Concerns over Hongkongers' mental health have been on the rise in recent years. Tragedy often strikes when untreated psychiatric patients suddenly tip over the edge into violent madness. With the benefit of hindsight, many such incidents seem both preventable and - when one learns more about individual circumstances - unremarkable.
Dense overcrowding, intense competition at schools and work, and other triggering factors mean Hong Kong's relative lack of serious mental health problems is a matter for comment.
A custom-built asylum was completed in 1885 in Sai Ying Pun, initially with eight beds. From the outset, it accepted persons of all races but by 1894 it was hopelessly overcrowded. Government policy towards mental patients only provided for temporary institutionalisation in the colony. Eventually, patients were repatriated to wherever they had come from. At this time there were no restrictions on entry to Hong Kong for Chinese from the mainland and, from 1894, the Chinese authorities accepted the repatriation of mental patients to reduce overcrowding.
China's first modern mental institution was established in Canton (modern Guangzhou) in 1898. Known as the Canton Refuge for the Insane, this asylum was established by John Glasgow Kerr (1824-1901), a medical missionary with the American Presbyterian Mission who worked for many years in Canton and eventually died and was buried there. In the absence of any other reliable information, this organisation - rather than the Hong Kong or provincial governments - presumably footed the bill for patient care after they had left Hong Kong.
Hong Kong's early mental hospital building still exists, on the corner of High Street, Eastern Street and West End Path in Sai Ying Pun. Now 120 years old, the graceful red-brick building has a shady courtyard filled with mature Chinese fan palms and other well-established trees. For many years, this building has been used as a methadone treatment centre for drug addicts. While this is - without question - a worthwhile social enterprise, surely it could be accommodated nearby in a less historically significant building?
Also on High Street, just across from the early asylum, the old Civil Hospital nurses' quarters, built in the 1890s, became an overspill mental hospital from the late 1930s. It was used for this purpose until it closed in 1971. A friend's mother, who has lived in the area all her life, recalls seeing, in her childhood, just after the Pacific war, a demented woman, clinging to the barred verandah, rocking herself back and forth, and endlessly chanting 'nan yan sum hoi dae jum' ('a man's heart is like a needle at the bottom of the sea'). Who the woman was, and whatever happened to her to cause such a deeply wounded response, she never discovered, but the memory remains vivid more than 70 years later.
Castle Peak Hospital, in Tuen Mun, has been Hong Kong's principal mental institution since 1961, and the last patients were moved from Sai Ying Pun in 1971. After the High Street hospital closed, the building was locked up and left to decay. Over the next three decades, the floors rotted, roof beams sagged, windows broke and pipes burst. Addicts from the adjacent methadone clinic crept into the building, and during the night their drug-addled moans, combined with flickering lights from matches and torches shining within, inevitably gave the building a reputation as a 'ghost house'.
Eventually the building was demolished, and the Sai Ying Pun Community Complex was built on the site. One of the district's most distinctive landmarks, the massive stone facade has been retained and remains a popular backdrop for wedding photographs.
Stone chimneys from the demolished Civil Hospital nurses' quarters were incorporated into Murray House when it was reconstructed at Stanley in 2001-2002.