Replies to LegCo questions
LCQ6: Mental health policy
Following is a question by the Hon Wong Sing-chi and a reply by the Secretary
for Food and Health, Dr York Chow, in the Legislative Council today (February
15):
Question:
An incident of a person with mental illness killing another person happened
earlier at Choi Yuen Estate in Sheung Shui. There have been comments that this
is a result of the reduction in psychiatric beds by the Hospital Authority (HA)
in recent years, which has substantially increased the number of people
recovering from mental illness in the community, but the ancillary facilities in
the community are insufficient. In addition, some cases of people with mental
illness receiving social rehabilitation services are followed up by various
government departments such as the Police, Housing Department and Social Welfare
Department (SWD) as well as non-governmental organisations, but the patients'
records of violence kept by such departments may be different. In this
connection, will the Government inform this Council:
(a) whether the aforesaid problems of follow-up by government departments and
organisations and records of cases arose from insufficient communication and
co-ordination among various departments; whether this problem has been reviewed
by the Working Group on Mental Health Services, which is a multi-disciplinary
consultation mechanism set up by the Government;
(b) of the progress of the authorities' efforts in enhancing community support;
of the progress of introducing Community Treatment Orders; whether it knows the
number of case managers to be recruited by HA for launching the Case Management
Programme in the 12 districts across the territory, the number of vacancies not
yet filled at present, and the number of people with severe mental illness to be
followed up by each case manager; of the number of Integrated Community Centres
for Mental Wellness being planned by SWD for which the locations have yet to be
identified, and of the District Councils or districts the residents of which
oppose to the provision of such centres; and
(c) whether it has assessed how incidents of people with mental illness
committing killings affect the views of the public towards people with mental
illness, and whether they will give rise to ostracism and discrimination, as
well as what difficulties will be created for the implementation of
community-based rehabilitation; of the authorities' measures to respond to
members of the public having a prejudice against people with mental illness
after the occurrence of the aforesaid incident; whether they will consider
making reference to overseas experience and adopt measures to encourage the
media to be impartial and positive in their reports about mental illness and
people with mental illness?
Reply:
President:
The Government is concerned about all incidents involving violence, including
cases involving persons recovered from mental illness. The Government is
committed to promoting mental health among members of the public. As the mental
health policy and provision of related service programmes involve a number of
policy bureaux and government departments, the Food and Health Bureau assumes
the overall responsibility of co-ordination and works in close collaboration
with the Labour and Welfare Bureau (LWB), Department of Health (DH), Hospital
Authority (HA), Social Welfare Department (SWD) and other relevant government
departments.
It is the international trend to gradually focus on community and ambulatory
services in the treatment of mental illness, and to allow the early discharge of
mental patients when their conditions are stablised for treatment in the
community. Hence, the Government has strengthened its community psychiatric
services in line with this direction in an effort to allow more patients who are
suitable for discharge to receive treatment in the community, so that they can
re-integrate into the community and start a new life as early as possible. The
Government has increased the funding allocation for mental health services on a
continuous basis. The revised estimate in 2011-12 has increased by about 30%
when compared with the actual expenditure in 2007-08, with the total amount of
funding allocation for the past five years exceeding $19 billion.
My reply to various parts of the question is as follows:
(a) The directions of our mental health policy is to adopt a multi-disciplinary
and cross-sectoral team approach in delivering a comprehensive range of mental
health services which are accessible by people in need on a continuous basis. We
have also put in place a platform for communication and a mechanism for
co-ordination at various levels to foster collaboration between the medical and
social service sectors.
At the level of policy formulation, we set up the Working Group on Mental Health
Services in 2006. It is chaired by me and comprised of stakeholders with
relevant service experience from the medical, social service and other related
sectors to assist in the formulation and review of our mental health policy and
services.
At the level of service delivery, since 2010, SWD Headquarters and HA Head
Office have set up a Central Co-ordinating Group in collaboration with the
non-governmental organisations (NGOs) operating Integrated Community Centre for
Mental Wellness (ICCMW) to discuss the co-ordination of the service strategies
and explore more effective models of collaboration.
