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Following is a question by the Hon Wong Sing-chi and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (January 6):
Question:
It was reported that a woman who had a manic-depressive disorder seizure and killed her adoptive daughter was convicted last month of manslaughter. In this connection, will the Executive Authorities inform this Council whether they know:
(a) the number of Consultation Liaison Teams under the Hospital Authority (HA), as well as the respective attendances of the services of in-ward consultation and consultation at the Accident and Emergency Departments provided by the teams in each of the past five years;
(b) the respective numbers of patients currently suffering from the various kinds of mental illnesses such as depression, mania and schizophrenia, etc.; if they do not know, of the reasons for that;
(c) the respective average waiting time and the waiting time at the 99th percentile for the various types of psychiatric services at present (including specialist out-patient services, community psychiatric nursing services and occupational therapy); what measures are currently in place to shorten the waiting time; whether it will set a target waiting time; if so, of the details; if not, the reasons for that; and
(d) if HA has set up a mechanism to assist mental patients who are waiting for psychiatric services so that their clinical conditions can be alleviated or will not deteriorate; if so, of the details; if not, the reasons for that?
Reply:
President,
(a) In the past five years, there were over 200 psychiatrists and nearly 2,000 psychiatric nurses providing mental health services in the Hospital Authority (HA). In 2008-09, the number of psychiatrists and psychiatric nurses in HA were 288 and 1,880 respectively.
Psychiatric healthcare staff of HA provides psychiatric consultation-liaison services in non-psychiatric inpatient wards or Accident and Emergency (A&E) departments of various clusters. The services provided include conducting clinical assessment for patients who may have mental health problems and providing appropriate treatment or follow-up recommendations such as referring patients with needs to receive psychiatric specialist out-patient (SOP) or psychiatric inpatient services based on the clinical conditions of the patient. Apart from providing consultation-liaison services to patients by visiting inpatient wards or A&E departments, psychiatric healthcare staff also provides telephone consultation services to healthcare staff of other clinical departments. HA does not have statistics of its psychiatric consultation-liaison services at present.
(b) In 2008-09, the psychiatric specialty of HA provided services to around 41,000 persons diagnosed with schizophrenia and around 40,000 persons diagnosed with emotional disorders (including depression and mania).
(c) and (d) At present, under the triage system for new appointment at SOP clinics in HA, psychiatric SOP clinics classify new patients into the following categories on the basis of the urgency of their clinical conditions: priority 1 (urgent), priority 2 (semi-urgent) and routine categories. The targets of HA are to maintain the median waiting time for cases in the priority 1 and priority 2 categories within two weeks and eight weeks respectively so as to ensure that patients with urgent healthcare needs are provided with treatment within reasonable time. In 2008-09, the median waiting time for first appointment of priority 1 and priority 2 cases at psychiatric SOP clinics were around one week and three weeks respectively.
To ensure that cases with urgent medical conditions would not be overlooked during triage at the initial stage, all patients classified as routine cases would be reviewed by a senior doctor of the relevant specialty within seven working days of the triage. If a patient's condition deteriorates while waiting for the appointment, he or she may contact the SOP clinic concerned and request to advance the appointment. If the condition is acute, the patient could seek immediate treatment at A&E departments. Healthcare staff would arrange for the patient to receive earlier treatment as necessary.
In 2008-09, the median waiting time and the waiting time at the 99th percentile for HA's psychiatric SOP service were four weeks and 112 weeks respectively. In the same year, the median waiting time and the waiting time at the 99th percentile for occupational therapy outpatient services were one week and 16 weeks respectively and service users include psychiatric and non-psychiatric patients.
As the conditions of patients at HA's psychiatric SOP clinics vary, healthcare staff arranges the date of medical appointment for patients having regard to their conditions and clinical needs. As such, the service provision cannot be assessed simply by looking at the waiting time at the 99th percentile. In fact, 90% of new patients at psychiatric SOP clinics (i.e. 90th percentile) are provided with treatment within one year.
To improve the waiting time of non-urgent new cases, HA has set up in 2009-10 triage clinics at the psychiatric SOP clinics in five clusters, including Hong Kong East, Kowloon East, Kowloon West, New Territories East and New Territories West. The triage clinics mainly provide services to new psychiatric patients classified as routine cases. To further enhance mental health services, HA plans to foster closer collaboration between its psychiatric SOP service and primary care service in 2010-11 to strengthen the assessment and treatment services for persons with common mental disorders so that patients with different conditions can all receive more appropriate treatment services to meet their needs.
Community psychiatric nurses provide follow-up service to individual discharged psychiatric patients and monitor the progress of their treatment and rehabilitation. The range of services provided includes risk management, home visit, telephone follow-up etc. Healthcare staff arranges for individual discharged patients to receive services by community psychiatric nurses having regard to the treatment and rehabilitation needs of the patient. The frequency and duration of the follow-up service depend on the needs and condition of the patient. In general, patients who are referred for follow-up services by community psychiatric nurses do not have to wait for the service.
Ends/Wednesday, January 6, 2010
Issued at HKT 14:45
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