Mentally ill slipping through the cracks

PUBLISHED : Wednesday, 26 May, 2010, 12:00am
UPDATED : Wednesday, 26 May, 2010, 12:00am

The treatment and rehabilitation of mental patients and their underlying threat to the community have again come under the spotlight in the wake of a recent chopping attack involving one such patient in Kwai Shing, which left two dead and three seriously injured.

The welfare of mental patients remains a serious problem in Hong Kong. Between September 2008 and August last year, there were 64 suicide cases involving mental patients, and eight cases of homicide and wounding. According to the Food and Health Bureau, about 150,000 Hongkongers suffer from various degrees of psychiatric problems, of whom more than 40,000 have severe disorders.

The government has increased its spending on mental health services in recent years, with total health spending of HK$3 billion. But with only 150 specialist nurses to cover such a huge number of patients with serious mental disorders, there is an obvious shortage of resources in this area. For example, in order to provide these 40,000 patients with a home visit every month, the nurses are required to visit at least 10 families per day. It's not difficult to see that we are facing a ticking time bomb due to a serious lack of resources.

After the recent tragedies, the media-savvy secretary for labour and welfare, Matthew Cheung Kin-chung, and Secretary for Food and Health York Chow Yat-ngok, the two relevant officials, made no public response. Instead, it was Secretary for Transport and Housing Eva Cheng who addressed the media because the attack took place on a public housing estate. If we apply this absurd logic, does that mean if a similar tragedy takes place in a private residential unit in future, the two will again remain silent?

This has exposed the fact that our government does not have a comprehensive strategy and wide-ranging programmes to deal with the treatment and rehabilitation services for people with mental illnesses. There doesn't seem to be any collaboration between departments to co-ordinate responses and services even when serious cases emerge.

After the attacks, the chief executive expressed serious concern and noted that the government had spent HK$30 million extra to boost mental health care services last year, and increased this year's budget to HK$100 million. However, the resources do not match the size of the problem. We don't have the dedicated manpower and resources to co-ordinate rehabilitation programmes for the increasing number of mentally ill in Hong Kong.

In theory, we follow the widely accepted international practice of helping psychiatric patients reintegrate into society through community rehabilitation programmes. Unfortunately, these initiatives have not been fully implemented, with only one of the 20 outreach teams conducting services, in Tin Shui Wai. The remaining teams are unable to roll out their services because of a lack of support from local community groups. But even if all 20 teams could work at full steam, our outreach programmes are still not comparable to those overseas.

A good outreach service is a comprehensive strategy that addresses and manages the needs of each patient until he or she recovers. For example, if patients have no family support, the health care manager can help them apply for public housing and financial assistance. A well-run outreach programme can closely monitor patients and alert relevant parties if their condition deteriorates.

We need a comprehensive strategy to support the development of mental health services and strengthen the coherence and effectiveness of current and future initiatives to prevent the recurrence of similar tragedies.

Albert Cheng King-hon is a political commentator.