Replies to LegCo questions
LCQ1: Psychiatric specialist services
Following is a question by the Hon Chan Han-pan and a reply by the Secretary for
Food and Health, Dr Ko Wing-man, in the Legislative Council today (June 28):
Question:
Quite a number of patients with mental illness and concern groups have relayed
to me that the healthcare manpower and beds in the psychiatric service of public
hospitals are now in short supply. This situation, coupled with the inadequate
community support, has made it difficult for the mentally ill and the
ex-mentally ill persons to integrate into the community. In this connection,
will the Government inform this Council:
(1) whether it knows the number of psychiatric healthcare staff members, the
attendance of each type of psychiatric service, and the number of acute
psychiatric beds, in respect of each hospital cluster under the Hospital
Authority (HA) in each of the past five financial years; whether HA has plans to
increase the psychiatric healthcare manpower and the number of acute psychiatric
beds in the coming five years; if so, of the details and implementation
timetable; if not, the reasons for that;
(2) whether it knows if HA has issued clear guidelines to its psychiatrists
setting out the circumstances under which the cases of patients with mental
illness are to be referred to the relevant department for provision of community
support services to them; if HA has, of the details; if not, the reasons for
that; of the details of the referral mechanism; and
(3) as some working persons with mental illness have pointed out that since the
psychiatric specialist outpatient clinics of public hospitals currently provide
only daytime services, it is necessary for them to take leave for follow-up
consultations, making their supervisors and colleagues aware that they are
receiving psychiatric treatment, who then discriminate against and ostracise
them by depriving them of promotional opportunities or even dismissing them,
whether the Government will request HA to provide additional psychiatric
specialist outpatient service in the evening or during weekend; if so, of the
details and implementation timetable; if not, the reasons for that?
Reply:
President,
The Hospital Authority (HA) adopts a multi-disciplinary approach in its
provision of psychiatric specialist services. Medical teams comprising
psychiatric doctors, psychiatric nurses, clinical psychologists, occupational
therapists, Medical Social Workers, etc., provide patients, according to their
conditions and clinical needs, with the appropriate treatment and follow-up
care, including in-patient, specialist out-patient (SOP), daytime rehabilitative
training and community support services. My reply to the various parts of the
question is as follows:
(1) The numbers of psychiatric doctors, psychiatric nurses, community
psychiatric nurses, clinical psychologists, medical social workers and
occupational therapists providing psychiatric services in HA in the past five
years by hospital cluster are set out at Annex 1.
The numbers of attendances for in-patient (note 1), SOP, daytime rehabilitative
training (note 2) and community psychiatric services in the past five years by
hospital cluster are set out at Annex 2.
HA does not classify psychiatric beds into acute or non-acute ones. The number
of beds in psychiatric wards of HA in the past five years by hospital cluster is
set out at Annex 3.
In 2017-18, HA will further strengthen its psychiatric services. Details are set
out as follows:
(1) Psychiatric SOP services in the New Territories East Cluster (NTEC) will be
strengthened by recruiting one additional doctor, three additional nurses
(comprising one advanced practice nurse (APN) and two registered nurses (RNs)),
two additional occupational therapists, one additional clinical psychologist and
three additional supporting staff to provide services for patients with common
mental illness;
(2) Psychiatric in-patient services in the Kowloon Central Cluster, Kowloon East
Cluster and NTEC will be strengthened by recruiting 29 additional nurses
(comprising one ward manager, six APNs and 22 RNs), one additional
physiotherapist and 32 additional supporting staff;
(3) Clinical psychological services in all seven clusters will be strengthened
by recruiting one additional clinical psychologist and eight additional
supporting staff;
(4) The peer support element of the Case Management Programme will be
strengthened by recruiting five additional peer support workers;
(5) Four additional APNs and four additional supporting staff have been
recruited to support the implementation of a two-year pilot scheme named Student
Mental Health Support Scheme. Under the pilot scheme, professional and
multi-disciplinary platforms are established to enhance cross-sectoral
co-ordination and collaboration among the medical, education and social sectors,
in order to provide more effective support for students with mental health needs
at schools; and
(6) Eight APNs and four supporting staff have been recruited to support the
implementation of a two-year pilot scheme named Dementia Community Support
Scheme. Under the pilot scheme, community support services are provided to
elderly persons with mild or moderate dementia through 20 District Elderly
Community Centres based on a medical-social collaboration model.
HA will continue to review and monitor its services to meet the needs of
patients.
(2) The Community Psychiatric Services of HA provides a range of community
psychiatric services, including Standard Community Psychiatric Services, Case
Management Programme, Intensive Care Teams and Mental Health Direct hotline, for
needy patients according to their conditions, clinical needs and risk levels.
Psychiatric doctors of HA will, depending on patients' conditions, clinical
needs and risk levels, decide whether patients should be referred to the
Community Psychiatric Services for follow-up treatment according to the
established guidelines of HA. Details of the guidelines are at Annex 4.
(3) HA provides multi-disciplinary services at its psychiatric SOP clinics for
patients with mental illness according to their clinical needs. Comprehensive
multi-disciplinary support is provided during daytime on weekdays by SOP
clinics. Given the fact that the provision of evening or weekend services will
inevitably require re-deployment of resources from the weekday daytime SOP
clinics and hence affect the overall services provided for patients with mental
illness, HA has no plans at present to provide psychiatric SOP services in the
evenings, on weekends or public holidays. Nevertheless, HA has set up designated
depot clinics in all seven clusters to provide depot injection treatment during
non-office hours to facilitate the use of the service by patients in need.
Note 1: including in-patients and day-patients
Note 2: conducted in day hospitals
Ends/Wednesday, June 28, 2017
Issued at HKT 16:02
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LCQ1 Annexes