HONG KONG’S FIRST MENTAL HEALTH STUDY by ALICE PEARCE

Hong Kong’s growing mental health decline: We need to face up, not save face. Let’s talk mental health in the skyscraper jungle. Back in 2010, Hong Kong conducted its first mental health survey (a bit late don’t you think?). The population-based interview was conducted over three years; on 5,700 ethnic Chinese men and women aged between 16 and 75 years old. The researchers cited the rising burden of mental disorders on quality of life, society, and health care systems as the reason behind the need to conduct such a survey. This initial territory-wide study of mental morbidity provided much needed information for planning health and social services, monitoring mental disease trends and generating hypotheses for future research.

The study is a promising (baby) first-step to addressing the growing mental health problem in Hong Kong, not just in terms of therapeutic treatment for individuals, but to also break down deep-rooted Chinese cultural barriers that misconceptualise mental health.

What researchers found was worrying, but not surprising. Factors such as being separated, a lack of exercise, stress, alcohol, substance abuse and financial difficulties were associated with common mood disorders. 1 in 7 individuals suffer from a common mood disorder (such as depression or anxiety), but only 26% of them sought professional psychiatric help. 

Not only are mental illnesses hugely underdiagnosed in Hong Kong, but it’s mental health services are inadequate and taking in more than it can handle. The number of people seeking treatment has almost doubled to over 300,000 in the past 12 years. Those who do manage to get on a government waiting list to see a government psychiatrist have to wait up to 3 years before their first consultation, which lasts less than 15 minutes. This gives almost no time for therapists and patients to build rapport, trust and understanding – key ingredients to proper diagnosis and formulating an effective treatment plan. 

Additionally, the lack of mental health service in the primary care sector means that up to three quarters of patients fail to get the help they need. This is just a snippet of the survey, and the survey is just the tip of the iceberg -but it tells us how much work needs to be done. Obviously, primary care services need to be boosted to screen for patients at risk of mental health problems to ease the pressure on mental services. The government needs to start spending more on its mental health services to meet the demand and shorten waiting lists, and to really start community education on mental illness.

As a developed, global city laced with cultural intricacies, collective acceptance and understanding of mental illness is first and foremost a vital starting point. Becoming more mindful about yourself, your lifestyle, body and your emotions instead of ignoring it, because many unexplained physical symptoms are related to mental health -and whilst you get treated for the physical side-effects, your mental health remains neglected. 

In my workplace and at home, I notice how quickly we become bystanders to those struggling from mental health problems -often minor or common ones like stress; especially when the individual presents the stress aggressively (verbal or physical), or becomes tired & loses focus, or retreats into themselves.

Admittedly, we live in a crowd culture and we don’t really like being the odd one out, whether it is the one who has a mental health problem, or the one who steps up and offers a hand to them. Looking honestly at situations and taking a moment of compassion to meaningfully ask ‘what’s wrong?’ or ‘how are you doing?’, and to listen, can make a big difference to someone. Passing off someone’s stress-related behaviour or mental illness as them being ‘weird’, ‘crazy’ or ‘weak’ redirects a real issue into a stereotyped view of misunderstanding, and keeps things in stage one. But why as a society are we reluctant to ‘lose face’ and pretend nothing is wrong?

Alice Pearce is a Final year Psychologist at Durham University. She wrote this because growing up in HK and studying in the UK has made her realise how big the gap is between Asia and the West in mental health understanding -and HK’s first mental health survey highlights exactly this, as well as pointing to major underlying cultural reasons for this gap.