Deep Dive: What plans does Hong Kong have to better support mentally disabled people and their carers?

Hong Kong’s government has promised to step up efforts to take better care of people with mental disabilities and their carers. Experts and concern groups said the city’s safety net and support for these groups were not enough.

In September, two brothers with mental disabilities were believed to have starved to death in a flat after their mother – who was also their carer – was admitted to hospital. Later that month, authorities launched a 24-hour hotline for carers. It had received about 2,500 calls by mid-November.

In 2020, Hong Kong had 77,000 to 90,000 people with intellectual disabilities, which is about 1 per cent of the population. For most of these people, their parents are their main carers. But because of Hong Kong’s ageing population, experts have warned that these carers are slowly losing the ability to look after their children.

Crystal Yuen Shuk-yan is a community organiser with the Society for Community Organisation. Yuen said that some of the most high-risk people in Hong Kong were elderly parents looking after mentally disabled children.

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“They are simply holding on, worried that they won’t be able to take care of their mentally disabled children when they get older,” she said. She noted that for carers, it was helpful to have support within their neighbourhood. For example, professional workers could lead a group of trained residents to provide care for those in need; this could help solve the problem of not having enough staff.

During his annual policy address last month, Chief Executive John Lee Ka-chiu said authorities would task community care teams in Southern and Tsuen Wan districts with identifying and sending carers in need to government services. The pilot programme is set to launch in the first quarter of next year.

This programme is among other government plans to support disabled people in Hong Kong.

Authorities will also ask 20 residential care homes for people with disabilities to provide respite services whenever possible. These services allow carers to have short breaks from their round-the-clock responsibilities.

Hector Tsang Wing-hong is the head of the department of rehabilitation sciences at Polytechnic University. He said the supply of respite services under the government’s new initiative was not enough to help people in need, and the current ones were not flexible enough. For example, he said carers in urgent need of respite services should not have to make reservations ahead of time.
Staff writers

Question prompts:

1. Based on the information in News, which groups of people are facing challenges?
(1) individuals with mental disabilities
(2) volunteers at residential care homes
(3) elderly carers of people with intellectual disabilities
(4) mental health professionals

A. (1) and (2) only
B. (1) and (3) only
C. (2) and (3) only
D. (2) and (4) only

2. Kwan Chi-kin, a professor of social and behavioural sciences, said the 24-hour hotline for carers might not be reaching those who need it most. Which group might he be referring to? Explain using News and your own knowledge.

3. “Hong Kong lacks a supportive environment for people with intellectual disabilities and their families.” To what extent do you support this statement? Justify your answer.

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Question prompts:

1. Which TWO conclusions can be made from the table?
(1) The government only needs to provide more day activity centres for people with moderate mental disabilities.
(2) The demand for services for people with intellectual disabilities exceeds what is available.
(3) Authorities should improve the services offered in sheltered workshops.
(4) It is urgent that the government look into reducing the waiting time for residential care.

A. (1) and (2) only
B. (1) and (3) only
C. (2) and (3) only
D. (2) and (4) only

2. Based on News, list TWO ways that reducing the waiting time for the services shown in the table can help carers.

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• The Hong Kong government has assigned community care teams to reach out to vulnerable groups and carers in Southern and Tsuen Wan districts

• These care teams have been joined by volunteers, who will receive training on communication and counselling skills under a pilot scheme

The Hong Kong government has tasked community care teams with reaching out to vulnerable groups and carers. Last month, Secretary for Home and Youth Affairs Alice Mak Mei-kuen said these teams should aim to meet an annual target for the number of homes they visit.

“Every care team has to reach key performance indicators, such as an annual target to reach a certain number of visits to households and residents in need,” Mak told a radio programme.

Mak also said that under a pilot scheme, professional training would be provided to team members to equip them with skills to communicate with the elderly.

She added that the government would consider and review the quality of support provided by the care teams.

Launched in April, care teams in Southern and Tsuen Wan districts have been joined by volunteers in the community. Under the pilot scheme, the teams are expected to work with staff from the Social Welfare Department and Health Bureau, and they will also be trained in counselling and how to identify the needs of vulnerable people, especially those with mental disorders.

“We are not underestimating the difficulties of the task,” the minister said.

“It is hard to guarantee that the team will not miss one or two [people in need] because they are not professionally trained social workers, so we must ensure the team provides proper services.”

According to Mak, the government had allocated sufficient resources to the care teams. For example, an application platform is in the making to speed up the filing of visit records and spare the team members from extra administrative work.

Mak said the goal of the teams was to provide information and referrals to services that vulnerable people were not aware of, such as meal deliveries and chaperoning assistance for medical consultations.

