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Following is a question by the Hon Wong Sing-chi and a reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (February 15):
Question:
An incident of a person with mental illness killing another person happened earlier at Choi Yuen Estate in Sheung Shui. There have been comments that this is a result of the reduction in psychiatric beds by the Hospital Authority (HA) in recent years, which has substantially increased the number of people recovering from mental illness in the community, but the ancillary facilities in the community are insufficient. In addition, some cases of people with mental illness receiving social rehabilitation services are followed up by various government departments such as the Police, Housing Department and Social Welfare Department (SWD) as well as non-governmental organisations, but the patients' records of violence kept by such departments may be different. In this connection, will the Government inform this Council:
(a) whether the aforesaid problems of follow-up by government departments and organisations and records of cases arose from insufficient communication and co-ordination among various departments; whether this problem has been reviewed by the Working Group on Mental Health Services, which is a multi-disciplinary consultation mechanism set up by the Government;
(b) of the progress of the authorities' efforts in enhancing community support; of the progress of introducing Community Treatment Orders; whether it knows the number of case managers to be recruited by HA for launching the Case Management Programme in the 12 districts across the territory, the number of vacancies not yet filled at present, and the number of people with severe mental illness to be followed up by each case manager; of the number of Integrated Community Centres for Mental Wellness being planned by SWD for which the locations have yet to be identified, and of the District Councils or districts the residents of which oppose to the provision of such centres; and
(c) whether it has assessed how incidents of people with mental illness committing killings affect the views of the public towards people with mental illness, and whether they will give rise to ostracism and discrimination, as well as what difficulties will be created for the implementation of community-based rehabilitation; of the authorities' measures to respond to members of the public having a prejudice against people with mental illness after the occurrence of the aforesaid incident; whether they will consider making reference to overseas experience and adopt measures to encourage the media to be impartial and positive in their reports about mental illness and people with mental illness?
Reply:
President:
The Government is concerned about all incidents involving violence, including cases involving persons recovered from mental illness. The Government is committed to promoting mental health among members of the public. As the mental health policy and provision of related service programmes involve a number of policy bureaux and government departments, the Food and Health Bureau assumes the overall responsibility of co-ordination and works in close collaboration with the Labour and Welfare Bureau (LWB), Department of Health (DH), Hospital Authority (HA), Social Welfare Department (SWD) and other relevant government departments.
It is the international trend to gradually focus on community and ambulatory services in the treatment of mental illness, and to allow the early discharge of mental patients when their conditions are stablised for treatment in the community. Hence, the Government has strengthened its community psychiatric services in line with this direction in an effort to allow more patients who are suitable for discharge to receive treatment in the community, so that they can re-integrate into the community and start a new life as early as possible. The Government has increased the funding allocation for mental health services on a continuous basis. The revised estimate in 2011-12 has increased by about 30% when compared with the actual expenditure in 2007-08, with the total amount of funding allocation for the past five years exceeding $19 billion.
My reply to various parts of the question is as follows:
(a) The directions of our mental health policy is to adopt a multi-disciplinary and cross-sectoral team approach in delivering a comprehensive range of mental health services which are accessible by people in need on a continuous basis. We have also put in place a platform for communication and a mechanism for co-ordination at various levels to foster collaboration between the medical and social service sectors.
At the level of policy formulation, we set up the Working Group on Mental Health Services in 2006. It is chaired by me and comprised of stakeholders with relevant service experience from the medical, social service and other related sectors to assist in the formulation and review of our mental health policy and services.
At the level of service delivery, since 2010, SWD Headquarters and HA Head Office have set up a Central Co-ordinating Group in collaboration with the non-governmental organisations (NGOs) operating Integrated Community Centre for Mental Wellness (ICCMW) to discuss the co-ordination of the service strategies and explore more effective models of collaboration.
