LCQ3: Prevention of youth suicide

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     Following is a question by the Hon Benson Luk and a written reply by the Secretary for Education, Dr Choi Yuk-lin, in the Legislative Council today (November 22):

Question:

     It has been reported that from July to the end of October this year, there were about 18 suicide deaths or suicide attempts among students. Moreover, according to the information of the Samaritan Befrienders Hong Kong, the number of suicide deaths among young people aged 19 or below has almost doubled from 20 in 2012 to 39 in 2022. It has been learnt that the number of fatal suicide cases among young people aged 19 or below has also been on the rise in the past five years. In this connection, will the Government inform this Council:

(1) whether it has analysed the causes of youth suicide in recent years; if so, of the details; if not, the reasons for that;

(2) whether it has compiled statistics on the number of students among young people who have attempted suicide in recent years; if so, of the details; if not, the reasons for that;

(3) whether it has conducted studies and surveys on the phenomenon of the increasing number of suicides among young people in recent years; if so, of the main causes of suicide in order of importance; if not, the reasons for that;

(4) whether it has compiled statistics on the number of cases of suicide attempts by students in recent years which were successfully prevented by the "early identification and intervention" approach; if so, of the details; if not, the reasons for that; and

(5) of the resources (both personnel and funding) allocated by the Government in the past three years to organisations/professionals such as schools, teachers, counsellors and social workers for the prevention of student suicide; whether the Education Bureau has urged schools to formulate corresponding measures in view of the continuous increase in the number of student suicide cases, including organising courses on the prevention of student suicide, conducting seminars and enhancing counselling services; if so, of the details; if not, the reasons for that?

Reply:
 
President,

     The Government has always attached great importance to the mental health of young people. To address the recent tragic incidents of students, the Government is pooling efforts from all parties through cross-sectoral collaboration to strengthen support for schools, students and parents so as to build a stronger safety net for students. Regarding the question raised by the Hon Benson Luk, after consulting the Health Bureau (HHB), the Security Bureau and the Labour and Welfare Bureau, the comprehensive reply is as follows:
 
(1) to (3) Relevant international and local studies have pointed out that suicide is a complicated problem, involving the interaction of multiple risk and protective factors, therefore cannot be attributed to any single factor. The Government has reviewed the recent suicide cases of primary and secondary school students and analysed the risk factors that have emerged. The major risk factors are related to interpersonal relationships (including family, social and relationship problems) and personal problems (such as learning and school adjustment, depressed mood and mental illness). The Government will continue to review and optimise the existing services and support provided to students, strengthen protective factors for students' mental health, and reduce the impact of risk factors on students.

     The Education Bureau (EDB) has been requiring primary and secondary schools to report suspected fatal suicide cases of students so that appropriate professional support to the schools concerned can be provided. In the past three years (i.e., 2020 to 2022), the numbers of suspected fatal suicide cases reported by all primary and secondary schools in the territory were 21, 25 and 25 respectively, while the number as of October 2023 is 27. It is believed that the upward trend may be affected by the epidemic and the greater challenges facing students after the resumption to normalcy. The EDB does not collect data on attempted suicide cases of students from schools or keep such statistics.

(4) and (5) The EDB has been encouraging schools to adopt the Whole School Approach directed at three levels, namely Universal, Selective and Indicated, to promote mental health amongst students and to enhance support for students with mental health needs, including those with suicide risk.

     At the Universal level, to lead a Healthy Lifestyle is one of the seven learning goals of school curriculum. Relevant learning elements are already embedded in certain subjects. The EDB has been continuously promoting diversified programmes on student growth, with a view to enhancing students' resilience and helping them embrace challenges with courage and an optimistic and proactive attitude. The EDB provides comprehensive student guidance and support services in primary and secondary schools through the Whole School Approach and multi-disciplinary collaboration. This includes early identification and support of students with mental health needs through collaboration among teachers and professionals from different disciplines in schools (including guidance personnel, school social workers and school-based educational psychologists). The EDB provides resources for public sector primary schools to implement the policy of "one school social worker for each school". The expenditure on students' guidance services for public sector primary schools is $490 million, $493 million and $498 million (revised estimate) in 2020-21, 2021-22 and 2022-23 financial years respectively. The Social Welfare Department (SWD) has put in place in secondary schools the arrangement of "two school social workers for each school" with supporting manpower strengthened on school social work service in secondary schools. The expenditure on school social work service for secondary schools is $749 million, $758 million and $786 million (revised estimate) in 2020-21, 2021-22 and 2022-23 financial years respectively.

