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Tragedy has shown up lack of care for mentally ill

The dire assessment that one of Hong Kong's most prominent psychiatrists has given on our public health system for psychiatric patients should ring alarm bells. Lee Sing, of Chinese University, says it is in danger of collapse. He did not choose the word lightly. Overworked professional staff, long queues and short consultations for patients, a lack of resources and follow-up care - the litany of problems is long.

Dr Lee was responding to the killing of a three-year-old boy by a mentally ill neighbour on Friday. The whole community has been shocked and saddened by the tragedy. However, we do not know the full details and circumstances surrounding the attack. Therefore, we must, for the time being, refrain from drawing any conclusions about the attack or the suspect charged with committing the crime. But the tragic incident does draw attention to the acute inadequacy of the care given to mental outpatients living in the community. In the case of the suspect, social workers had closed his file after he twice rejected their services.

The number of psychiatric patients has risen 25 per cent in the past five years, but the number admitted to wards actually fell by 5 per cent during the period. The trend of rehabilitating patients in the community is a laudable and positive one, but that must be coupled with adequate provision of care and treatment, along with appropriate social-network support. However, experts say it is precisely in those areas that Hong Kong is falling behind other advanced economies. There is no question of Hong Kong lacking the necessary financial resources; the problem is one of neglect. The city spends just 0.24 per cent of its gross domestic product on psychiatric resources, compared with an average of 1 per cent in developed economies.

Dr Lee said patients often wait more than a year for a public-hospital appointment. Another psychiatrist, Tsang Fan-kwong, said complaints were growing about the length of patient consultations - as little as 6 minutes. Patients have plenty of time to get worse without being treated. We are a civilised and wealthy society. It is time we give more help to those among our most vulnerable.

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