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Isolation rooms at Penny’s Bay quarantine centre on Lantau Island, Hong Kong. Photo: Dickson Lee

How Covid-19 quarantine isolation in Hong Kong is hurting mental health amid reports of suicide attempts at Penny’s Bay; experts offer tips on managing feelings

  • Uncertainty and a lack of control over testing and isolation increase mental health risks, experts say, with pressure reaching boiling point in Hong Kong
  • Being able to isolate at home with your own things around you would help people better cope, says researcher who studied impact of world’s longest quarantine

Frustration is mounting as Covid-19 sweeps across Hong Kong, compounded by bottlenecks in the testing system and stretched resources at medical facilities. Within the mandatory quarantine camps, however, the pressure is already at boiling point.

In a widely circulated video, a visibly distraught woman at the community isolation facility at Penny’s Bay, on Lantau Island, is heard shouting at camp security guards, “Don’t pretend to care about me! I want to go back! I have recovered! I’m crazy!”

Because the distressed woman allegedly struck a security guard, police called to the scene listed the case as assault occasioning actual bodily harm.

Four suicide attempts within a 27-hour period were reported at Penny’s Bay last week. Police and firefighters were called to talk down a 59-year-old woman who was threatening to jump from a building. Meanwhile, a man who slept outside his isolation unit to protest a lack of support in getting urgent medication for a chronic condition said, “It [isolation] is like a concentration camp. No one would know if I died.”

Screenshots of a viral video on Facebook of a distressed woman in the Penny’s Bay facility shouting at security guards (left) and in an altercation with a Penny’s Bay staffer (right). Photo: Facebook
“Someone taking their life or threatening to take their life – we need to look hard at what is going on,” says Dr Judith Blaine, who published the first scientific paper on the impact of the world’s longest mandatory quarantine in 2021. “What punitive measures are going to help your well-being if you’ve just had a breakdown?”

“It is the tip of the iceberg,” says Professor Paul Yip Siu-fai, director of the Centre for Suicide Research and Prevention at Hong Kong University (HKU), referring to the recent spate of reported suicide attempts at Penny’s Bay. “The general mental health is not good.”

New guidebook aims to help Hongkongers beat quarantine stress

“Wellcation”, an online guidebook that a group of HKU professors compiled offering mental health support for those in isolation, saw a massive spike in visits over the last week, Yip says, from 8,000 in the week before February to 212,000 visits a week a fortnight later.

Wellcation is an excellent resource if you are self-isolating in a hotel, but for those issued with a mandatory quarantine order and sent to a large makeshift facility where hundreds of beds are packed into a massive dorm, tips such as “think about how you may rearrange the furniture to suit your needs” are not as relevant.
And advice to “become acquainted with food delivery services” doesn’t apply at facilities such as AsiaWorld-Expo where inmates are dependent on the food provided, and there have been complaints about missed meals and poor food hygiene.
Professor Paul Yip Siu-fai, director of the Centre for Suicide Research and Prevention at Hong Kong University. Photo: Dickson Lee

Research shows that prolonged isolation has a profound negative impact on people’s mental well-being, Blaine says. She is concerned that this isn’t being addressed, nor are measures in place to protect the most vulnerable.

“In Hong Kong, people are not screened for any mental health issues before they go into [mandatory] quarantine, they are not asked if they are at risk or what medication they are on,” she says.

In Australia, those who are vulnerable or who have a previous mental health condition are assigned a different kind of accommodation: a flat with windows that open, and from which knives are removed, Blaine says. And everyone in quarantine receives a daily phone call from the government to check in on them and ask how they are coping.

Dr Judith Blaine published the first scientific paper on the impact of the world’s longest mandatory quarantine in Hong Kong. Photo: Jonathan Wong

Acknowledging the lack of screening of the vulnerable in Hong Kong, Yip calls for better support and resources.

“If you say you have a phobia, I don’t think they will let you off the hook. But I think they could provide additional support for people who are susceptible [to mental health problems or suicide ideation],” he says, adding that help hotlines have been jammed, leading him to recommend the government opens a 24-hour text line.

