Replies to LegCo questions
LCQ14: Hospital Authority's mental health services
Following is a question by the Hon Wong Sing-chi and a written reply by the
Secretary for Food and Health, Dr York Chow, in the Legislative Council today
(January 6):
Question:
It was reported that a woman who had a manic-depressive disorder seizure and
killed her adoptive daughter was convicted last month of manslaughter. In this
connection, will the Executive Authorities inform this Council whether they
know:
(a) the number of Consultation Liaison Teams under the Hospital Authority (HA),
as well as the respective attendances of the services of in-ward consultation
and consultation at the Accident and Emergency Departments provided by the teams
in each of the past five years;
(b) the respective numbers of patients currently suffering from the various
kinds of mental illnesses such as depression, mania and schizophrenia, etc.; if
they do not know, of the reasons for that;
(c) the respective average waiting time and the waiting time at the 99th
percentile for the various types of psychiatric services at present (including
specialist out-patient services, community psychiatric nursing services and
occupational therapy); what measures are currently in place to shorten the
waiting time; whether it will set a target waiting time; if so, of the details;
if not, the reasons for that; and
(d) if HA has set up a mechanism to assist mental patients who are waiting for
psychiatric services so that their clinical conditions can be alleviated or will
not deteriorate; if so, of the details; if not, the reasons for that?
Reply:
President,
(a) In the past five years, there were over 200 psychiatrists and nearly 2,000
psychiatric nurses providing mental health services in the Hospital Authority
(HA). In 2008-09, the number of psychiatrists and psychiatric nurses in HA were
288 and 1,880 respectively.
Psychiatric healthcare staff of HA provides psychiatric consultation-liaison
services in non-psychiatric inpatient wards or Accident and Emergency (A&E)
departments of various clusters. The services provided include conducting
clinical assessment for patients who may have mental health problems and
providing appropriate treatment or follow-up recommendations such as referring
patients with needs to receive psychiatric specialist out-patient (SOP) or
psychiatric inpatient services based on the clinical conditions of the patient.
Apart from providing consultation-liaison services to patients by visiting
inpatient wards or A&E departments, psychiatric healthcare staff also provides
telephone consultation services to healthcare staff of other clinical
departments. HA does not have statistics of its psychiatric consultation-liaison
services at present.
(b) In 2008-09, the psychiatric specialty of HA provided services to around
41,000 persons diagnosed with schizophrenia and around 40,000 persons diagnosed
with emotional disorders (including depression and mania).
(c) and (d) At present, under the triage system for new appointment at SOP
clinics in HA, psychiatric SOP clinics classify new patients into the following
categories on the basis of the urgency of their clinical conditions: priority 1
(urgent), priority 2 (semi-urgent) and routine categories. The targets of HA are
to maintain the median waiting time for cases in the priority 1 and priority 2
categories within two weeks and eight weeks respectively so as to ensure that
patients with urgent healthcare needs are provided with treatment within
reasonable time. In 2008-09, the median waiting time for first appointment of
priority 1 and priority 2 cases at psychiatric SOP clinics were around one week
and three weeks respectively.
To ensure that cases with urgent medical conditions would not be overlooked
during triage at the initial stage, all patients classified as routine cases
would be reviewed by a senior doctor of the relevant specialty within seven
working days of the triage. If a patient's condition deteriorates while waiting
for the appointment, he or she may contact the SOP clinic concerned and request
to advance the appointment. If the condition is acute, the patient could seek
immediate treatment at A&E departments. Healthcare staff would arrange for the
patient to receive earlier treatment as necessary.
In 2008-09, the median waiting time and the waiting time at the 99th percentile
for HA's psychiatric SOP service were four weeks and 112 weeks respectively. In
the same year, the median waiting time and the waiting time at the 99th
percentile for occupational therapy outpatient services were one week and 16
weeks respectively and service users include psychiatric and non-psychiatric
patients.
As the conditions of patients at HA's psychiatric SOP clinics vary, healthcare
staff arranges the date of medical appointment for patients having regard to
their conditions and clinical needs. As such, the service provision cannot be
assessed simply by looking at the waiting time at the 99th percentile. In fact,
90% of new patients at psychiatric SOP clinics (i.e. 90th percentile) are
provided with treatment within one year.
To improve the waiting time of non-urgent new cases, HA has set up in 2009-10
triage clinics at the psychiatric SOP clinics in five clusters, including Hong
Kong East, Kowloon East, Kowloon West, New Territories East and New Territories
West. The triage clinics mainly provide services to new psychiatric patients
classified as routine cases. To further enhance mental health services, HA plans
to foster closer collaboration between its psychiatric SOP service and primary
care service in 2010-11 to strengthen the assessment and treatment services for
persons with common mental disorders so that patients with different conditions
can all receive more appropriate treatment services to meet their needs.
Community psychiatric nurses provide follow-up service to individual discharged
psychiatric patients and monitor the progress of their treatment and
rehabilitation. The range of services provided includes risk management, home
visit, telephone follow-up etc. Healthcare staff arranges for individual
discharged patients to receive services by community psychiatric nurses having
regard to the treatment and rehabilitation needs of the patient. The frequency
and duration of the follow-up service depend on the needs and condition of the
patient. In general, patients who are referred for follow-up services by
community psychiatric nurses do not have to wait for the service.
Ends/Wednesday, January 6, 2010
Issued at HKT 14:45
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