Reconceptualising misconceptions of mental health: Can results of Hong Kong’s mental health survey be explained by cultural and societal reasons? 
In many Western societies, awareness and understanding of mental health problems have grown drastically in the past few decades. However, many Asian societies lag still lag behind in this acceptance due to differences in cultural perceptions of mentality, health and the self.
Hong Kong is very unique when it comes to its mental health landscape. As a Chinese city living through 137 years under British rule, Hong Kong has been caught in between its Western influences and its traditional Chinese culture. The integration of these two cultural streams have effected dramatic social, political and economic change, which have been experienced by many of its citizens.

For those caught in the whirlwind side of the international city’s fast-paced, business-oriented and stressful lifestyle, it is easy to prioritise climbing the corporate and social ladder over our emotional needs.

And for an overlapping majority who have been born and brought up with traditional Chinese cultural values, it concerns experiencing some side-effects have been ingrained in the city’s social fabric. Of course, many aspects of traditional Chinese culture are without doubt beautiful and ingenious, but a minority of its values have bred a negative social mentality from which mental health stigma’s stem from. 
The massively underdiagnosed mental health population can be attributed to many misconceptions in Chinese culture. Firstly, there is a fear of the mentally ill. This originates from the Chinese belief of reincarnation, where misfortune is the result of wrongdoings in past life. Therefore, many perceive mentally ill individuals as dangerous, violent and going to kill someone, and don’t want to mix with them. Although stigmatization and discrimination against those with mental illnesses is a global problem, it is particularly acute in Hong Kong. 

One of my friends recently opened up about their depression diagnosis, and shared the mixed responses they received; some friends were supportive and continued their friendship as it had always been, whilst other began to distance themselves and behave awkwardly. 

Secondly, for many Chinese, they have been taught since young not to talk about their emotions, and so it is very hard for them to openly talk about what they feel or to empathise. It could be this reason why those with depression are not easily recognised by themselves or others -and not that they are hiding it deliberately.
In the BBC Health article on Hong Kong’s survey, they interviewed a lady who migrated from China to Hong Kong, who had suicidal thoughts and major depression. She revealed that there is no actual word for depression in Chinese. Her perception of her depression in her words was: “feeling stressed and depressed is only a natural reaction towards the hardship of life”. (BBC, 2011). 
It could also just be a matter of denial from both parties, with the attitude of ‘if I pretend there’s nothing wrong, then it doesn’t exist’, when really, it just digs a deeper hole and more problems in the future that will make it harder to climb out of. These are just a few of the myriad of problems that underlie mental health misconceptions.

Although professional help is necessary for major and serious mental illnesses such as schizophrenia and major depression, we can all do our small part in preventing and easing the minor symptoms of mental illness. It can start with lifestyle changes, having honest conversations, listening, opening up, taking up hobbies, eliminating the environmental triggers. 

Fortunately, the recognition that mental disorders and mental health are serious health issues that need to be addressed have begun to surface in our collective consciousness. This is evident in the need of mental health services tripling in the past 20 years, and hopefully we can see Hong Kong society and its health services catching up to modern day needs. 

“Mental illness is nothing to be ashamed of, but stigma and bias shame us all” – Bill Clinton

References: BBC (2011). Hong Kong conducts first mental health survey. [Online] Available at: http://www.bbc.com/news/health-13687793 [Accessed 23/09/16]
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.