Hong Kong needs a fresh look at mental health services

November 18, 2016 17:36
Hong Kong needs to strengthen its medical facilities as well as the manpower to deal with the growing mental healthcare problem in the city. Photo: HKEJ

The World Health Organization (WHO) had warned as far back as 2000 that depression could become the second leading cause of disease and disability in the world by 2020.

Despite the stark warning, the Hong Kong government failed to conduct any population-based survey of mental disorders in the city for a long time.

It was only in 2010 that we finally saw some action. That year, the Food and Health Bureau commissioned the first territory-wide mental health study, aiming to examine the prevalence of mental disorders in the city.

In an interim report, The Hong Kong Mental Morbidity Survey 2010-2013 revealed that 362 (14.5 percent) out of 2,500 respondents aged between 16 and 75 were deemed to be having significant levels of neurotic symptoms.

Applying the percentage to the overall population, it is possible that over a million Hong Kong citizens are in need of mental healthcare and community support.

Meanwhile, findings from a Mental Health and Integration report published by the Economist Intelligence Unit in 2016 also deserve our attention.

In that report, Hong Kong was ranked the seventh among 15 Asia-Pacific states and jurisdictions with a total score of 65.8, the lowest figure in the high income Asia category, in mental health policies. 

In comparison, Taiwan had a score of 80.1, Singapore 76.4, South Korea 75.9, and Japan 67.4.

Reasons for Hong Kong's weaker score included the absence of a formal overarching mental health policy, and unsatisfactory access to mental health services.

Hong Kong's Hospital Authority, in its Mental Health Service Plan for Adults 2010-2015 report, has said the estimate of people with mental disorders would be in the 1-1.7 million range.

Of the total, between 70,000 and 200,000 people might be having severe mental illness, it said.

While Hong Kong has a population of over 7 million (excluding domestic helpers and individual visitors from mainland China), the number of registered medical practitioners with a specialist registration in psychiatry is just about 340.

It means that there are only 4.8 doctors serving every 100,000 population in the city, which is far below the median rate of 8.59 psychiatrists per 100,000 population in the high income countries, according to a WHO survey in 2011.

In short, the mental health service here in terms of the availability of psychiatrists is at best half the level of that in other advanced societies.

Let us not forget the fact that professional comprehensive mental health services depend not only on specialists, but also psychiatric nurses, psychiatric medical social workers, clinical psychologists, occupational therapists, etc.

Based on my knowledge, I can say that the above-mentioned professionals are in serious shortage in Hong Kong, given the strong actual demand for the services.

Risks factors for mental disorders are aplenty, with social, family and psychological pressures as well as genetic factors coming into play. Upbringing and social economy also play an important role in affecting people.

As the problem threatens to get worse in the coming years, it is time for the government to take a fresh look at the issue and come up with ways to upgrade both the infrastructure and the human resources needed to ensure good mental healthcare for the citizens.

This article appeared in the Hong Kong Economic Journal on Nov. 15.

Translation by Darlie Yiu with additional reporting

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convener of the Hong Kong Mental Health Counsel and chairman of the Hong Kong Association for the Promotion of Mental Health