Mentally ill in Hong Kong need more government support

Wong Kwong-lui says overworked and underfunded psychiatric services are an injustice to the often-marginalised mentally ill, and calls for greater support from both the government and society at large

Reading Time:2 minutes

Police officers stand guard outside a closed Tsim Sha Tsui MTR station on February 10, after a man hurled a firebomb on a crowded train during the evening rush hour, injuring at least 18 people. Photo: EPA

Published: 8:03am, 19 Feb 2017Updated: 7:14pm, 19 Feb 2017

The MTR arson incident on February 10 was saddening, with many of the injured still in a serious or critical condition. In the aftermath of the tragedy, attention should focus on the need to tangibly increase government support for mental health patients.

Hong Kong currently has 200,000 people suffering from severe mental illnesses, of whom 48,000 have schizophrenia. While the Hospital Authority provides support for those deemed not stable, the case manager to patient ratio is very high. In 2015/2016, there were only 327 case managers for some 15,400 patients, a ratio of 1 to 50. In clusters with more serious staff shortages, the ratio goes up to one per 60 or even 70 patients.

MTR firebomb attack throws spotlight on mental health care

The very heavy caseload means the time given to each patient is, inevitably, extremely limited. In other developed economies such as Australia and the US, the case manager to patient ratio is one to 20 or 25, or half that of our city.

Given the huge pressure on managers, turnover is predictably high, worsening staff shortages. Case managers are needed not only by those requiring special care. Mental patients in stable conditions must also get regular attention, to prevent a relapse or for its early signs to be detected. News reports said the suspect in the MTR incident was a patient with a severe mental illness who appeared stable but did not benefit from the sustained care of a case manager.

Pressure groups including the Alliance of Ex-mentally Ill of Hong Kong protest at the Equal Opportunities Commission against derogatory remarks made about the mentally ill by University of Science and Technology professor Francis Lui and columnist Chris Wat, last May 4. Photo: Nora Tam

Hong Kong ranks 7th in mental health study, scoring lower than its Asian neighbours

It is unrealistic to expect that the number of case managers and related medical staff can be substantially increased within a short time, given that the services required involve specialist training. But the government can improve the situation in the short term by providing new kinds of treatment.