Following is a question by the Hon Tang Fei and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (June 21):
Question:
A survey has found that the mental health of Hong Kong people has fallen below the passing level for five consecutive years since 2018. In addition, it has been reported that a number of suicide or suspected suicide cases have occurred one after another in Hong Kong in recent months, involving people of different ages and strata. There are views that the Government and the authorities concerned should expeditiously review the strategies for improving the mental health of members of the public and enhance various measures and support services. In this connection, will the Government inform this Council:
(1) (i) of the number of cases since 2022 in which a verdict of suicide has been returned, together with a breakdown by the age group to which the deceased belonged, gender and reason for suicide, and (ii) how the suicide rates in Hong Kong compare with those in the neighbouring regions in Asia;
(2) whether it knows the respective government departments and community organisations which currently provide suicide prevention and mental health support services;
(3) whether the Government will strengthen the relevant measures or support services targeting the groups with higher suicide rates in the cases mentioned in (1), so as to reduce their chances of committing suicide; if so, of the details; if not, the reasons for that; and
(4) whether it has assessed if there is an increase in the demand of members of the public for mental health services with the full resumption to normalcy of society; if it has assessed and the outcome is in the affirmative, whether the Government will allocate additional resources to increase the relevant services and manpower?
Reply:
President,
In consultation with the Department of Health, the Education Bureau (EDB), the Hospital Authority (HA), the Labour and Welfare Bureau (LWB) and the Security Bureau, the consolidated reply to the question raised by the Hon Tang Fei is as follows:
Suicide is a complicated issue with multi-faceted causes. Reasons leading to one making this extreme decision are complex. In addition to mental health issues, it could also be caused by a combination of factors including biological, social and interpersonal relationships that interact with one another.
At the mental health level, the Government attaches great importance to the mental health of the public and recognises that mental health goes beyond medical care, but also covers support in various aspects. The Government adopts an integrated and multi-disciplinary service approach towards mental health, including promotion, prevention, early identification, as well as timely intervention, treatment and rehabilitation services for persons in need so as to enhance the overall mental health of the public and encourage them to take a positive outlook on life. The specific response to the question raised by the Member is as follows:
(1) From 2022 to the first quarter of 2023, according to the preliminary classification of cases by the Hong Kong Police Force (HKPF), the number of suicide cases in Hong Kong was 880. The HKPF does not maintain statistics on other breakdowns (including the age group to which the deceased belonged as well as gender and reason for suicide).
The Government does not maintain statistics on the suicide rates of Hong Kong and neighbouring regions in Asia. However, according to the analysis conducted by the Hong Kong Jockey Club Centre for Suicide Research and Prevention (CSRP) of the University of Hong Kong (HKU) based on data provided by the Coroner's Court, the suicide rate of Hong Kong in the five years from 2017 to 2021 was steady at large (Note), and Hong Kong's suicide rate was not higher than that at international level.
(2) and (3) Different government bureaux and departments, the HA and government-subsidised non-governmental organisations (NGOs) have been providing mental health support, including services on suicide prevention.
On mental health promotion and education:
(a) the Government has earmarked a recurrent annual funding of $50 million to embark on an ongoing mental health promotion and public education initiative, so as to enhance public knowledge about mental health and encourage members of the public in need to seek help and intervention in a timely manner. The "Shall We Talk" initiative provides mental health-related information, including information on knowledge and skills in suicide prevention and relevant information on ways to seek help provided in support of the "World Suicide Prevention Day", through an array of channels, such as its one-stop website (shallwetalk.hk), social media pages, TV and radio programmes, offline events;
(b) in support of the World Mental Health Day initiated by the World Federation for Mental Health, the LWB has since 1995 organised annually the "Mental Health Month" in collaboration with various Government departments, public organisations and NGOs providing mental health services. Different types of public education activities including radio programmes, mental health index survey, district-based publicity campaigns and newspaper advertorials have been organised to promote to the public messages of mental wellness and encourage public acceptance of persons in mental recovery; and
(c) the Social Welfare Department (SWD) has deployed Mobile Vans for Publicity Service on Mental Wellness in five designated regions of Hong Kong (i.e. Hong Kong Island, Kowloon East, Kowloon West, New Territories East and New Territories West) to step up community education and at the same time promote awareness of the public (including those with suicidal risks) on mental wellness and develop positive help-seeking attitude / behaviour in order to achieve the objectives of early prevention, early identification and early intervention.
