Dealing with tsunami of mental health problems
The Suicide Prevention Early Warning System developed by the HKJC Centre for Suicide Research and Prevention at the University of Hong Kong found that the number of suicide cases in Hong Kong rose from late February to late March, reaching a two-year peak. During the period, the average of the past 7 days’ estimates for suicide has exceeded the "extremely high" level, showing an average of 4 persons committing suicide every day, which has doubled compared with the same period last year. Among all age groups, those aged 65 or above recorded the highest number of suicides. Fortunately, the number has dropped afterwards. If the situation continues, up to 1,400 people may commit suicide within this year.
The news is disturbing. We could recall that 1,264 people committed suicide during the SARS outbreak in Hong Kong in 2003, that is, 18.8 suicides per 100,000 people, which was the highest in the 40 years from 1981 to 2020. Nineteen years later, Hong Kong people’s mental health is again adversely affected by the epidemic.
It is indeed a big challenge for people to maintain physical and mental wellbeing amid the waves of the epidemic. The latest Hong Kong Mental Health Index conducted by Joyful (Mental Health) in 2021 also found that the mental health index of more than half of the respondents fell short of the passing mark. It is not surprising. The survey assessed the impact of work, study, bringing up a child, physical condition, family, interpersonal relationship, living environment, financial status and the epidemic on people's emotions. However, contrary to the findings from the HKU, the survey involving more than 1,000 respondents found that the elderly aged 65 or above, retirees or those with children have better mental health, while respondents aged 25 to 34, divorced/separated or unemployed have significantly poorer mental health.
According to the World Health Organization (WHO), mental disorder like depression can lead to other physical illnesses and suicide. The WHO issued a scientific brief in March this year, pointing out that in the first year of the COVID-19 epidemic, the global prevalence of anxiety and depression increased by 25%, and the most affected groups were young people and women.
The above three studies have different conclusions, which I believe are due to different research methods, time and places, perhaps they also reflect the disastrous situation of mental health of the population across the world.
With the increasing awareness of mental disorders in Hong Kong, the corresponding demand for related services has also increased. In view of the high fees charged by private clinics (consultation fee ranges from HK$790 to HK$3,000 per visit), many patients, thus, seek public services (public specialist clinics for Hong Kong residents, HK$135 for the first consultation and HK$80 for each subsequent visit).
But the increase in doctors cannot keep pace with the increase in patients. Over the past 10 years, the number of patients receiving the mental health services under the Hospital Authority (HA) has increased by 45% from 186,000 in 2011-12 to 271,000 in 2020-21. However, during the period, the number of psychiatrists in the HA only increased by 16% to 390, resulting in only an average of 5.2 government psychiatrists per 100,000 citizens, which is far below that of many middle and high-income countries. According to the figures from the Organization for Economic Co-operation and Development (OECD) in 2007, there were 15 psychiatrists for every 100,000 population.
In recent years, the Hong Kong government has significantly increased the resources for mental health services, expenses in this area accounted for 6% (HK$5.6 billion) of the HA's total expenditure in 2020-21, while the funds allocated has increased by 23% in the past five years. Is this enough? Prof. Alfred Chan Cheung-ming, former chairman of the Equal Opportunities Commission, pointed out that "mentally ill people need more than drugs and treatment". Are there other ways to improve people's mental health through a multi-pronged approach? Let’s talk about this next time.
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