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Following is a question by the Dr Hon Pan Pey-chyou and an oral reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (February 4):
Question:
Earlier on, a family tragedy occurred which involved a woman who had just left a psychiatric hospital to convalesce at home. She was suspected to have committed suicide and died after killing her son and daughter. It has been reported that similar tragedies occurred time and again in recent years. In this connection, will the Government inform this Council:
(a) of the number of cases in the past five years of mental and ex-mental patients inflicting harm on themselves and/or other people while such patients were taking leave from hospital to stay at home or at the initial stage of their return to community, as well as the trend of such data;
(b) what support the Government and Hospital Authority currently provide specifically for mental and ex-mental patients who will soon be discharged and those who have just been discharged, as well as for their families, so as to reduce the pressure they are facing and occurrence of incidents involving casualties; and
(c) as the authorities have indicated that the Working Group on Mental Health Services chaired by the Secretary for Food and Health will work on the formulation of an appropriate framework for developing mental health services and identify key areas for priority action, of the latest progress of such tasks, and whether the Working Group has, since its establishment, reviewed if the existing support services for the families of mental patients are adequate and able to meet their needs?
Reply:
President,
(a) The Hospital Authority (HA) has introduced a new incident reporting system since October 1, 2007 to further strengthen the reporting of medical incidents in public hospitals. During the 12-month period ending September 30, 2008, HA received a total of 12 reports of mental patients having died of suicide during home leave. HA does not have the data on mental patients inflicting harm on other people.
(b) HA is providing mental patients with medical rehabilitation and community psychiatric services mainly through its eight multi-disciplinary community psychiatric teams (CPT) and it is also providing associated support service for patients' families. At present, all hospital clusters under HA have CPTs comprising psychiatrists, community psychiatric nurses, clinical psychologists, medical social workers, occupational therapists, etc. Community psychiatric services cover a range of services including risk management, home visit, telephone consultation and follow-up service. CPTs also work closely with other service agencies in the district, providing support for community service groups and rehabilitation organisations and helping mental patients re-integrate into the society. HA also offers psychiatric ambulatory service to those mental patients with more stable conditions by providing them with continuous care and rehabilitation service.
In recent years, HA has enhanced the support for mental patients who are being or newly discharged and for their families through various programmes. Since 2001, HA has launched the "Extending Care Patients Intensive Treatment, Early Diversion and Rehabilitation Stepping Stone" scheme (EXITERS) to provide intensive rehabilitation training for long stay mental patients so as to facilitate their early discharge and integration into the community. The scheme also provides follow-up and support services to discharged patients.
In 2008-09, HA has set up community psychiatric support teams in Kowloon West Cluster and New Territories East Cluster to provide support for frequently readmitted psychiatric patients through a case management approach so that effective follow-up care can be provided in a timely manner. To further enhance its community psychiatric service, HA plans to deploy additional community psychiatric nurses and other allied health professionals in various clusters in 2009-10 with a view to providing appropriate support to discharged patients.
Meanwhile, the Social Welfare Department (SWD) also provides a range of services for ex-mentally ill persons and their families: (i) the psychiatric Medical Social Workers offer counselling service and assist the patients and their families to handle emotional, family, caring, interpersonal relationship problems and make referral for them to apply for rehabilitation service and community resources; (ii) the Community Mental Health Care Programme and Community Rehabilitation Day Services assist ex-mentally ill persons to resolve adjustment problems they have encountered in their daily life and facilitate their integration into the community through outreaching visits and outreaching occupational therapy services respectively; (iii) the Community Mental Health Link service assists ex-mentally ill persons and their families/carers to establish their district support network and provides them with care and support, including counseling service, social/recreational/educational activities and outreaching visits, etc; (iv) the Resource and Service Centres are set up for families and relatives of ex-mentally ill persons with the purpose of providing them with emotional support and counseling service so as to enhance their acceptance of their dependants with mental illness and to strengthen their ability to take care of the ex-mentally ill persons at home; (v) At present, there are five Training and Activity Centres for ex-mentally ill persons with the aims of helping them develop their social and vocational skills, providing them with suitable leisure activities and preventing the recurrence of mental illness and the need for re-hospitalisation.
To enhance mental health services at the district level, SWD will set up an integrated community support centre in Tin Shui Wai on a trial basis in March this year to provide one-stop, comprehensive and in-depth mental health support services for local residents and to reach out to those with mental health problem through intensive outreaching service. It is expected that the centre will serve 450 ex-mentally ill persons, people who are receiving mental health service and those suspected to have mental problem. The centre will also provide support to 1,200 families/carers each year.
SWD has also been providing residential service to ex-mentally ill persons. Types of residential services include: (i) supported hostel (83 places) that provide group home living for ex-mentally ill persons who can live semi-independently with a fair amount of assistance from hostel staff in daily activities; (ii) half-way houses (1,509 places) that provide transitional community rehabilitation service for an average of three years in preparation for ex-mentally ill persons' re-integration into the community; and (iii) long stay care homes (1,407 places) that provide long-term residential care and active maintenance services to discharged chronic mental patients.
(c) In 2006, the Food and Health Bureau set up a Working Group on Mental Health Services (the Working Group), which is chaired by me and comprises professionals providing medical and rehabilitation services to mental patients, academics and representatives of HA and SWD. The purpose of the Working Group is to assist the Government in reviewing the existing mental health services in Hong Kong and mapping out the long-term development of our services.
Under the Working Group, there is a sub-group which is tasked to study in-depth the demand for mental health services and the relevant policy measures. The sub-group is co-chaired by two members of the Working Group and comprises professionals from the healthcare and social welfare sectors. The sub-group has drawn up a framework on the objectives and directions of the mental health policy. It is now studying the service needs of three different age groups (adults, adolescents and elders) with a view to making proposals for service improvement in the relevant areas.
Since mental illness is a complex health problem and mental health services cover both healthcare and rehabilitation services, I will work closely with the Secretary for Labour and Welfare. The long-term development of mental health services will be examined and planned under the overall framework of the healthcare reform.
In the short and medium term, we will allocate additional resources on prevention, medical treatment and rehabilitation services to further improve our mental health services and enhance the community support for mental patients, so as to facilitate their early recovery and re-integration into the society. From 2001-02 to 2008-09, the Government has provided a total of $250 million additional recurrent funding to HA and $76.1 million to SWD to support a number of new initiatives to improve the treatment and rehabilitation services for mental patients, including various community support services to provide continuous support for ex-mentally ill persons and their families/carers.
Ends/Wednesday, February 4, 2009
Issued at HKT 16:01
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