Why Hong Kong’s Nimby attitude is a threat to mental health
Siu-man Ng says mental health service centres are struggling to find a home in housing estates because of residents’ opposition, and officials need to do more to lead changes
During election season, those campaigning to be Hong Kong’s next chief executive will generally promise to strengthen community health and social services. Such “morally correct” pledges are popular. Once a new leader is in power, translating these promises into actual policy can be swift. What, then, is the problem?
For some services, such as those related to mental health care, the biggest obstacles come during implementation. Over the past decade, efforts to locate mental health services in a neighbourhood have often run into opposition by residents. This has led to severe delays in the roll-out of some policy initiatives. Eradicating such barriers should be a priority for our next leader.
In Hong Kong, many people fear and/or dislike mental health problems. Though they agree that the community needs more mental health care, many do not want such services sited in their neighbourhood.
Of course, this “not in my backyard” (Nimby) mentality is a problem all over the world, not just in Hong Kong, but it appears entrenched here. Despite the government’s heavy investment in public education, it seems to have grown worse. There are various explanations for this: our high population density, and people’s preoccupation with any negative impact on real estate prices, for example.
How can we persuade more communities to welcome these services? This is particularly important in public housing estates, where about half of Hong Kong’s population reside. These estates must have easy access to mental health services if the city really means to adopt a community-based service model.
In his 2009 policy address, Chief Executive Leung Chun-ying announced the launch of the city’s first Integrated Community Centre for Mental Wellness in Tin Shu Wai. Since then, a total of 24 such one-stop centres have been set up. But they face daunting challenges.
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A typical centre needs premises of about 500 square metres, since it has to run a day centre, on top of working with individual cases and promoting community education. Yet, despite the hard work by the Social Welfare Department and service operators, which are non-governmental organisations, only 14 of the 24 centres have secured permanent premises. The other 10 are still struggling in severely substandard temporary sites. Even among the 14 centres with permanent premises, many fall short in terms of space and accessibility.
Finding a suitable home has turned out to be an exceeding lengthy process for these centres. Identifying the right premises in a public housing estate is the easy step, but signing the lease contract with the Housing Department has been anything but.
Under department guidelines, the estate management advisory committee, which includes tenants, and all of its tenant-led mutual aid committees must agree on having the centre there before the lease can be signed. Typically, the chair of these committees will – while expressing support for the centre in principle, in case they are accused of discriminating against people with mental health problems – give endless reasons why their estate is not the best site for it.
Meanwhile, the Housing Department “helpfully” pledges to reserve the vacant premises for the centre, for years if necessary. This bureaucratic tactic of self-protection on the part of the department should be condemned.
To ease the deadlock, the department should give up its insistence on having a “no objection motion” passed by tenant committees. Yet, despite repeated appeals for change by various NGOs and patients’ organisations, the department has stood its ground.
Perhaps only a strong top-down intervention, preferably from the chief executive, can motivate the department to abandon such a self-defensive stance.
Meanwhile, we appeal to the senior officers of the Social Welfare Department to stand firm in the consultation process, as they work for the best interests of the service users.
Dr Siu-man Ng is associate professor, deputy department head and director of the Bachelor of Social Work programme in the Department of Social Work and Social Administration at the University of Hong Kong