Dr David Owens, a Hong Kong-based general practitioner who specialises in family medicine, says change, uncertainty and a lack of control increase mental health risks and that quarantine is likely to aggravate mental health issues in the most vulnerable.

“Removal of agency is a key factor in the stress that people experience. For people who are vulnerable, if you remove their support systems, it makes it harder for them to manage behaviour factors which can keep mood under control,” he says.

Dr David Owens, a Hong Kong-based general practitioner who specialises in family medicine.

He points to the increase in suicides in 2003, coinciding with the Sars (severe acute respiratory syndrome) outbreak in Hong Kong that year.

“I think we haven’t really begun to understand the psychological and social impact of Covid-19,” Owens says.

A 2010 academic paper by Yip and three colleagues – “The impact of epidemic outbreak: the case of severe acute respiratory syndrome (Sars) and suicide among older adults in Hong Kong” – looked at how the Sars outbreak resulted in a higher suicide rate, especially among older adults in Hong Kong.

The report concluded: “We recommend that the mental and psychological well-being of the community, in particular older adults, be taken into careful account when developing epidemic control measures to combat the future outbreak of diseases in the community.”

Security monitors at Penny’s Bay. Photo: Dickson Lee

Blaine does not see that happening in Hong Kong at present. She sees the government doing its best to mitigate the effects of the virus and protect people’s physical well-being, but in the pursuit of those goals, she questions whether the government has lost sight of the humanity.

“I worry about mental well-being in general, particularly for those in isolation, but the main thing that worries me and other people is being separated from family and support,” she says.

For many people, the lack of autonomy around the mandatory quarantine means that it is perceived as a punishment, and this has an adverse effect on how you deal with quarantine, she says.

“If you were given some sense of autonomy, for example being able to isolate at home with your own things around you, it would mitigate these mental health issues,” she says.

A room inside Penny’s Bay. Photo: Brian Rhoads
The building of an isolation facility in process at Kai Tak, Hong Kong, on February 24. Photo: Martin Chan

Blaine sees Hongkongers, who collectively went through the experience of Sars, as having a high sense of civic responsibility and much more likely to accept decisions if the process leading to those decisions is inclusive, responsible and reasonable.

“Aside from Covid-19, it’s the general fear around being taken to Penny’s Bay that is gripping everyone, and the separation from families. Entering these situations with an already high level of anxiety, the potential suicide risk is high,” she says.

Commenting on the widely circulated video of the distressed woman at Penny’s Bay, Blaine expresses concern about the “bystander effect”. Most people’s natural reaction would be to comfort a distressed individual, but everyone is too scared because they are concerned about being punished, she says.

“How badly distressed must a person be for you to go there and help and b***** the consequences? It goes against the natural way of being, the natural support you’d ordinarily give a person,” she says.

Mental health tips for those in isolation

Dr Hannah Reidy, CEO of mental health charity Mind HK, says it is understandable and completely normal to feel frightened if you are quarantining alone, and that you may wish to escape some of these big feelings.

“Ground yourself by focusing in on your breath or an object in the room, helping yourself to slow down a little and remind yourself that this experience in isolation is temporary and it will change,” says Reidy.

Dr Hannah Reidy, CEO of mental health charity Mind HK.

Quickly reach out for support and someone to listen to how you are feeling. At this early stage, that person could be a mental health professional or someone who cares about you, such as a friend or family member.

“If you are feeling you can’t keep yourself safe and you are isolating at home, we recommend calling 999 or a suicide hotline,” Reidy says.

“If you are in isolation in a professional facility, then we recommend urgently calling the nurses or the care staff managing that facility, or the hotline of the isolation facility, and you could also seek help on one of the suicide prevention hotlines.

“Please remember you are not on your own through all of this.”

If you are having suicidal thoughts, or you know someone who is, help is available. For Hong Kong, dial +852 2896 0000 for The Samaritans or +852 2382 0000 for Suicide Prevention Services. In the US, call The National Suicide Prevention Lifeline on +1 800 273 8255. For a list of other nations’ helplines, see this page
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