitation and support services as well as manpower needs.
While addressing the manpower shortage in health services is important, it is equally critical to comprehensively review Hong Kong’s mental health and related services, to address the crux of the challenge in order to improve and sustain the mental health of the population.

Prevention is more effective and cost-efficient than treatment after illness has developed. To properly address the mental health needs of our community, we need to examine public services at the macro level. The authorities should address four aspects: increasing the number of healthcare staff, improving the matching and allocation of resources, nurturing individual resilience, and creating a caring and empathetic society.

Based on a projection at the end of last year, the Hospital Authority has 293,000 psychiatric patients and just 385 psychiatrists, with a doctor-patient ratio of one to 761, which is much lower than that of nearby countries. Meanwhile, demand for outpatient psychiatric services continues to rise, from 897,777 visits in 2018-19 to 957,149 in 2021-22.

With manpower in the public sector constrained, it has been suggested that patients should be diverted to the private healthcare system, but the cost of this is prohibitive. If we take the annual incidence rate of mental health breakdown as 1 per cent, then based on a population of 7 million, there are potentially 70,000 new patients every year. This is an increase of 20 per cent over the existing workload in a year but the system cannot stretch to provide 20 per cent more manpower now. It looks like Hong Kong’s mental health services will always be playing catch-up.

In recent tragic events, the deadly attacks were allegedly committed by people who had received psychiatric care (as in the Diamond Hill shopping centre stabbing), or community outreach services (in the Sham Shui Po case). We must reflect on whether these services are adequate, effective, appropriate and responsive to people’s needs.
People lay flowers to mourn two shoppers stabbed to death in a knife attack at the Plaza Hollywood shopping centre in Diamond Hill on June 4. A man with psychiatric issues has been charged. Photo: May Tse
In the Sham Shui Po case, police have arrested a woman from the local ethnic minority community after her three children were found unconscious in their subdivided home and were later certified dead in hospital. There is an NGO located in the same building that provides services to low-income households and its staff had conducted welfare checks, but, unfortunately, did not get a chance to establish contact with that family.
According to the Social Welfare Department, the woman and her daughters were an active case under an integrated family service centre. The quality of such services and allocation of resources should be reviewed and adjusted, especially for ethnic minorities. Their needs have sometimes been overlooked.

To sustainably improve the mental health of the population, we need to encourage and empower people to seek help. In addition to relying on the medical system for aid and treatment, we can improve our population’s “suboptimal health” through education.

Suboptimal health refers to the border state between good health and disease, and people in this state include those experiencing stress, who are often depressed, anxious or worried, prone to temper tantrums and who are hypersensitive. Those in suboptimal health do not have the obvious medical symptoms that warrant services from the healthcare system.

We can improve suboptimal health through community support and counselling services, online and offline. Our centre has been advocating for the inclusion of mental health education in the kindergarten, primary and secondary school curriculum so students can better learn to manage their emotions and interpersonal conflicts at an early age. This helps build self-esteem and hope when facing adversity.

05:09

Growing number of young people in China flock to religious temples to escape life’s pressures

Growing number of young people in China flock to religious temples to escape life’s pressures
The government and the people of Hong Kong should work together to create a caring community. We may not be able to achieve immediate improvements to Hong Kong’s crowded living conditions, but we can pursue policies conducive to mental health, such as adjusting working hours, improving low incomes and promoting family-friendly initiatives.

On the day of the incident in Sham Shui Po, the district officer organised a seminar on emotional support in the community. Through the seminar, residents who did not know how to seek help in the past learned more about their emotions and ways to find help. There were residents who said they were reluctant to seek help because of the high cost of mental health-related services.

Hongkongers’ ailing mental health calls for a system revamp

Fortunately, the Sham Shui Po community has a caring district commissioner, district councillors, business owners and neighbours willing to help each other and create a humanistic community. Through integrating community and service resources, we can ensure a better flow of aid to those in need.

To sum up, the prevention and treatment of mental illnesses should be integrated, and health and social services need to be better connected, as prevention is better than cure. Remedial measures are needed but they tend to be short-lived. We need to promote wellness in the community. It takes the whole community working together to improve and sustain collective mental health.

Paul Yip is director of the HKJC Centre for Suicide Research and Prevention, and associate dean (knowledge exchange and development) in the Faculty of Social Science, at the University of Hong Kong

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