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Sunday, Feb 05, 2023

Hong Kong must invest in mental health to protect its greatest wealth

Hong Kong must invest in mental health to protect its greatest wealth

From depression to anxiety, Covid-19 has worsened mental health worldwide, and Hong Kong in particular is suffering. Improvements are urgently needed, from a better public health system to expanded youth support and an end to stigma.
The human brain is wired for certainty and clings to routine. It finds comfort in the familiar. Uncertainty in our lives creates anxiety. Covid-19 has injected so much uncertainty into our lives: Will I test positive and have to self-isolate? Will schools shut down suddenly? Will Hong Kong tighten social distancing measures again?

The pandemic has exacerbated mental health issues globally, adding stressors into our lives while restricting the availability of support and services. According to the World Health Organization, Covid-19 triggered a 25 per cent increase in the prevalance of anxiety and depression worldwide in the first year. Other research suggests a prevalence of 28 per cent for depression and 27 per cent for anxiety.

The numbers are mind-boggling. Close to 1 billion people live with a mental health disorder. Every 40 seconds, someone dies by suicide. Among 15-29 year olds, suicide is the fourth leading cause of death.

Hong Kong’s numbers are just as disturbing. Nearly two out of every three adults suffer from poor mental well-being. More than half of all secondary school students show symptoms of depression, and a quarter have clinically high levels of anxiety. One in four workers suffer from symptoms of depression and anxiety – 2.5 times the global average.

In a fast-paced, congested city where people live on top of one another, it may not surprise that people here have less-than-optimal mental health. Add an unhealthy work culture, one of the world’s longest working hours and a lack of work-life balance, and we have a disaster in the making.

But perhaps the most troubling figure is that 74 per cent of mental health sufferers here do not seek professional help. This may be due to a fear of stigma, a perception of mental health disorders as being a lack of self-discipline and willpower rather than an actual illness, or a less-than-robust mental health support ecosystem.

This stigma is especially prevalent in Asia, where mental health disorders are often seen as negative, socially discrediting behaviour. This can be traced back to traditional ideas that place “face” in high regard, and see mental health conditions as a sign of weakness and a source of shame, leading to a loss of social standing.

One of the best things we can do is to talk openly about mental health, be conscious of language surrounding such disorders, and normalise mental health treatment and care.

There is a shortage of professional mental health resources here, with a psychiatrist-to-population ratio of 6.11 per 100,000 people, trailing behind the OECD average of 18.

Patients here can wait for up to two years to see a public-sector psychiatrist, with each appointment lasting on average only six to eight minutes. This gap in care can be debilitating for those in need.

Mental health is one of the most neglected areas of health globally. On average, countries spend just 2 per cent of their health budgets on mental health, despite a five times return on investment in improved health and productivity for every dollar spent.

To improve access to mental health treatment in Hong Kong, perhaps we can sustainably scale up of our public health system. One suggestion is to build up community-centric mental health support at the primary care level, and to explore incorporating more mental health services into the district health centres. This would facilitate early detection and early intervention, and, importantly, reduce mental health stigmatisation.

In line with early intervention, we need to expand the Student Mental Health Support Scheme to as many schools as possible, as 50 per cent of mental disorders develop by age 14 and 75 per cent by age 24. We need to have earlier conversations about mental health with both students and parents to destigmatise the Asian taboo of mental disorders, improve community mental health literacy and support positive academic outcomes.

Perhaps it would also make sense to implement more school-based mental health prevention programmes that include resilience or life skills training and mindfulness.

In the wake of a global pandemic that has put a strain on everyone’s mental health, surely an investment into augmenting mental health resources makes sense. After all, well-being is both mental and physical, and as they say, good health is the greatest wealth.
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