Expert warns that HK's shortage of psychiatrists could last two decades

Professor warns the city needs at least 700 specialists but only has 275 - not enough to cope with rise in tragedies involving mental patients

PUBLISHED : Monday, 27 August, 2012, 12:00am
UPDATED : Monday, 27 August, 2012, 5:59am

The severe shortage of psychiatrists in public hospitals is likely to continue for at least two decades, while the city struggles to deal with an increase in fatal tragedies involving mental patients, a leading psychiatrist has warned.

Citing standards established by the World Health Organisation, Hong Kong College of Psychiatrists president Professor Linda Lam Chiu-wa said there should be one psychiatrist for every 10,000 people - meaning Hong Kong needs at least 700. At present, there are only 275.

Meanwhile, only nine out of 305 trainee doctors have been assigned to six-year psychiatric courses this year, a drop of more than half from 20 in 2011. At the same time, the pace of recruitment has fallen behind the turnover rate in psychiatry, which saw a loss of 11 doctors last year.

The shortfall was put in sharp focus this month when a schizophrenic woman allegedly threw her two-month-old daughter to her death from a high-rise building. Lam said the tragedy was another sober reminder of the inadequate attention our society had given to mental health care.

"Lack of clinicians in mental health has been a long-standing problem. The manpower for psychiatrists in the city still falls far short of our counterparts with comparable socio-economic standards," she said.

Of the 275 registered psychiatrists in the city, around 70 work in private clinics, leaving those remaining in public hospitals to take care of at least 200,000 patients who have been diagnosed with severe mental disorders.

"Even if 20 trainees are assigned to the field each year, it would still take 20 years or so for the number to meet the international standard," the professor said.

The Hospital Authority says there are not enough medical graduates to assign to certain specialities while other fields such as internal medicine, accident and emergency, and surgery have far greater need for doctors.

Dr Pang Fei-chau, the authority's chief manager (medical grades), said: "Our priority is to fill existing vacancies in different specialities first. We are trying our best to hire people, but the number of graduates is limited."

The authority has assigned 69 trainees to internal medicine, a field which saw the departure of 70 doctors last year - the greatest loss of all specialties. Accident and emergency units and surgery have been assigned 42 doctors, while surgery has 32 trainees this year to take up vacancies.

Pang expected the overall shortage in doctors would not begin to be resolved until 2015, when the number of graduate doctors will increase from the existing 250 a year to around 400. It takes a trainee at least six years of college and clinical training to become a specialist.

Lam said the government should formulate a long-term mental health policy so that psychiatrists - who are working under great pressure with huge workloads in public hospitals - can see better prospects.

"They feel gloomy about their future now, as it seems no balance can be reached in the foreseeable future between the manpower shortage and increasing public demand," she said.

"It is to be expected more will chose to leave the public sector under this undesirable environment, and that society may suffer with tragedies harder to prevent."