Hong Kong announced it would streamline its student suicide prevention system after a request from John Lee. Photo: Shutterstock Hong Kong has streamlined its suicide prevention mechanism for at-risk students, extending the emergency three-tier system and improving referral processes. The changes aim to provide timely support and address concerns about resource imbalance, ensuring students receive appropriate care.
The government also announced on Friday a one-year extension of the emergency three-tier mechanism, which was launched in December 2023 and was due to end next month.
Chief Executive John Lee Ka-chiu earlier asked for improvements after he pointed out that the number of students referred to public hospital psychiatrists under the highest level exceeded those handled by the off-campus support network team in the second tier.
Under the first tier, schools prioritise helping students at higher risk of suicide by seeking professional counselling or treatment services for them. The improved arrangements include strengthening the training of parents and staff in identifying and supporting relevant students.
Schools, under the improved second tier, will no longer need referrals from the Education Bureau and can directly seek help from external support teams organised by the Social Welfare Department. Schools can only refer students to the teams if parents agree.
“After understanding the situation of the students at risk of suicide, the teams will refer the students or their family to other community support services if needed,” a circular the bureau sent to schools on Friday said.
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The final tier involves principals referring students with severe mental health needs to the psychiatric specialist services of the Hospital Authority. Students with urgent cases are given priority treatment.
As of August 31, the bureau referred 123 students to the team under the second tier, while the authority’s psychiatric service received 290 referrals under the third tier.
The government also introduced changes to the third tier as students considered to be in stable condition after screening might receive first-tier in-school support. They could also get external support under the second tier while waiting for psychiatric services.
But those students can seek help from the emergency services or public hospital psychiatrists if their conditions have changed.
The government also provided a new guideline to schools to clarify the criteria for considering cases to be referred to public hospitals.
For example, students troubled with quite serious emotional distress and subject to relatively frequent, strong and long-term suicidal thoughts with an actual attempt of suicide are considered as high risk and should be transferred to the third tier.
Professor Paul Yip Siu-fai, head of the Jockey Club Centre for Suicide Research and Prevention at the University of Hong Kong, said the changes introduced under the second tier responded to concerns raised by observers as it took time for the bureau to refer cases and might not provide timely help to students in need.
The expert also said the updated arrangement in the third tier could allow better cooperation between the schools, external support team and public hospitals.
He added that handling students in stable conditions was also important as they would require more medical resources and costs when their situation deteriorated.
“I also stress that the emergency mechanism is serving children in need and the government still needs to step up efforts on prevention,” the expert said.
Yip said earlier that cumbersome procedures and reluctance from parents could be behind the lower number of students being treated in the second tier, while others have pointed to long waiting times for psychiatric services as the cause behind the issue.
If you have suicidal thoughts, or you know someone who is, help is available. For Hong Kong, dial +852 18111 for the government-run “Mental Health Support Hotline” or +852 2896 0000 for The Samaritans and +852 2382 0000 for Suicide Prevention Services. In the US, call or text 988 or chat at 988lifeline.org for the 988 Suicide & Crisis Lifeline.
For a list of other nations’ helplines, see this page.