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Opinion | 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

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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
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.
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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.

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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.
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