At district level, District Social Welfare Officers of SWD and the Chiefs of
Service of the Department of Psychiatry in various HA clusters hold working
group meetings at regular intervals to maintain liaison with psychiatric medical
social workers and ICCMWs in the respective districts as well as other relevant
Government departments, including the Police and the Housing Department. When
handling cases involving mental patients, various departments will hold case
conferences where necessary in order to formulate rehabilitation plans for the
patients.
The existing multi-disciplinary team approach and the inter-department
communication mechanism are functioning effectively. We will continue to
strengthen our co-ordination role and provide more comprehensive and intensive
support for mental patients.
(b) There is suggestion that the Government should introduce a Community
Treatment Order to require mental patients to receive designated treatment while
living in the community. Since the relevant legislative proposal will have
far-reaching impact on both patients and the society in a number of aspects,
such as protection of patients' personal data and scope of authority of
healthcare professionals, thorough consideration is necessary.
Since April 2010, a Case Management Programme has been launched on a pilot basis
for patients with severe mental illness. At present, the Programme has been
implemented in eight districts. As at the end of 2011, HA has employed a total
of 138 healthcare and allied health personnel with experience in community
mental health services as case managers for the provision of intensive and
personalised community support to some 9,000 patients. In the coming year, this
Programme will be further extended to cover another four districts. By then,
this service will be available at all HA clusters and it is estimated that some
40 additional case managers will be employed.
ICCMWs, set up by SWD, are operated by NGOs to provide community support and
referral services for clinical assessment and psychiatric treatment through a
new district-based and one-stop service mode. Since October 2010, ICCMWs have
been in operation at 24 service points across the territory. Of these 24 ICCMWs,
6 have already been operating in permanent accommodation. Furthermore, nine have
secured permanent accommodation, including seven where preparatory work is being
carried out and two where local consultation will be conducted later this year.
Some members of the local community may have opposing views on the proposed
locations for ICCMWs. However, SWD has not shelved any construction or
reconstruction plan for the setting up of ICCMWs as a result of such views. SWD
will continue to strengthen communication with the local community in a
proactive and pragmatic manner with a view to identifying permanent
accommodation for ICCMWs in the other districts as soon as possible.
(c) The Government has all along launched publicity campaigns and promotional
activities on mental health on an on-going basis so as to reduce
misunderstanding and discrimination against persons with mental illness in the
public.
Since 1995, LWB has been organising the "Mental Health Month" programme annually
in collaboration with more than 20 government departments, public organisations,
NGOs and the media, and co-operation with the media to report on mental illness
and mental patients in a positive manner is included under the programme. In the
coming year, LWB will continue to reinforce its efforts in promoting the spirit
and core values enshrined in the United Nations Convention on the Rights of
Persons with Disabilities. The themes of the public education activities will
include promotion of mental health and full re-integration of persons recovered
from mental illness into the community.
HA has already launched the "Child and Adolescent Mental Health Community
Support Project" to promote mental health among youngsters and their parents
through the schools and community youth centres while DH has also included
mental health in its public health education programme. Moreover, ICCMWs have
organised over 2700 public education activities to enhance the community's
understanding on mental health. ICCMWs will continue to organise public
education and publicity activities to eliminate discrimination against persons
recovered from mental illness among members of the public.
Like other illnesses, there are both mild and serious cases of mental illness.
Given the advancement in medical technology and development of medicines in
recent years, psychiatric treatments nowadays are much more effective than those
in the past. To achieve the objective of facilitating early re-integration of
patients into the community, the public should have understanding and acceptance
for mental patients, and should not have double standards when treating patients
with mental illness and those with other illnesses. Most mental patients do not
have propensity to violence and a majority of persons recovered from mental
illness can re-integrate into the community and start a new life.
There has been greater awareness of mental illness among the public in recent
years. Mental patients need the support and care from their family and friends
in the course of treatment and recovery. Early identification of the symptoms of
mental illness and seeking treatment in a timely manner can help patients
receive the appropriate treatment at the earliest possible time. The relevant
government departments will continue their close collaboration to raise the
public's awareness of mental illness so that both mental patients and persons
recovered from mental illness can be accepted by the general public for building
an inclusive society.
Thank you, President.
Ends/Wednesday, February 15, 2012
Issued at HKT 17:16
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