In Hong Kong, the alarm bells are ringing for children’s mental health

Child abuse is on the rise, alongside mental disorders and suicides among youngsters, with too many still not getting the help and treatment they need

Grenville Cross

Published: 4:30pm, 20 Dec 2023

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Although many children will be celebrating Christmas, some will not. Child abuse is still rife; the Social Welfare Department reported 1,439 cases last year. Much abuse, however, goes unreported, particularly when it involves mental illness.

Although the focus is invariably on children who have been physically abused, some suffer from mental disorders, which can produce unique suffering. Children with special needs, for example, those with attention deficit hyperactivity disorder (ADHD), sometimes face physical abuse from adults infuriated by their behaviour. They may also be discriminated against at school and in society, and their condition can easily deteriorate.

It’s not hard to identify youngsters needing help; the telltale signs are obvious. If a child or adolescent is depressed for long periods, exhibits confused thinking, worries excessively about things, experiences mood swings, withdraws from friends and activities, or exhibits significant tiredness and low energy, the alarm bells should be ringing.

In November, the Chinese University of Hong Kong disclosed that almost one in four children and adolescents suffered from at least one mental disorder in the past year, and that 8 per cent of secondary students had contemplated suicide. The government-commissioned study showed that 24.4 per cent of children and adolescents aged 6 to 17 had experienced at least one mental health issue in the past year, with half of them suffering simultaneously from two or more such conditions.

The researchers, between 2019 and 2023, interviewed 6,082 children and adolescents, as well as their parents, and found that one in 10 children and adolescents suffered from significant sleeping problems. The most common condition was ADHD, which afflicted 10.2 per cent.

The study also found that almost 50 per cent of carers, despite observing mental health problems in their children, were unwilling to seek professional help for them. This was mind-boggling, and points to a system in need of overhauling.

Moreover, the Centre for Suicide Research and Prevention at the University of Hong Kong announced last month that 37 students had taken their own lives since January, with 269 students known to have attempted suicide this year. It noted that school-related matters, family issues and mental health problems were the main contributory factors.

What was particularly disturbing was the disclosure that, out of the 306 students who attempted or died by suicide, over 55 per cent had reported their mental problems but fewer than 40 per cent had received treatment from welfare professionals.

The annual coroner’s report, moreover, has flagged a deteriorating situation. Whereas 15 youngsters aged 19 or under committed suicide in 2013, the figure had reached 39 by last year.

Regrettably, the community’s capacity to respond to this troubling situation is questionable. The founder of HKU’s Centre for Suicide Research and Prevention, Paul Yip Siu-fai, said last month it was “impossible to deal with all the children and adolescents with mental disorders with our medical system as we do not have the manpower” – which comes as a surprise.

After all, since 2019-2020, the Social Welfare Department has set aside an annual provision of around HK$56 million (US$7.2 million) for its integrated community mental health centres, and this should have helped. The sum was to enable the centres to extend their service targets to secondary school students with mental health needs, and strengthening support for them, their parents and their carers.

Although the centres provide such things as public education on mental health, clinical psychiatric services and community outreach, they depend on referrals from doctors, social worker and others, and the system is not working as intended.

Last month, five NGOs, including Caritas Hong Kong, exhorted schools to provide more mental health support for students, and urged parents and the public to be on the alert for “warning signs”.

Initially, it is down to parents and teachers to ensure students’ mental health problems are not overlooked. Many young people, however, live in crowded housing where tensions can flare and over time, this can take a heavy toll on their mental health. This is not something most parents want publicised, and little is done.

Hong Kong must not fail pupils in need of mental health support

Although, therefore, teachers will often be the main line of support, they usually have their hands full, and there is only so much they can do. They may sometimes be able to ease academic pressures for troubled students, but far more is required. Their supervisory role inside schools needs to be buttressed by experts, whether social workers, educational psychologists or medical professionals, as the government appears to be realising.

On November 22, Secretary for Education Choi Yuk-lin told the Legislative Council that the government would be establishing “a three-tier school-based emergency mechanism”, which sounds promising.

It would involve the early identification of adolescents with mental health needs, an “off-campus support” network, and the direct referral by school principals of students with severe problems to Hospital Authority psychiatrists. The aim was the promotion of “students’ physical and mental well-being”; the proof of the pudding will now be in the eating.

Although fine words and good intentions have never been in short supply, they alone cannot suffice. With more enlightened attitudes and greater resolve, the case for the prioritisation of the mental wellness of children and adolescents is now overwhelming. In 2024, the authorities must implement clear strategies that will realistically promote the mental health of young people, whatever their age.

Grenville Cross SC is the patron of Against Child Abuse

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