On community support:
(a) the SWD subvented NGOs to set up a total of 24 Integrated Community Centres for Mental Wellness (ICCMWs) to provide one-stop and district-based community mental health support services, ranging from early prevention to risk management, including services related to the suicide prevention, such as casework counselling, outreaching services and public education programmes;
(b) the SWD has also provided suicide prevention services through its subvented NGOs, such as subventing the Suicide Crisis Intervention Centre (SCIC) of the Samaritan Befrienders Hong Kong to provide outreaching, immediate risk intervention and intensive counselling services for persons in need, including relatives and friends of persons who committed suicide. The SCIC also proactively engages internet users with suicide ideations with a view to calming their negative emotions and rendering timely support;
(c) to address the impacts brought to the public's mental health by the epidemic, the Government earmarked $300 million to launch the Mental Health Initiatives Funding Scheme (Funding Scheme) in 2021 to provide better support to the needy in the community and raise public awareness of mental health. The Funding Scheme was implemented in two phases, with a total of 172 projects approved and implemented in phases since February 2022 and March 2023 respectively; and
(d) Announced in the 2022 Policy Address, the Health Bureau (HHB) would set up a mental health support hotline to provide immediate support and referral services; and establish a service centre on a trial basis to provide emotional support and counselling for ethnic minorities. The target implementation timeline of both proposals is within 2023.
On school support:
(a) the EDB has all along attached great importance to the mental health of students and is committed to assisting schools in adopting the Whole School Approach to promote mental health of students and enhance support for those with mental health needs at three levels, namely the Universal, Selective and Indicated Levels. The EDB promotes positive values education and diversified development programmes on an ongoing basis and encourages schools to provide diverse learning experiences for students, so as to enhance their resilience, help them engage in school life and build a caring campus.
The EDB disseminates a wide range of information to schools and parents about students' mental health and support to student's physical and mental development through the one-stop information websites on student mental health "Mental Health@School" and parent education "Smart Parent Net". It also shares the latest information and related resources to facilitate teachers in promoting student mental health in schools via the "Mental Health@School" Teacher Professional Network;
(b) the EDB is committed to providing "gatekeeper" training for teachers, parents and students to enable their early identification and support for students with mental health needs (including those with suicidal risks);
(c) there are professionals in schools, including guidance personnel, school social workers and school-based educational psychologists who have been providing appropriate support and referral services to students with mental health needs; and
(d) the HHB, in collaboration with the EDB, the HA and the SWD, has launched the Student Mental Health Support Scheme to provide appropriate support services for students with mental health needs.
On psychiatric services:
(a) the HA's multi-disciplinary teams, comprising doctors, nurses, clinical psychologists, occupational therapists and medical social workers, etc, will provide patients with appropriate medical services depending on their medical conditions and clinical needs, including inpatient, specialist outpatient, day rehabilitation training and community support services; and
(b) the HA has implemented the Elderly Suicide Prevention Programme (ESPP) since 2002 to provide timely and appropriate psychiatric diagnosis and treatments for elderly suspected to have suicidal tendency, with a view to reducing the suicidal risk of the elderly concerned. Under the ESPP, elderly identified with suicidal risks will be immediately referred to the HA’s psychiatric services by the SWD, NGOs, social workers or doctors for further diagnosis and treatment.
(4) The Government has been mindful of the impact of the full resumption to normalcy of society on the mental health of the public.
The Government has noted that some groups in the community may, in order to adapt to the resumption to normalcy, have their mental health put under pressure. The Government has taken corresponding measures to address the situation. For instance, to help students adjust to the resumption of whole-day face-to-face classes and social life, the EDB adopted specific measures, such as launching a designated webpage titled "Resuming Vibrant Life@School" and conducting online seminars in January this year with a view to helping students resume normal learning and social life as early as possible; releasing a variety of practical resources, such as school resource kits, parent tips and videos, through a designated webpage to assist parents and teachers in enhancing adaptability of students; and providing advice of professionals for parents and teachers in February this year to assist students in adapting to the cancellation of mask-wearing requirement so as to welcome the life under resumption of normalcy with a positive attitude.
On the other hand, the Government has all along been dedicated to enhancing mental health services and related manpower, including:
(a) the HA has earmarked additional funding of over $18 million in 2023-24 to enhance mental health services. Relevant measures include enhancing community psychiatric services by recruiting additional case managers; strengthening nursing manpower and allied health support for psychiatric inpatient and day hospital services; and strengthening psychiatric consultation liaison service;
(b) in 2023-24, the SWD will increase the manpower of clinical psychologists in 24 ICCMWs to strengthen professional support and training, and provide additional funding to assist ICCMWs in enhancing the application of information technology in service delivery so as to strengthen the support for persons in mental recovery and their carers. The estimated annual recurrent expenditure for these enhancement measures is about $23 million; and
(c) apart from the aforementioned measures, the Government announced 10 measures in June 2023 to enhance support for persons in mental recovery and those with mental health needs, including enhancing HA's manpower with an aim to optimising the ratio of case manager under the Case Management Programme to patients with severe mental illness to no higher than 1:40 by the fourth quarter of this year; exploring the introduction of a pilot scheme in individual District Health Centres to provide mental health assessment for members of the public in need; and enhancing the services of ICCMWs.
Note: The most recent announcement of estimated suicide rate in Hong Kong by the CSRP of the HKU is in September 2022 when figures on the estimated suicide rate of Hong Kong in 2021 were announced.
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