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But she emphasised that the role of care teams should not be mistaken for that of professional social workers or counsellors, as their primary responsibility was to serve as the first point of contact when identifying a potential case in need of help.

She said the care teams would also collaborate with mental health professionals to ensure they had support when dealing with complicated cases.

Hector Tsang Wing-hong, a professor of rehabilitation sciences, welcomed the initiative, which he described as a more proactive approach.

“But the task is like finding a needle in a haystack, considering the dense population,” he said. “Instead of going door-to-door in every building, the care teams could make use of ... questionnaires developed by researchers to locate high-risk families efficiently.”
Staff writer

Question prompts:

1. In what ways will volunteers of the care teams and Social Welfare Department and Health Bureau staff be able to help those in need?
(1) They will be able to identify and treat patients’ medical issues.
(2) They will be able to identify the needs of vulnerable people.
(3) They will provide basic counselling.
(4) They will be able to effectively communicate with the elderly.

A. (1), (2) and (3) only
B. (1), (2) and (4) only
C. (2), (3) and (4) only
D. all of the above

2. How effective are the measures mentioned in News and Issue in helping people with intellectual disabilities and their carers? Explain.

3. Besides the hotline for carers, community care teams, and respite services, propose ONE other way the government can better support disabled people and their ageing carers. Explain why this is needed.

Question prompts:

1. What groups mentioned in News are being represented by the people in this illustration?

2. What does the hole in the net suggest?

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• ageing population: refers to a population where the proportion of older people is increasing. According to the World Health Organization, this is the result of a decline in birth rates and increased life expectancy. In Hong Kong, the government predicts residents aged 65 or above will account for 36 per cent of the population in 2046, excluding foreign domestic workers.

• carer: someone who takes care of a person who is young, old, ill, or has a condition that makes it difficult for them to do important things that other people do

• community care teams: volunteer teams tasked with reaching out to vulnerable groups and carers. The teams in Southern and Tsuen Wan districts are divided into 17 to 19 small groups. Each team has been given between HK$800,000 and HK$1.2 million for two years of service.

• other government plans: in his policy address, Chief Executive John Lee Ka-chiu also said a three-year pilot scheme would provide a subsidy of HK$500 a month to disabled people on Comprehensive Social Security Assistance (CSSA) who also held a job. He has also made pledges to increase the quota for residential care and day care services.

• people with mental disabilities: also refers to those with intellectual disabilities. This refers to those who are unable to care for themselves or who have limited learning, communication and social skills.

• respite services: short-term relief for primary carers so they have time to rest, travel or spend time with other family and friends. Hong Kong offers temporary residential respite services, day respite services, and emergency placement for people with disabilities.

• safety net: a system of social welfare programmes and services that provide a basic level of support for people who are unable to care for themselves because of poverty, disability, unemployment or other factors. These programmes can provide benefits, such as financial assistance, food and housing, healthcare, and job training.

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News
1. B
2. He might be referring to the elderly carers of individuals with mental disabilities because they might not know about the hotline or may find it difficult to navigate its usage due to technological barriers. (accept other reasonable answers)
3. I completely agree with this statement. The fact that Hong Kong has about 90,000 people with intellectual disabilities, yet their primary caregivers are primarily their elderly parents, highlights the city’s inadequate support system. The concerns expressed by Crystal Yuen Shuk-yan, a community organizer with the Society for Community Organisation, underscore the vulnerability of this group and the significant burden placed on their elderly parents. In addition, initiatives such as asking residential care homes for people with disabilities to provide respite services require reservations to be made in advance. This is extremely inflexible and fails to address the immediate needs of those who require urgent, short-term assistance.

Table
1. D
2. Elderly carers may lack the resources to provide the specialised support their children need and by making these services readily available, this will reduce the burden on carers and possibly alleviating the stress associated with caring for their children

Issue
1. C
2. When implemented together, the measures can benefit people with intellectual disabilities and their carers, especially for the elderly who are taking care of their children. The care teams can help educate carers about the different sorts of assistance available, including meal deliveries, chaperoning assistance for medical consultations and the 24-hour hotline for carers so that they are aware there is help available around the clock. They will also be able to identify vulnerable people and carers who require additional support and help them to get the help they need from mental health professionals.
3. The government needs to start training more professional staff to handle these cases so that they don’t have to rely on volunteers. They can do this by allocating more funding to social workers and providing subsidies for people who want to be trained to be social workers. (accept other reasonable answers)

Illustration
1. The woman represents elderly carers, and the man represents people with disabilities.
2. There are not enough social welfare programmes and services to provide a basic level of support for people with intellectual disabilities and their ageing carers.