By Lau Kin-shing

The consultation sessions for the 2023 Policy Address arranged by the government of the Hong Kong Special Administrative Region have spurred discussion among professionals on the best way to address the public’s concerns over the city’s mental well-being and the proposed solutions. Improving the psychological well-being of citizens is a daunting and challenging task, calling for the involvement and commitment of social and economic sectors, families and communities.

Extensive consultation is necessary and commendable; over 30 consultation sessions with Legislative Council members, representatives of various concerned groups, and the general public will be highly informative for policymakers. The dedication of Chief Executive John Lee Ka-chiu and his administrative team demonstrates the government’s commitment to addressing public concerns for the welfare of the citizens.

The recent roll-out of 10 measures to promote mental health support is a significant step forward . The measures recognize the importance of addressing the needs of individuals recovering from severe mental illness and promoting overall mental wellness. Some further refinements will help achieve the goal through a comprehensive and effective approach.

By increasing the ratio of case managers to severe mental health patients (1:40), the government is ensuring that individuals receive sufficient personalized attention and care tailored to their specific needs. A well-designed training plan will be needed to ensure that prospective case managers are fully equipped with essential skills, including effective communication, crisis intervention, and long-term support. By doing so, a satisfactory outcome and a more efficient mental health care system can be forged for the foreseeable future.

New medications with fewer side-effects are a promising step toward improving patient well-being. To bolster this initiative, it’s advisable to promote a shared decision-making model between healthcare providers and patients. Engaging patients in medication discussions and keeping them informed about potential side-effects will enhance treatment adherence and empower patients to manage their own health.

Waiting times for psychiatric specialist consultations need to be reduced to ensure early intervention and timely treatment. To further reinforce this goal, establishing a robust telehealth infrastructure could provide virtual access to mental health professionals, ensuring immediate support, especially in urgent cases.

The government has the potential to establish a comprehensive and integrated mental health care system that not only addresses current concerns but also cultivates a culture of resilience and well-being

Expanding the availability of psychiatric nursing services in community clinics contributes to continuity of care during waiting periods. Collaborating with local community centers, schools, and NGOs to develop psycho-education programs could help raise awareness about mental health, reduce stigma, and encourage early help-seeking behaviors.

Exploring the feasibility of “community treatment orders” is important, but it’s equally critical to ensure that the rights and autonomy of patients are upheld. A robust oversight mechanism involving patient advocates, legal experts, and mental health professionals can strike a balance between treatment and individual rights.

The commitment to offering specialized support for marginalized groups could include targeted outreach programs, culturally sensitive mental health education, and bilingual services for ethnic minorities. Collaborating with community leaders and local influencers can facilitate trust-building and destigmatization.

In addition, family issues in Hong Kong should not be overlooked. The fast-paced and highly competitive lifestyle is stressful for everyone, especially the working population who put in long hours and juggle multiple responsibilities to meet the ever-rising cost of living. This situation affects both the quality and quantity of time spent with family members. The lack of a healthy work-life balance leads to a “burnout mentality” that takes a toll on both mental and physical health and strains family relationships.

Mental health problems such as depression, anxiety, and stress are more prevalent in Hong Kong than the general public realizes. On top of which, such issues have been stigmatized in society, discouraging those in need from seeking help from their families. As a result, as family members are kept in the dark, mental health problems could escalate to an unmanageable stage before any effective action is taken.

Addressing family issues in Hong Kong requires a multifaceted approach that takes into account the changing dynamics within families, the impact of societal pressures, and the challenges posed by economic conditions. By implementing strategies to enhance work-life balance, promote mental health awareness, provide affordable housing solutions, reform the education system, and address economic inequalities, Hong Kong can promote healthier family relationships and create a more supportive environment for families to thrive.

The government could propose that employers organize wellness programs and initiatives focused on physical and mental health. This could include offering counseling services, stress management workshops, and recreational activities, fostering a work environment that recognizes the importance of work-life balance.

Through the implementation of policies promoting mental health awareness and providing support within families, it is possible to reduce stigma and encourage open communication. Launching public awareness campaigns to destigmatize mental health issues and emphasize the importance of seeking help and support can encourage families to engage in open discussions about mental health. Introducing mental health education in schools and community centers can help young individuals and parents understand the significance of mental well-being, identify signs of distress, and learn coping strategies. Ensuring easy access to counseling and mental health services for individuals and families in need can provide necessary support during challenging times.

