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
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.
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.
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