On June 2nd last year, a horrific incident of a stabbing at Diamond Hill Hollywood Plaza involved a perpetrator with a history of mental illness. As the incident approaches its one-year anniversary, a recent survey conducted by the Hong Kong Mental Health and Rehabilitation Association revealed troubling statistics. Less than 10% of respondents believe they understand how to seek help and handle severe mental illnesses, and less than 5% think the current societal support for caregivers of severely mentally ill patients is adequate. The association has recommended that the government enhance support and public education on this issue.
In January this year, the association successfully surveyed 850 citizens aged 18 and above over the phone to gauge their self-assessment of knowledge about severe mental illnesses. The findings were analyzed based on the age distribution of the Hong Kong population.
The survey showed that only 11.3% of respondents claimed to understand the primary symptoms of severe mental illnesses, less than 9% expressed confidence in knowing how to seek help and handle such conditions if they or their loved ones were affected. Furthermore, less than 5% believed that society currently provides sufficient support for caregivers of severely mentally ill individuals, with 70.7% of respondents feeling that the support for caregivers is inadequate.
Regarding medication, the survey indicated that fewer than 5% of participants felt they understood the differences in treatment outcomes between new-generation and previous-generation long-acting injectables and oral medication for schizophrenia. Over 60% of respondents admitted to having a significant lack of knowledge in this area.
The association stated that the number of severe mental illness patients in Hong Kong has remained relatively stable at around 51,100 in recent years. A mental health assessment report from 2017 revealed that the ratio of case managers to severely mentally ill patients was 1:47 at that time. Following the tragedy at Diamond Hill in June last year, measures were implemented to increase case managers, reducing the ratio to 1:38. However, only 18,175 cases were managed, accounting for just one-third of the total number of severely mentally ill patients.
Dr. Wong Ming Sum, Chairman of the Hong Kong Mental Health and Rehabilitation Association and a specialist in psychiatry, cited research indicating that roughly half of schizophrenia patients on oral medication fail to fully comply with their prescribed regimen, increasing the risk of relapse and hospitalization. The insufficient number of healthcare workers and case managers places the burden of patient care on their families or the community. However, public awareness of the treatment and management of this illness is lacking, making it challenging to ensure patients adhere to their prescriptions, which is detrimental to patients, caregivers, and the healthcare system.
The association has recommended that the government adopt a “personnel and medication” strategy. By actively increasing medical staff and case managers while incorporating the early use of second-generation long-acting injectables in the treatment of severely mentally ill patients, the healthcare system can alleviate manpower pressures and reduce treatment costs, given the higher medication adherence and lower relapse and hospitalization rates associated with long-acting injectables.
Additionally, the government and the Hospital Authority should regularly collect and analyze data on the relapse and hospitalization rates of patients using oral medications and first- and second-generation long-acting injectables to evaluate the effectiveness of different treatment methods locally. They should implement more comprehensive public education programs to enhance awareness among the general public regarding treatment options for severe mental illnesses and the correct ways to seek help.