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Following is a question by the Hon Lau Kong-wah and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (May 18):
Question:
According to the estimation of the World Health Organization, depression will become the second leading disease in the world by the year 2020. Earlier on, in a survey which interviewed 1,120 young people aged below 25, it was found that 32.5% of them showed symptoms of depression, with the youngest aged only 12, which was almost four times as high, in comparison to the 8.3% of people who showed symptoms of depression in the adult population of Hong Kong. In addition, more than half of them were even prone to suicide or self-harm. In this connection, will the Government inform this Council:
(a) whether the authorities had compiled statistics on the number of people suffering from depression in Hong Kong in the past five years, and the number of those who need treatment because they had symptoms of depression; of the distribution by age, gender and occupation of these two types of people; whether they have assessed if there is an upward trend in the number of Hong Kong people suffering from depression and if the problem of adolescent depression is particularly serious; if they have assessed, of the outcome;
(b) whether it knows at present the average waiting time for first appointment for various types of public mental health services and psychiatric specialist out-patient services; what measures the authorities have to shorten the waiting time for such services; whether they will strengthen the healthcare and counselling services for depression, as well as enhance publicity and education so as to enable members of the public to better understand and identify depression;
(c) whether the authorities have plans to step up its efforts in addressing the problem of depression and adjust their strategy to tackle the problem of high rates of depression among young people by providing more services which targeted at their needs; and
(d) given that some members of the public have relayed that as the existing antidepressant drugs have quite a number of side-effects causing some patients to discontinue medication, which affects the progress and efficacy of their treatment, whether the authorities will request the Hospital Authority to include more new drugs with fewer side-effects in its Drug Formulary in order to enhance the treatment of depression and boost the confidence of patients with depression in the prescription of medication?
Reply:
President,
(a) The Department of Health (DH) conducted a Population Health Survey in 2003/04 in collaboration with the Department of Community Medicine under the Faculty of Medicine of the University of Hong Kong. According to the Survey, about 1.5% of the population in Hong Kong aged 15 and above self-reported doctor-diagnosed depression. The prevalence of depression by gender and age group is at Annex 1. Figures obtained from the Survey show that the prevalence rate of depression was 2.1% in females and 0.7% in males. The prevalence rate among the younger age groups (15 to 35 years of age) was 1%. It was lower than that of the older age groups (35 years of age or above), which was between 1.5% and 1.9%. In addition, the prevalence of depression by occupation according to the Survey is at Annex 2. The number of patients diagnosed with depression and receiving psychiatric in-patient and specialist out-patient (SOP) services at the Hospital Authority (HA) by age and gender over the past five years is at Annex 3.
In order to keep track of the latest developments regarding the prevalence of mental illnesses in Hong Kong, the Food and Health Bureau commissioned the Department of Psychiatry of the Chinese University of Hong Kong in October 2010 to conduct a 5-year "Hong Kong Mental Morbidity Survey" in collaboration with the Department of Psychiatry of the University of Hong Kong and psychiatric services units under HA, with funding from the Health and Health Services Research Fund, with a view to examining the prevalence of common mental illnesses among the adult population of Hong Kong. The survey is now under way.
(b) and (c) In 2010-11, the median waiting time for first appointment of all new cases at HA's psychiatric SOP clinics was four weeks.
In 2010-11, HA set up Common Mental Disorder Clinics at the psychiatric SOP clinics in all seven clusters to provide more timely assessment and treatment services for patients with common mental disorders (including depression) who were triaged as non-urgent cases. In addition, HA has since October 2010 launched the Integrated Mental Health Programme at designated general out-patient clinics in five clusters (Hong Kong East, Hong Kong West, Kowloon East, Kowloon West and New Territories East). Under the programme, patients with mild mood disorders and other common mental disorders who are in stable conditions are provided with timely treatment in the primary care settings by multi-disciplinary teams comprising family medicine specialists, general practitioners, nurses, social workers and other allied health practitioners.
After implementation of the above measures, the median waiting time for first appointment of non-urgent new cases at psychiatric SOP clinics was reduced from 17 weeks in 2008-09 to nine weeks in 2010-11. To further enhance the support to patients with common mental disorders, HA will expand the Integrated Mental Health Programme in 2011-12 to cover all clusters to tackle more effectively cases of mild mental illness in the community. Meanwhile, psychiatrists from the Common Mental Disorder Clinics will continue to provide support to family medicine specialists and general practitioners under the programme to facilitate the management of patients in need in the primary care settings.
The Government is committed to promoting mental health. We seek to enhance public awareness and understanding of mental health (including emotional disorders) through public education and publicity to promote the acceptance of ex-mental patients by the public so as to facilitate their re-integration into the community.
To enhance public's concern and awareness of mental health, and to promote social acceptance of ex-mentally ill patients, the Labour and Welfare Bureau has organised a "Mental Health Month" every year since 1995 in collaboration with various government departments, non-governmental organisations and the media, aiming at promoting a proper understanding of mental health and emotional disorders in the community, and facilitating the integration of ex-mental patients into society, through a series of territory-wide and district-based major promotional activities. The Social Welfare Department (SWD) has also launched community mental health education activities through the Integrated Community Centre for Mental Wellness set up in various districts across the territory, so as to enhance the community's awareness of mental health. Meanwhile, DH has produced a comprehensive range of health educational resources and audio-visual aids on mental health, and set up a round-the-clock pre-recorded telephone information hotline and webpage to disseminate messages on mental health and to promote the psycho-social well-being of the public.
In view of the needs of adolescents, the Student Health Service under DH has launched the Adolescent Health Programme to promote the physical and psycho-social health of adolescents through outreach activities for students, their parents and teachers in schools. The Programme is provided by multi-disciplinary teams comprising such professional staff as doctors, nurses, social workers and clinical psychologists. The basic life skills training is tailored-made for students and covers emotion management, harmonious interpersonal relationship building, communication skills and stress management, etc. Such training serves to help adolescents establish a positive attitude and outlook so that they would be able to deal with changes and challenges with confidence and competence during their development. In addition, to facilitate the early identification of children and adolescents with mental health problems with a view to providing them with necessary services as early as possible, SWD and HA jointly implemented the Child and Adolescent Mental Health Community Support Project since 2005. The Project has been fully transferred to HA for implementation since July 2009. Under the project, outreaching services are provided to children and adolescents aged 6 to 18 with emotional problems (e.g. depression and anxiety disorder). The scope of services includes promotion of public education to facilitate identification of children and adolescents in need as early as possible; provision of advisory and support services to youth workers and parents; and establishment of linkages with local community organisations for provision of personalised rehabilitation services as well as training and activities on daily living and vocational skills in the community settings to children and adolescents with emotional problems. This is to help them overcome the adverse impact of mental health problems and develop a healthy lifestyle.
(d) Generally speaking, HA's healthcare teams will provide appropriate treatment to patients with depression according to their needs, such as drug therapy, psychotherapy and stress management skill training. If patients are in need of drug therapy, doctors will prescribe proper medications having regard to the clinical conditions of individual patients. Over the years, HA has been taking measures to increase the use of new psychiatric drugs with fewer side effects. At present, 11 new anti-depressant drugs with fewer side effects have been included in the HA Drug Formulary to enhance treatment for patients with depression. HA will continue to review the use of psychiatric drugs and consider introducing more drugs with proven efficacy in its Drug Formulary through the established mechanism.
Ends/Wednesday, May 18, 2011
Issued at HKT 14:06
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