At district level, District Social Welfare Officers of SWD and the Chiefs of Service of the Department of Psychiatry in various HA clusters hold working group meetings at regular intervals to maintain liaison with psychiatric medical social workers and ICCMWs in the respective districts as well as other relevant Government departments, including the Police and the Housing Department. When handling cases involving mental patients, various departments will hold case conferences where necessary in order to formulate rehabilitation plans for the patients.
The existing multi-disciplinary team approach and the inter-department communication mechanism are functioning effectively. We will continue to strengthen our co-ordination role and provide more comprehensive and intensive support for mental patients.
(b) There is suggestion that the Government should introduce a Community Treatment Order to require mental patients to receive designated treatment while living in the community. Since the relevant legislative proposal will have far-reaching impact on both patients and the society in a number of aspects, such as protection of patients' personal data and scope of authority of healthcare professionals, thorough consideration is necessary.
Since April 2010, a Case Management Programme has been launched on a pilot basis for patients with severe mental illness. At present, the Programme has been implemented in eight districts. As at the end of 2011, HA has employed a total of 138 healthcare and allied health personnel with experience in community mental health services as case managers for the provision of intensive and personalised community support to some 9,000 patients. In the coming year, this Programme will be further extended to cover another four districts. By then, this service will be available at all HA clusters and it is estimated that some 40 additional case managers will be employed.
ICCMWs, set up by SWD, are operated by NGOs to provide community support and referral services for clinical assessment and psychiatric treatment through a new district-based and one-stop service mode. Since October 2010, ICCMWs have been in operation at 24 service points across the territory. Of these 24 ICCMWs, 6 have already been operating in permanent accommodation. Furthermore, nine have secured permanent accommodation, including seven where preparatory work is being carried out and two where local consultation will be conducted later this year.
Some members of the local community may have opposing views on the proposed locations for ICCMWs. However, SWD has not shelved any construction or reconstruction plan for the setting up of ICCMWs as a result of such views. SWD will continue to strengthen communication with the local community in a proactive and pragmatic manner with a view to identifying permanent accommodation for ICCMWs in the other districts as soon as possible.
(c) The Government has all along launched publicity campaigns and promotional activities on mental health on an on-going basis so as to reduce misunderstanding and discrimination against persons with mental illness in the public.
Since 1995, LWB has been organising the "Mental Health Month" programme annually in collaboration with more than 20 government departments, public organisations, NGOs and the media, and co-operation with the media to report on mental illness and mental patients in a positive manner is included under the programme. In the coming year, LWB will continue to reinforce its efforts in promoting the spirit and core values enshrined in the United Nations Convention on the Rights of Persons with Disabilities. The themes of the public education activities will include promotion of mental health and full re-integration of persons recovered from mental illness into the community.
HA has already launched the "Child and Adolescent Mental Health Community Support Project" to promote mental health among youngsters and their parents through the schools and community youth centres while DH has also included mental health in its public health education programme. Moreover, ICCMWs have organised over 2700 public education activities to enhance the community's understanding on mental health. ICCMWs will continue to organise public education and publicity activities to eliminate discrimination against persons recovered from mental illness among members of the public.
Like other illnesses, there are both mild and serious cases of mental illness. Given the advancement in medical technology and development of medicines in recent years, psychiatric treatments nowadays are much more effective than those in the past. To achieve the objective of facilitating early re-integration of patients into the community, the public should have understanding and acceptance for mental patients, and should not have double standards when treating patients with mental illness and those with other illnesses. Most mental patients do not have propensity to violence and a majority of persons recovered from mental illness can re-integrate into the community and start a new life.
There has been greater awareness of mental illness among the public in recent years. Mental patients need the support and care from their family and friends in the course of treatment and recovery. Early identification of the symptoms of mental illness and seeking treatment in a timely manner can help patients receive the appropriate treatment at the earliest possible time. The relevant government departments will continue their close collaboration to raise the public's awareness of mental illness so that both mental patients and persons recovered from mental illness can be accepted by the general public for building an inclusive society.
Thank you, President.
Ends/Wednesday, February 15, 2012
Issued at HKT 17:16
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