In the aftermath of Friday’s firebomb attack that left 19 people injured, it’s understandable people are worried about safety on the MTR, Hong Kong’s railway system. But equally worrying, if not even more so, is inadequate mental health care. The MTR attack may well be an isolated case. But if officials are investigating the incident as a public transport issue, surely health authorities are also justified in looking into whether the suspect might have fallen through the cracks in our public health care system. This is entirely possible, given the woefully inadequate state of our public-sector psychiatric service. The statistics are too depressing to contemplate. New psychiatric cases registered in specialist outpatient clinics jumped from 39,770 in 2009-2010 to 47,958 in 2014-2015. Waiting times for mental health treatment are the longest of all specialist services, ranging from one to more than three years. Even if you do get face time with a public-sector psychiatrist, it usually would not last more than a few minutes. The Hospital Authority estimates that up to 1.7 million Hong Kong people may suffer from some types of mental illness, with 70,000 to 200,000 of them considered to have severe conditions. But the city only has 4.5 psychiatrists per 100,000 people, compared with 14.63 per 100,000 in Britain, and 9.16 per 100,000 in Australia. In 2015, there were just 315 psychiatric nurses and specialised occupational therapists taking care of more than 14,700 severe mental patients within the public sector. Clearly, this is the result of years of negligence by the government, which has cut back or frozen spending on mental health services. Most mental patients are non-violent, and people with no history of mental illness can become violent. Yet, given the nature of the MTR attack, it is legitimate to look at the broader issue of mental illness. This is not to assign blame to already overworked professionals, but to identify systemic failure.