The problems associated with treating the city's 200,000 psychiatric patients, whether in hospital or in their homes, are so wide-ranging that they can no longer be managed by the Hospital Authority and individual government departments, say psychiatrists and a patients' group. They advocate the creation of a super-high-level body that would cover not just medical services but also housing, social welfare and employment for psychiatric patients. The College of Psychiatrists, the top training body for psychiatrists in Hong Kong, and the Patients' Rights Association envisage something similar to the special task force created three years ago to tackle youth drug abuse, and which is headed by Secretary for Justice Wong Yan-lung. At the same time the Hospital Authority has drawn up a five-year plan for public mental health services. Meanwhile, a government working group on mental health services has set out general principles, goals and directions - though this framework policy has not yet been made public. The authority blueprint and the groups' call for a higher-level body follow several violent incidents involving mental patients. In the latest, on the Kwai Shing East estate in Kwai Chung, last month, a resident of the public housing estate with a mental illness chopped two people to death and seriously injured three others. People familiar with the situation said a mental health policy for Hong Kong was being finalised but the government had no timetable for when it would be released for public consultation. One person close to the working group said: 'The bureau may think that even if it works out a plan, it can't move other departments to act together.' This person agrees with the patients' group and psychiatrists on the type of body needed to oversee mental health services, saying: 'What the government needs is a higher-level mechanism like the one for tackling youth drug abuse.' The College of Psychiatrists issued a position paper to its members on May 25 which holds 'the establishment of an overarching mental health policy that cuts across all government departments and bureaus to be of paramount importance'. The document expresses the hope that the government 'would act promptly on this'. College president Dr Hung Se-fong, who is also head of the Kwai Chung Hospital, a centre for treatment of psychiatric patients, said: 'The public medical service is an important piece of the puzzle, but not the whole picture. We need the collaboration of various agencies.' The government working group on mental health services was set up in 2006. Its chairman is Secretary for Food and Health Dr York Chow Yat-ngok and its members include academics, health professionals and service providers. A health bureau spokesman said the working group had formulated a framework on mental health policy and services setting out the general principles, goals and directions. In a reply to questions from the South China Morning Post, the bureau only mentioned general principles, such as 'to promote mental health and prevent mental problems, to foster a caring environment, and to ensure the provision of quality, comprehensive and accessible mental health services'. 'The framework for our mental health policy and services are under review on an ongoing basis and we will continue to explore initiatives to enhance the support for mental patients in the community,' the spokesman said. The city has 57 psychiatric-care beds per 100,000 people, in line with other developed countries. The bed occupancy rate is steady at around 75 per cent. But having adopted community care as the future direction of mental health services, the Hospital Authority will continue to reduce in-patient services. The number of psychiatric beds has been cut from 4,730 in 2003/04 to 4,000 in 2008/09. The number of long-stay psychiatric patients - those kept in hospital for more than a year - dropped from 1,690 to 767 during the same period. At the same time, demand at specialist outpatient clinics is growing. The workload of the clinics has increased by 19 per cent since 2003/04. Its five-year mental health services plan, released recently for internal consultation, estimates that half of the 40,000 schizophrenic patients in the city will be managed exclusively in the community over the next few years. The plan estimates that Hong Kong has between 70,000 and 200,000 people suffering from severe mental illness, based on worldwide figures show that between 1 per cent and 3 per cent of people suffer such illness. It currently treats 150,000 such patients. It acknowledges that the current long waiting time for medical care and a lack of access to therapies is a concern and that mental health services for young people and older people are underdeveloped. The document says that, by 2015, the authority should provide high-quality care for mental patients, inform users about decision-making and provide services in a 'relaxed, informal setting'. Hospital settings will be as home-like as possible, provided in rooms not wards and with patients wearing casual clothes, not pyjamas. The authority should also develop 'outcome-driven' mental health services by using a single set of measures to review service quality, it says. A mental health users group will be set up to provide advice on improving services. Tim Pang Hung-cheong, spokesman for the Patients' Rights Association, said the authority should release its five-year plan for public consultation, instead of just releasing part of it at the authority's annual convention last month. Pang said Hong Kong needed a high-level mechanism to take care of mental health services. 'We only have the authority plan. How about the other related department such as the police, the social welfare and labour departments and the Housing Authority? Obviously the government has failed to make mental health a priority, despite repeated tragic incidents,' he said.