Murderous minds a symptom of ailing mental health system, say social workers

The grisly killing of a security guard by a mentally ill man yesterday highlights Hong Kong's poor monitoring and treatment of psychiatric outpatients, social workers say.

'In light of the event, we are hoping more will be done by the government by way of resources and service allocation for the district,' said Christine Chuk So-shan, team supervisor at Caritas Hong Kong, which runs a centre in North District.

Chuk's centre and many other mental health centres are hampered by inadequate resources.

Months after a mentally ill patient chopped two people to death at a Kwai Chung estate in May 2010, Chief Executive Donald Tsang Yam-kuen said he would invest HK$13.8 million in 24 Integrated Community Centres for Mental Wellness in 18 districts.

But today all but six of those centres are operating in temporary offices and cramped spaces.

'We have been unable to secure a permanent site for the centre and are now using a small room temporarily loaned to us,' said Chuk, whose North Point facility covers Sheung Shui, the site of yesterday's killing.

Btu Caritas said the attacker was not one of its patients.

Chuk says crammed into the 200 sq ft space are eight social workers who look after 950 patients - or about 120 patients - each afflicted with a variety of mental problems.

'The workload is huge. We are still two staff short. The small room we are using now is not satisfactory at all. We are looking for a 5,000 square feet space where we could provide facilities for mental patients,' she said.

The Hospital Authority estimates the number of mentally ill people in Hong Kong at 150,000, with 40,000 suffering from schizophrenia. Of those, 20,000 are considered medium- to high-risk patients.

Lawmaker Wong Sing-chi called for more co-operation and improved information-sharing among police, doctors and social workers to alert authorities about troubled cases.

Meanwhile, public hospitals were urged to invest in pricier but effective medication for schizophrenics, who suffer from hallucinations and make up a significant number of mental health cases.

Dr Marcus Chiu, from Baptist University's social work department, said those patients should switch to monthly injections that cost HK$1,000 instead of taking daily pills.

'A monthly dosage can reduce the chance of missing out on oral medication and reduce the risk of relapse,' he said. 'Total medical expenses will be reduced if the chance of relapse - and the need to be admitted to hospital - is less.'

Pandora Pang Suk-yin, chairman of the FamilyLink Mental Health Advocacy Association, also said patients should be given the choice between oral medicines or injections.