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Hong Kong health care and hospitals

Nine-year-old Hongkonger diagnosed with ADHD only after she told tutor she wanted to kill herself

Children and teenagers with emotional or mental health problems have to wait up to 17 months for treatment at Hong Kong’s overburdened public hospitals

PUBLISHED : Saturday, 28 April, 2018, 11:01am
UPDATED : Saturday, 28 April, 2018, 11:27am

Eva Chan, a mother of two, began to notice that her then six-year-old daughter was emotionally unstable and became nervous easily. The girl would get sick and have diarrhoea before a test, and nipped herself so hard that she left red marks all over her arms.

When she was nine, she told her tutor that she wanted to kill herself by jumping off a building.

It was then that teachers and social workers warned Chan that the girl’s problems could be more than just behavioural. 

Her daughter, now 10, was diagnosed with attention deficit hyperactivity disorder (ADHD), one of the most common mental conditions affecting children. Those with the disorder have problems paying attention or sitting still, and lack self-control. But due to the high demand for public psychiatric treatment, the girl has had to wait over a year to see a doctor.

After her daughter’s diagnosis, Chan took her seven-year-old son for an assessment, and it was confirmed that he too had the condition.

But he will have to wait more than two years for a scheduled session to see a public psychiatric in June 2020 – longer than his sister because he has not displayed any suicidal tendencies.

“Our family can’t afford private treatment, so I felt quite helpless,” says Chan, 33, a housewife whose husband earns about HK$15,000 (US$1,923) a month to support the family of four.

“I didn’t know much about ADHD, I could only do research on the internet and see what to do.

“Since my son was diagnosed, many parents have come to ask me about ADHD as they suspect their children have some problems, but they do not know where to find help or what they should do.” 

Chan adds that society lacks awareness and information about the illness. 

Hong Kong is still failing ADHD and other special-needs children

ADHD affects about one in 20, or 5 per cent, of Hong Kong children, according to the Department of Health. In general, 16 per cent of children suffer from some kind of kind of mental health issue, and the number who need public treatment is increasing by as much as 5 per cent annually.

But children and teenagers with emotional or mental health problems have to wait up to 17 months for treatment at overburdened public hospitals, with most queuing for an average of 14½ months – the wait is even longer than for adult patients, according to the Food and Health Bureau.

There are about 330 psychiatrists employed in public hospitals – 400 fewer than the number recommended by the World Health Organisation for a population of Hong Kong’s size. Even fewer practitioners specialise in treating children and adolescents.

The cost of seeking private treatment is substantial, at around HK$3,000 to HK$10,000 per monthly consultation.

“The children will lose valuable study time and social opportunities if there is a long delay in getting treatment,” says Dr May Lam Mei-ling, director of Variety, a charity that provides free mental health treatment to children from low-income families. 

The organisation, which has about 20 volunteer psychiatrists, is treating Chan’s children.

Lam said the charity, which works with Caritas, provides patients with consultations and medication until they are finally seen by a public doctor.

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The international branch of the children’s charity, formed in the US in 1927, has raised over US$1.8 billion to help 42 associations in 11 countries. 

The local branch’s scheme, launched in August 2016, has treated 370 Hong Kong children with different psychiatric problems. In the first phrase, which covered 130 patients, more than 60 per cent had ADHD. 

The average waiting time for these patients for public treatment was 1.3 years, although the longest was 3.4 years, according to the group.

Last week, the group organised a peer support event for patients and their families to watch Cirque du Soleil at Central Habourfront, after being given sponsored tickets.

“The special care given to ADHD patients can also bring enormous stress to their carers, which is not well addressed in society,” Lam says. 

“We hope to provide holistic support to include family and carers.” 

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Lam urges the government to increase resources to help children from low-income families get treatment as early as possible and end the long waiting times.

Those wishing to make a donation to Variety can go to www.variety.org.hk.

What is ADHD?

Attention deficit hyperactivity disorder affects children and teens and can continue into adulthood. ADHD is one of the most commonly diagnosed mental disorders of children due to the brain development. It affects attention, the ability to sit still and self-control. The exact cause of ADHD has yet to be made clear, according to the Department of Health.

What are the symptoms?Children with ADHD may be hyperactive and unable control their impulses. Or they may have trouble paying attention or focusing. Some children may have a hard time regulating their emotions and become easily irritated, leading to intense and sudden reactions such as anger or frustration. 

How many people in Hong Kong have ADHD?

According to the Child Assessment Service of the Department of Health, ADHD affects about 5 per cent of children, with twice as many boys as girls affected. For adults, the prevalence is around 2.5 per cent. A paper published by the University of Hong Kong in 2015 estimated the prevalence of ADHD in Hong Kong was 6.1 per cent in childhood and 3.9 per cent in early adolescence. The prevalence rate in Hong Kong is comparable to that of other countries

How to treat it?

The treatment strategies vary according to age. The mainstream treatment usually consists of medication, psycho-educational talk and behavioural therapy for the children and their parents. While medical therapy is very effective in controlling the symptoms, improving attention and reducing hyperactive behaviour, some psychologists suggest the treatment would make it more difficult to identify children’s talent. Behavioural therapy and educational support can improve learning and reduce behavioural problems.

Can children grow up normally?The Child Assessment Service says symptoms of ADHD persist to adolescence in 80 per cent of children, and to adulthood in 65 per cent. But the extent to which an individual can cope or make adjustments in daily life and in choice of occupation depends on many other factors, such as the severity of symptoms, the individual’s intelligence, the family situation and treatment received.