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Britain launched a BN(O) scheme after the national security law was imposed on Hong Kong. Photo: EPA-EFE

Almost half of new Hong Kong immigrants in Britain have symptoms of depression or anxiety, survey finds

  • But more than half of Hongkongers report an improvement in their mental health after moving to the country
  • Study by graduate student and advocacy group Hongkongers in Britain is the first UK-wide one on the mental health of new immigrants from city
Almost half of newly arrived Hong Kong immigrants in Britain have symptoms of depression or anxiety, with one in four reporting signs of post-traumatic stress disorder (PTSD) related to the 2019 protests and implementation of the national security law, the first UK survey of its kind has found.

But more than half of respondents reported an improvement in their mental health after moving to Britain.

The study, by a university graduate student and advocacy group Hongkongers in Britain, was the first United Kingdom-wide one on the mental health of new Hong Kong immigrants.

Hong Kong was rocked by months of anti-government protests in 2019. Photo: Winson Wong
Some 658 people answered an online survey from March to April and additional interviews were carried out with 12 case studies. Among the respondents, 90 per cent were British National (Overseas) passport holders and the rest UK citizens or asylum seekers. Most were between 35 and 44 years old and had spent between seven and 11 months in Britain. Such surveys are used by Britain’s National Health Service (NHS).

The survey found one in four respondents reported clinically significant symptoms of anxiety disorder, with 18 per cent reporting symptoms of depressive disorder.

An anxiety disorder is a mental illness which can cause a person to worry and fear almost everything that happens.

Mark Liang, a graduate student at the University of Cambridge who led the study, said scholars had previously questioned whether anxiety or depression experienced by Hongkongers in the UK was a normal part of immigration, the result of culture shock for example, or feelings specific to the group.

As a result of that debate the survey included a questionnaire focused on PTSD and which asked respondents specifically how their symptoms related to the protests and the national security law.

For example, they were asked whether seeing images of the social unrest intruded on their daily lives or if they had difficulty speaking about the event.

“That’s really important, because specificity in regards to mental health is something that hasn’t been covered in a lot of other studies,” Liang said.

Strained ties, bittersweet feel: ex-Hongkongers who left under BN(O) bid look back on city

But 62 per cent of respondents said they believed that moving to Britain had improved their overall mental health.

Issues with English, finding a job and new-found tensions with family members and children were the most commonly discussed problems among the new immigrants adjusting to life in Britain, the researchers said.

Brent Horner, a clinical psychologist at the London Medical Clinic in Hong Kong, said aside from changing locations, immigrants could be experiencing an accumulation of life stressors simultaneously, including readjusting to new careers, financial status, living conditions and daily habits.

“They may also be lacking protective factors, such as proximity to family and social connections,” Horner said.

Hongkongers surveyed did not feel comfortable talking freely about their mental health, with only 6 per cent saying they had discussed it with a doctor, and most reporting they were unlikely to seek treatment in the next six months.

An estimated 5.4 million of Hong Kong’s 7.4 million population are eligible for the BN(O) visa scheme, which allows successful applicants and their dependants to live, work and study in the United Kingdom for up to five years. They can then apply for citizenship after six years. About 103,900 Hongkongers applied for the new route to citizenship in the first year of the scheme, with 97,057 winning approval.


China’s Rebel City: The Hong Kong Protests

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Britain launched the visa in response to Beijing’s imposition of the national security law on Hong Kong in June 2020 in the wake of the 2019 social unrest, with London saying the legislation constituted a “clear and serious breach” of the 1984 Sino-British Joint Declaration that paved the way for the city’s return to Chinese rule in July 1997.

The national security law bans acts of secession, subversion, terrorism and collusion with foreign powers.

Liang noted that several respondents reported a desire to visit family members still in Hong Kong and they were reluctant to discuss politics in general as they worried about running afoul of authorities back home. The Hong Kong government maintains that the security law applies to other jurisdictions, so effectively, the immigrants could be prosecuted for offences if they returned to visit relatives.

One respondent told researchers: “I hate to think [I] cannot travel back to [my] homeland freely, no one wants to be exiled or named a fugitive.”

The Hongkongers seeking new lives in Britain on BN(O) scheme

The researchers hoped the study would help raise awareness among British stakeholders of the ways Hongkongers were dealing with their mental health and how to intervene.

Language was another barrier for Hongkongers seeking help from psychologists. Under the British medical system, those who want to see a psychologist must first obtain a referral from their general practitioner.

Horner added that factors that typically prevented people from seeking support for mental health included financial issues, stigma and the belief that asking for help was a sign of weakness.

“New immigrants may also find it difficult to connect with services in their preferred language, or therapists who understand their specific personal and cultural experiences,” he said.

An estimated 5.4 million people are eligible for a British National (Overseas) passport. Photo: Bloomberg

Among the recommendations was integrating mental health services into more traditional immigration support, such as improving communication between schools and churches about the specific needs of Hong Kong immigrant families.

Last year, the British government launched a £43 million (US$59 million) package to support families arriving under the BN(O) scheme. Local councils across the country use the funds to help the arrivals find housing, education and employment.