Replies to LegCo questions
LCQ3: Support for mental patients and ex-mentally ill persons
Following is a question by the Dr Hon Pan Pey-chyou and an oral reply by the
Secretary for Food and Health, Dr York Chow, in the Legislative Council today
(February 4):
Question:
Earlier on, a family tragedy occurred which involved a woman who had just left a
psychiatric hospital to convalesce at home. She was suspected to have committed
suicide and died after killing her son and daughter. It has been reported that
similar tragedies occurred time and again in recent years. In this connection,
will the Government inform this Council:
(a) of the number of cases in the past five years of mental and ex-mental
patients inflicting harm on themselves and/or other people while such patients
were taking leave from hospital to stay at home or at the initial stage of their
return to community, as well as the trend of such data;
(b) what support the Government and Hospital Authority currently provide
specifically for mental and ex-mental patients who will soon be discharged and
those who have just been discharged, as well as for their families, so as to
reduce the pressure they are facing and occurrence of incidents involving
casualties; and
(c) as the authorities have indicated that the Working Group on Mental Health
Services chaired by the Secretary for Food and Health will work on the
formulation of an appropriate framework for developing mental health services
and identify key areas for priority action, of the latest progress of such
tasks, and whether the Working Group has, since its establishment, reviewed if
the existing support services for the families of mental patients are adequate
and able to meet their needs?
Reply:
President,
(a) The Hospital Authority (HA) has introduced a new incident reporting system
since October 1, 2007 to further strengthen the reporting of medical incidents
in public hospitals. During the 12-month period ending September 30, 2008, HA
received a total of 12 reports of mental patients having died of suicide during
home leave. HA does not have the data on mental patients inflicting harm on
other people.
(b) HA is providing mental patients with medical rehabilitation and community
psychiatric services mainly through its eight multi-disciplinary community
psychiatric teams (CPT) and it is also providing associated support service for
patients' families. At present, all hospital clusters under HA have CPTs
comprising psychiatrists, community psychiatric nurses, clinical psychologists,
medical social workers, occupational therapists, etc. Community psychiatric
services cover a range of services including risk management, home visit,
telephone consultation and follow-up service. CPTs also work closely with other
service agencies in the district, providing support for community service groups
and rehabilitation organisations and helping mental patients re-integrate into
the society. HA also offers psychiatric ambulatory service to those mental
patients with more stable conditions by providing them with continuous care and
rehabilitation service.
In recent years, HA has enhanced the support for mental patients who are being
or newly discharged and for their families through various programmes. Since
2001, HA has launched the "Extending Care Patients Intensive Treatment, Early
Diversion and Rehabilitation Stepping Stone" scheme (EXITERS) to provide
intensive rehabilitation training for long stay mental patients so as to
facilitate their early discharge and integration into the community. The scheme
also provides follow-up and support services to discharged patients.
In 2008-09, HA has set up community psychiatric support teams in Kowloon West
Cluster and New Territories East Cluster to provide support for frequently
readmitted psychiatric patients through a case management approach so that
effective follow-up care can be provided in a timely manner. To further enhance
its community psychiatric service, HA plans to deploy additional community
psychiatric nurses and other allied health professionals in various clusters in
2009-10 with a view to providing appropriate support to discharged patients.
Meanwhile, the Social Welfare Department (SWD) also provides a range of services
for ex-mentally ill persons and their families: (i) the psychiatric Medical
Social Workers offer counselling service and assist the patients and their
families to handle emotional, family, caring, interpersonal relationship
problems and make referral for them to apply for rehabilitation service and
community resources; (ii) the Community Mental Health Care Programme and
Community Rehabilitation Day Services assist ex-mentally ill persons to resolve
adjustment problems they have encountered in their daily life and facilitate
their integration into the community through outreaching visits and outreaching
occupational therapy services respectively; (iii) the Community Mental Health
Link service assists ex-mentally ill persons and their families/carers to
establish their district support network and provides them with care and
support, including counseling service, social/recreational/educational
activities and outreaching visits, etc; (iv) the Resource and Service Centres
are set up for families and relatives of ex-mentally ill persons with the
purpose of providing them with emotional support and counseling service so as to
enhance their acceptance of their dependants with mental illness and to
strengthen their ability to take care of the ex-mentally ill persons at home;
(v) At present, there are five Training and Activity Centres for ex-mentally ill
persons with the aims of helping them develop their social and vocational
skills, providing them with suitable leisure activities and preventing the
recurrence of mental illness and the need for re-hospitalisation.
To enhance mental health services at the district level, SWD will set up an
integrated community support centre in Tin Shui Wai on a trial basis in March
this year to provide one-stop, comprehensive and in-depth mental health support
services for local residents and to reach out to those with mental health
problem through intensive outreaching service. It is expected that the centre
will serve 450 ex-mentally ill persons, people who are receiving mental health
service and those suspected to have mental problem. The centre will also provide
support to 1,200 families/carers each year.
SWD has also been providing residential service to ex-mentally ill persons.
Types of residential services include: (i) supported hostel (83 places) that
provide group home living for ex-mentally ill persons who can live
semi-independently with a fair amount of assistance from hostel staff in daily
activities; (ii) half-way houses (1,509 places) that provide transitional
community rehabilitation service for an average of three years in preparation
for ex-mentally ill persons' re-integration into the community; and (iii) long
stay care homes (1,407 places) that provide long-term residential care and
active maintenance services to discharged chronic mental patients.
(c) In 2006, the Food and Health Bureau set up a Working Group on Mental Health
Services (the Working Group), which is chaired by me and comprises professionals
providing medical and rehabilitation services to mental patients, academics and
representatives of HA and SWD. The purpose of the Working Group is to assist the
Government in reviewing the existing mental health services in Hong Kong and
mapping out the long-term development of our services.
Under the Working Group, there is a sub-group which is tasked to study in-depth
the demand for mental health services and the relevant policy measures. The
sub-group is co-chaired by two members of the Working Group and comprises
professionals from the healthcare and social welfare sectors. The sub-group has
drawn up a framework on the objectives and directions of the mental health
policy. It is now studying the service needs of three different age groups
(adults, adolescents and elders) with a view to making proposals for service
improvement in the relevant areas.
Since mental illness is a complex health problem and mental health services
cover both healthcare and rehabilitation services, I will work closely with the
Secretary for Labour and Welfare. The long-term development of mental health
services will be examined and planned under the overall framework of the
healthcare reform.
In the short and medium term, we will allocate additional resources on
prevention, medical treatment and rehabilitation services to further improve our
mental health services and enhance the community support for mental patients, so
as to facilitate their early recovery and re-integration into the society. From
2001-02 to 2008-09, the Government has provided a total of $250 million
additional recurrent funding to HA and $76.1 million to SWD to support a number
of new initiatives to improve the treatment and rehabilitation services for
mental patients, including various community support services to provide
continuous support for ex-mentally ill persons and their families/carers.
Ends/Wednesday, February 4, 2009
Issued at HKT 16:01
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