     At the Selective level, the EDB is committed to providing "gatekeeper" training for teachers, parents and students to enhance their ability to identify and support students with warning signs of suicide. On teacher training, the EDB provides teachers a 60-hour thematic training course regularly. Up to the 2023/24 school year, the number of training places has increased to 320. Basic "gatekeeper" training is also provided for newly joined teachers by the EDB. The EDB will organise a series of workshops for teachers, social workers, school guidance personnel, etc., with more focus on enhancing their relevant knowledge and skills. For parents, the EDB has been organising "Parent Workshop on Gatekeeper Training" on a regular basis. The number of workshops has increased to 12 in the 2023/24 school year. In addition, the EDB organises thematic "gatekeeper" online workshops and produces videos for parents from time to time. The corresponding videos were uploaded onto the "Mental Health@School" website and "Smart Parent Net" website for easy browsing of parents. We also produce pamphlets giving a brief introduction on various types of mental illness (including depression and anxiety disorder) and the "Safeguard Children's Mental Health – Prevent Youth Suicide" factsheet for parents. These materials have been uploaded onto the "Mental Health@School" website. For students, the EDB has commissioned a non-governmental organisation (NGO) to launch the "Peer Power – Student Gatekeeper Training Programme" which aims to enhance their understanding of mental health and skills in coping with their own stress and emotions, equip them to identify and address the needs of their peers, and promote positive coping and help-seeking culture in schools. The number of participating schools has increased to 50 in the 2023/24 school year.

     In addition, the SWD set up five Cyber Youth Support Teams (CYSTs) in December 2018 to proactively approach the at-risk and hidden youths through online platform commonly used by young people including those with unstable emotion and suicidal ideation with timely intervention, support and counselling service through online and offline mode. The SWD has strengthened the supporting manpower for the five CYSTs since October 2021. Moreover, starting from 2019-20, the SWD has increased annual provision of around $56 million to integrated community centres for mental wellness to extend their service targets to secondary school students with mental health needs, and strengthened the support for them, their parents and their carers.

     At the Indicated level, the EDB provides public sector ordinary schools with the Learning Support Grant, which covers students with mental illness, so that schools can have additional resources to support the needs of these students. Moreover, the HHB, in collaboration with the EDB, the Hospital Authority (HA) and the SWD, has launched the Student Mental Health Support Scheme. A multi-disciplinary team is formed in each participating school to provide multi-disciplinary support services to students with mental health needs in the schools. Participating schools discuss with the professional teams every year to conduct mental health screening for students at a particular level and provide intervention based on the students' situations.  In the 2022/23 school year, the number of participating schools has increased to 210.

     Early identification and early intervention to support students in need are ongoing tasks of the school. The schools have no way of assessing whether students have eliminated the idea of committing suicide due to the school's intervention and support. Therefore, we do not have the relevant statistics.

     Since students still need time to gradually adapt to the various changes after the epidemic, they may experience pressure as they face the approaching tests and examinations.  In November 2023, the EDB issued a circular memorandum calling on all schools in the territory to carry out "Spread the Love, Care and Shine" Campaign, and recommended schools to make time and space to care for their students. The EDB has also launched "Mental Health Literacy" resource package for upper primary students in November 2023, and will gradually develop resource packages suitable for different key stages and organise relevant teacher training. Moreover, in order to support schools to promote mental health effectively and flexibly, the EDB will provide Mental Health@School One-off Grant and One-off Mental Health Grant for Parents and Students to all publicly funded primary and secondary schools and Parent-Teacher Associations to assist them in organising activities or purchasing services or supplies related to supporting students' mental health. The expenditure of the two grants involves about $80 million.

     In response to the recent tragic incidents of students, the Government will strengthen the collaboration between different bureaux and departments, including the HHB, the EDB and the SWD, to establish a three-tier school-based emergency mechanism as set below, to address the situation with the joint effort from schools, parents and various stakeholders in society.

(i) The first-tier mechanism is to assist schools to early identify students with higher suicide risk or mental health needs, with a view to giving priority to provide timely and appropriate intervention to them.

(ii) The second-tier mechanism is to organise an "off-campus support" network through cross-departmental, cross-professional and cross-sectoral co-operation to enhance "external support" for schools. If the school's manpower is insufficient to meet the needs of students, the Government will help the school connect to "external support" for additional support. Relevant support includes registered social workers and paramedical professionals from the SWD and subvented NGOs, as well as educational psychologists from the EDB. It aims to facilitate multi-disciplinary and cross-sectoral teams to provide immediate and appropriate services to at-risk students in schools.

(iii) For the third-tier mechanism, school principals can directly refer students with severe mental health needs to the psychiatric specialist services of the HA. The HA will give priority to those students.

     The Government will continue to work with various stakeholders to promote the mental health of young people and prevent student suicide in a more holistic way, jointly establish a support network and create a culture of acceptance and care, and enhance the mental health literacy of parents, teachers, and students, thereby promoting students' physical and mental well-being.

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