Mahtani, who grew up in Hong Kong and attended Island School, shares these worries, predicting an overall “deterioration” in the mental health of the city’s young people if the issue is not addressed.

In 2014, she set up her group, drawing members aged 18 to 65, and claims it is the only English-speaking one of its kind for anxiety and obsessive compulsive disorder in Hong Kong.

‘A loss of face’

“If a child is suffering at school, then they do not want to talk about it,” she said. “This culture is that people are weak if they have a mental health problem. It is still a taboo — it is a loss of face.”

Mahtani said the core fears of the young people she has worked with have been “a fear of making mistakes, of being not good enough, of losing control and of contamination”.

“Teachers and schools here need to sit parents down and tell them, ‘It is okay, it is not their fault’,” she said. “We do not know exactly why they are feeling like this, but it could be academic pressure. Hong Kong parents have a need for perfectionism.”

Her concerns are echoed by Dr Tony Lai Tai-sum of the Mental Health Association of Hong Kong.

Lai said parents and teachers needed to let children develop at their own pace, both emotionally and academically, in order to protect them from anxiety.

“They are developing anxiety because they are not ready to move on to the next stage,” he explained. “We need to let them move step by step.”

Lai said parents should watch for any “abnormal changes” in their child’s behaviour as they could indicate stress.

“We need to give them more time to express themselves otherwise they will keep silent,” he added.

Education Bureau efforts

The Education Bureau set up a number of initiatives earlier this year to help the city’s young people who were confronting mental health issues.

A bureau spokeswoman said schools were advised to adopt a three-tier support model: teachers assessing and identifying a pupil’s risk of emotional and behavioural difficulties and making appropriate adjustments; more action if the child showed no improvement, possibly leading the pupil to be referred for additional support services within the school; and referring those who show prolonged mental health issues for professional help with a psychologist or counsellor.

But the spokeswoman noted the approach was not compulsory.

“Students with mental health problems need treatment and follow-up by medical professionals,” she said.

The spokeswoman added the bureau always advocated early identification of and intervention for students with diverse educational needs, including those with mental health problems.

She said follow-up help could include medical treatment, emotional counselling and individual support.

Areas for improvement

Despite the apparent action from some institutions, mental health services in Hong Kong have been criticised for being severely underfunded given the high demand.

Psychiatrist appointments can take between one and two years to book, while a session with a private cognitive behavioural therapy practitioner can cost as much as HK$2,000.

Mahtani said she would ideally like to see all schools employ a social worker and a counsellor.

She also called for improved training for GPs, as anxiety often initially manifested as physical symptoms that were misdiagnosed.

“Early intervention is crucial to prevent anxiety becoming an anxiety disorder,” she said. “That whole notion that you have caused it and should be ashamed needs to change.”

“You feel like there is no one to talk to, so instead you go online,” she added. “But that is no replacement for face-to-face contact.”

If you are feeling stressed or in need of support, contact Samaritan Befrienders’ 24-hour hotline on 2389 2222