Investing in community-based family support programs and counseling services can empower families to cope with challenges and build resilience. Implementing parenting programs that offer guidance on effective parenting techniques and communication skills can enhance family dynamics and improve parent-child relationships. Establishing family counseling centers that provide professional counseling and mediation services can assist families in navigating conflicts and strengthening their bonds. Organizing support groups for families facing specific challenges, such as single parenting or caring for elderly family members, can create a platform for sharing experiences and seeking advice.

Through the recommendations put forth in the 2023 Policy Address, it is to be hoped that mental health services in Hong Kong can be enhanced. The government has the potential to establish a comprehensive and integrated mental health care system that not only addresses current concerns but also cultivates a culture of resilience and well-being.To further amplify the impact, the integration of robust monitoring, evaluation, and continuous improvement mechanisms should be considered to ensure the enduring effectiveness of these measures over the long term.

The author is vice-president of the Hong Kong Psychological, Counselling and Consultation Society, an international certified hypnotherapist instructor, and a senior Chinese psychological counselor and course instructor.

The views do not necessarily reflect those of China Daily.

【CDTT Newspaper Article】Lau Kin-shing：Improving HK’s mental well-being status in 2023 PA (China Daily HK Edition, 24 Aug 2023)

https://www.chinadailyhk.com/article/347381#Improving-HK’s-mental-well-being-status-in-2023-PA

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https://www.chinadailyhk.com/epaper/pubs//chinadaily/2023/08/24/09.pdf

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中國夢智庫｜ 對《2023年施政報告》改善市民精神健康狀況政策的期望

《2023年施政報告》諮詢會議討論內容引發香港專業人士之間的赤熱討論，討論焦點主要集中在如何更完善地回應公眾對社區層面精神健康狀況的關注，與此同時，政府應提出有效改善方案。大家注意，改善市民心理健康是一項具相當大的挑戰性艱巨任務，此項任務需要全社會、政府各部門、各社區與各各家庭的積極參與承擔。

為獲取更多第一手資訊，以李家超先生為首的政府團隊高度重視相關議題。政府已展開廣泛諮詢：與立法會議員們、各相關團體代表與廣大市民進行20多場的諮詢會議。政府為市民爭取心靈上的福祉，對大眾社會人士在精神健康狀況問題的關注，大力作出不懈努力，大家為政府點讚。

最近，政府推出的10項促進精神健康支援措施是朝着正確方向邁出的重要一步。這些措施針對解決嚴重精神疾病康復者的照顧計劃與促進全民關注社會整體精神健康的重要性。筆者認為，通過進一步完善相關措施，可達成一個綜合、有效政策，改善市民身心健康這個共同目標。

政府調整嚴重精神健康患者與個案經理的比例(1:40)，個案經理們能夠根據各患者自身需求量身定制治療方案，確保各患者能夠得到更全面與個性化治療。在此，政府應完善與設計一個「個案經理培訓計劃」確保新案例經理具備必須技能：包括有效溝通技巧、危機處理能力與為患者提供長期支援能力。通過這方面的建設，在可預見的未來，香港精神健康護理體系將會變得更高效，更好的改善市民的身心健康。

為確保患者們能夠得到更好的治療機會，應為他(她)提供更多具較少副作用的新藥物。筆者認為，應鼓勵醫務人員與患者之間的互相溝通，讓患者參與配藥方式的討論，讓患者們清晰所服用藥物的可能副作用，這將大大提高患者們的「服藥依順性」與增進患者們管理自己健康的自我認知能力。

為確保患者們能得到及時治療與醫務人員有機會盡早介入治療，政府需進一步研究改善精神科專科排期等待時間。在這個層面，政府可建立更健全的「遠程醫療」平台，讓心理健康專業醫務人員為患者提供網路虛擬影像問診服務，這個設備在緊急醫療情況下特別重要。

在分佈於各社區的社區衛生中心設立「精神科護理」配套設施是一個可行方案。此舉可進一步確保患者們的病人權利、自我醫療情況認知能力與維護。進一步探索「社區治療令」也是個可行方案，但執行「社區治療令」時，應確保患者權利與自主權能夠得到適當的維護。還有的就是應考慮建立一個完善的患者社區監督機制，這個方向涉及患者代表、法律專家與心理健康醫務人員三方的通力合作，在患者的治療與個人權益之間需要取得一個更好的平衡。

