In ill health
In 1982, a young man in Sham Shui Po grabbed a knife and stabbed his 48-year-old mother to death. Then he turned around and did the same to his 17-year-old sister.
But he wasn't done. Lee Chi-hang ran out of the flat, down the stairs and encountered two sisters, one of whom was pregnant, and hacked both of them to death along the stairwell.
Then the man barged into the classroom of a kindergarten next door, where about 60 children were sitting in two rows and singing. He went down the line, slashing and stabbing.
In total, the man killed five people and injured 42 children, some of whose hands were almost entirely severed.
Lee was never put behind bars. Declared mentally ill, he was sent to Siu Lam Psychiatric Centre.
The public horror surrounding this 1982 killing spree is not unlike the one we witnessed last month. Same district, new tragedy. On May 31, a former mentally ill patient chopped to death a three-year-old boy who accidentally bumped into him while playing outside with his father.
What the two cases have in common is that both were brutal and random acts of violence. Both times the outraged public immediately pointed fingers at the government for failing to provide enough funding for psychiatric services.
To be sure, the Hong Kong government spends relatively little on psychiatric resources. According to the Society for Community Organisation (Soco) community officer Tim Pang Hung-cheong, the city devotes less than .25 per cent of its GDP on public psychiatric resources, compared to about 1 per cent in other nations.
This follows a trend of moving away from patient institutionalisation and putting more emphasis on outpatient care.
From 1998-2005, for instance, the number of public psychiatric beds available dropped more than 8 per cent while outpatient attendance went up 30 per cent.
But the extreme under-funding has led to inadequate attention for patients, and long waiting times of two to three years.
One clinical psychologist said his patients frequently complained that their psychiatrists didn't even look up from their computers during appointments, and typically spent no more than five minutes talking to them.
Ultimately, says psychiatrist Tsang Fan-kwong, Hong Kong lacks a formal mental health policy guiding the direction of services in the city. Any improvements to the system are done in 'bits and pieces' and typically driven by tragedies, he says.
But, according to Andy Ng Wang-tsang, chief executive of the Society of Rehabilitation and Crime Prevention, the public has a large role to play as well.
'I don't think the issue can be effectively dealt with by legislation,' says Mr Ng. 'What we need is a stronger follow-up programme for high-risk patients, such as those who don't recognise that they need help or have a history of violence. These people are at higher risk when they live alone in the community.'
Social stigmatisation, or fear of the mentally ill, makes it even harder for released patients to recuperate, says Mr Ng, who argues the public has a responsibility to look out for each other, and report odd behaviour to the authorities.
'You know, instead of being scared when you see people with a 'crazy eye' or who are sleeping on the streets, report it. Keep an eye out for each other.'