Study reveals need for psychiatric services in Hong Kong, but also warns against forcing treatment on mentally ill
Human rights cited as reason not to implement legal order
The Hong Kong government should not make it a legal requirement for people diagnosed with mental illness to accept treatment as this raised concerns over ethics and human rights, a review of the city’s overburdened psychiatric services said.
The report, released on Tuesday and written by a committee formed in 2013, also warned of an increasing demand for psychiatric services in the city – especially for children – as well as a rising need to treat cases of dementia as the population ages.
But it ruled out the possibility of the government implementing a community treatment order – a legal rule for a person to accept treatment for mental illness – citing moral and human rights concerns.
A government source said that without such an order, it was even more important to strengthen services, especially for patients prone to relapses in severe cases.
Suggestions in 20 areas from the report include the delivery of a smooth service transition, adopting an intervention approach at school, and reinforcing facilities and manpower.
But the study failed to assess the current shortage of medics and stopped short of projecting the manpower needed to cope with future demand in a segment of the public health sector that is already strained.
A working group would be set up to look into reducing the workload of case managers who handle severe psychiatric patients, from an average of 50 patients each to 40, the source said.
“A standing advisory committee will be formed in the second quarter of this year to monitor the implementation of the recommendations and to follow up on development of mental health services,” the source added.
Currently there are about 330 psychiatrists employed in Hong Kong’s public hospitals – 400 fewer than the number recommended by the World Health Organisation, taking into account the city’s population.
According to the Hospital Authority, the overall number of mental health patients increased by 2 to 4 per cent every year, from about 187,000 in 2011-12 to more than 226,000 in 2015-16. The increase among children was particularly significant and could be as high as 5 per cent annually.
Last year, 12,589 patients below the age of 18 received treatment in public hospitals, up from 11,900 the previous year.
A majority of patients suffered from mood disorders, followed by neurotic, stress-related and somatoform disorders – a type of mental illness that can also cause bodily symptoms – as well as schizophrenia, the report stated.
Another suggestion made in the study was the review of the existing “conditional discharge mechanism” for mental illness patients.
Currently, conditionally discharged patients are put under regular surveillance and will be forcibly taken to hospital if they display violence, self-destructive behaviour or skip medication.
Dr Ng Chi-ho, president of the Public Doctors’ Association, said the government should also enhance the role of private or family doctors in treating mild mental illnesses such as insomnia or mild phobia, so that valuable public resources could be freed for more severe patients.
The Association of Hong Kong Nursing Staff also said there was a shortage of nurses in public psychiatric wards, and urged hospital authorities to increase resources and support.