專門為邊緣群體提供外展計劃也有其必要性。對文化差異敏感的少數族裔展開精神健康教育時需提供雙語服務。社區領袖與具影響力的社區領袖不但能為改善少數族裔身心健康上出一分力，而且可以促進建立社區不同群體之間的互信與減少社會歧視。

此外，香港快速、具高度競爭的生活方式對每個市民都會產生壓力感，不斷上漲的生活成本對勞動人口的影響更加巨大。生活壓力直接影響家人之間相處之道與質量。工作所產生的疲勞與家庭生活一但失衡就會導致過勞症狀，這將會對個人心理與身體健康產生一定程度的影響，而且有可能影響家庭關係。因此，家庭問題也應得到適當的重視。

不說不知道，隱藏在社區的抑鬱、焦慮與壓力等精神健康問題非常普遍，再加上社會人士一直以來都帶著有色眼鏡看待精神健康問題，許多患者都因此而在尋求相關醫療幫助時卻步，這將進一步導致患者在家庭成員面前刻意隱藏病情，導致患者的精神健康問題惡化，失去及時治療的機會。

解決家庭內發生的問題需要從許多不同層面進行思考：家庭內部變化是一種動態關係，來自社會的壓力對家庭成員關係也有影響，各各家庭的經濟條件也各不相同。因此，應進一步採取適當實施增強市民工作與生活之間建立平衡、推廣心理健康意識、提供更合理的住房解決方案、改革教育體系與解決經濟不平等，等等。只有通過以上一籃子綜合改善措施，政府才能促進維繫市民家庭健康關係，創造一個更富支援性的社區環境，讓各各家庭成員和睦相處。

政府也可在職埸層面推出健康計畫與倡議，建議雇主關注雇員們的身心健康：包括提供身心健康諮詢服務、壓力管理研討會與適當的工餘娛樂活動，培養雇主與雇員們正確認識工作與生活平衡的重要性。

政府可透過推行促進身心健康意識與家庭支援政策，不但可以改變市民一直以來對精神疾病抱有的錯誤態度，並提高社會對相關議題的開放態度。鼓勵在家庭範圍內進行有關心理健康的直接討論、在學校與社區中引入心理健康教育，幫助年輕人與父母更好了解心理健康的重要性，辨識困憂的徵兆，並學習應對策略。從而拓展更多渠道向公眾展開宣傳活動來強調病從淺中醫的重要性。確保有身心障礙的個人與問題家庭能獲得諮詢與心理健康服務便利，及時獲得療專業支援。

在家庭支援計劃與諮詢服務基礎建設的投資永遠都不嫌多，這個措施能使家庭更有能力應對在香港生活所帶來的挑戰並建立家庭成員之間的良好對話關係。在這點上，相關的措施是實行家長教育計劃，提供有效的育兒技巧與溝通能力指導來增強家庭成員之間的互動與改善親子關係。建立家庭諮詢中心，為可能有問題家庭提供專業諮詢與及時調解服務，可大大幫助問題家庭處理親人之間的衝突，增強家庭成員的和睦關係。還有，同時應組織家庭實務支援小組與分享經驗平台，幫助單親家庭或照顧有老年長輩的家庭。

通過了解《2023年施政報告》中提出的相關建議，筆者希望香港精神健康服務能得到進一步的加強。政府有能力建立一個綜合且具備整合性的精神健康護理體系，這不僅能解決當前的醫療問題，還能培養一種和睦與人人互相關愛的社會文化。為了進一步增強整體完善工程的持久性發展，應考慮整合強大的社區監測機制、早期治療評估系統與持續整體改進等機制。

文：劉建誠

「中國夢智庫」精神健康事務總監
（IAPC）催眠課程簽證講師、中國高級心理諮詢師及課程導師、中國高級企業EAP諮詢師

文：丁煌

深圳大學基本法研究中心兼職研究員
經民聯港島支部主席，「中國夢智庫」主席
香港薈萃協會法律顧問，城市智庫成員
國際公益法律服務協會顧問委員會成員
全國港澳研究會會員

《中國夢智庫》是一間扎根特區的非牟利團體；與心存熱誠的資深義工、專家與職業專業人士們合作，攜手「說好中國故事」。

*作者文章觀點，不代表《觀新聞》立場