LCQ14: Psychiatric services
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     Following is a question by the Dr Hon Chiang Lai-wan and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (November 20):

Question:

     According to a report released by the World Health Organization in 2001, approximately 25% of individuals across the world developed one or more mental or behavioural disorders during their lifetime.  It was projected that depression would become the second leading disease in the world by the year 2020.  In recent years, there have been newspaper reports from time to time on cases about people suffering from emotional problems committing suicide or inflicting injuries on their family members.  Emotional problems have become more prevalent among the people of Hong Kong.  Statistics also show that one in every five people in Hong Kong suffers from emotional problems to a certain extent, and there is a rising demand for professionals who assist in solving emotional problems in the community.  In this connection, will the Government inform this Council:

(a)  whether it knows the numbers of patients (including new and old cases) on the waiting lists of public psychiatric specialist out-patient clinics and the waiting time, with a breakdown by District Council district; if such information is unavailable, of the reasons for that;

(b)  whether it knows the numbers of counsellors, psychologists and psychiatrists currently practising in Hong Kong; if such information is unavailable, of the reasons for that;

(c)  whether it knows the information such as the numbers of places and the duration of study, etc. about the counselling and psychology programmes (including both first-degree and master degree programmes) offered by various tertiary institutions at present, as well as the statistics on graduates working in the relevant professions; if such information is unavailable, of the reasons for that;

(d)  of the channels and means for the registration of counsellors, psychologists and psychiatrists in Hong Kong; if such information is unavailable, of the reasons for that;

(e)  whether it knows the names of the organisations currently providing training for counsellors, psychologists and psychiatrists which have yet to be recognised by the Government, as well as the reasons for such organisations not being recognised yet; if such information is unavailable, of the reasons for that;

(f)  whether the authorities will consider allocating additional funding for developing counselling and psychology programmes (including both first-degree and master degree programmes); if they will not, of the reasons for that;

(g)  whether the authorities will consider subsidising family doctors to take diploma courses on psychiatry, so that they will be well qualified with adequate professional knowledge for treating patients suffering from mild emotional problems, with a view to reducing the number of cases in which the patients have to wait for treatment at public psychiatric specialist out-patient clinics; if they will not, of the reasons for that; and

(h)  whether the authorities will consider allocating additional resources in future for enhancing the support services provided to members of the public suffering from emotional problems; if they will not, of the reasons for that?

Reply:

President,

(a), (g) and (h) In 2012/13, more than 195 000 persons with mental health problems received treatment and support through the hospitals and psychiatric specialist out-patient clinics (SOPCs) of the Hospital Authority (HA).  Among them, about 30 000 were first attendances.  As at March 31, 2013, there were 334 doctors (including psychiatrists), 2 073 nurses, 54 clinical psychologists, 189 occupational therapists and 243 medical social workers in the psychiatric departments of the HA providing various in-patient, out-patient and outreach psychiatric services.  New cases received at SOPCs will be triaged into priority 1, priority 2 and routine cases according to their severity and urgency.  The HA seeks to keep the median waiting time for first appointment at SOPCs for priority 1 and priority 2 cases within two and eight weeks respectively to ensure that more urgent and severe cases are followed up promptly. This performance pledge has been fulfilled.  In 2012-13, the overall median waiting time for first appointment at SOPCs was seven weeks.  As the HA service statistics are maintained on a hospital cluster basis, we do not have breakdown by District Council constituency areas.

     To enhance support for patients with mild mental illness, the HA launched the Integrated Mental Health Programme in 2010. In 2011-12, the service was expanded to cover all hospital clusters, providing timely support for patients in the primary care settings.  Under the Programme, diagnosis and treatment are provided at designated general out-patient clinics in all seven clusters of the HA for patients with mild mental illness in the primary care settings through multi-disciplinary team led by family medicine specialists and general practitioners.

     In addition, in order to enhance the support for patients with common mental disorders such as emotional distress, anxiety disorder and depression, the HA started to set up Common Mental Disorder Clinics at psychiatric SOPCs in its seven clusters in 2010.  These clinics help strengthen the assessment and treatment services for patients with common mental disorders.   

     To further promote mental health, the Food and Health Bureau (FHB) set up a Review Committee on Mental Health in May this year.  The Committee is tasked to review existing mental health policies so as to map out the future development of mental health services in Hong Kong.  The FHB and the HA will continue listening to views of different parties and working closely with the relevant departments to improve and enhance psychiatric services according to the needs of the community.

(b) and (d) Established under the Hong Kong Academy of Medicine Ordinance (Cap. 419), the Hong Kong Academy of Medicine is responsible for organising, monitoring, assessing and accrediting all medical specialist training.  There are 15 colleges under the Academy, including the College of Psychiatrists. Any medical practitioner who wishes to apply for fellowship must sit for and pass the examination conducted by the Academy.

     To become a psychiatrist, an applicant should first register as a general practitioner under the Medical Registration Ordinance (Cap. 161) and then apply to the Medical Council of Hong Kong (MCHK) for registration of specialist qualification.  An applicant may register as a specialist if the MCHK is satisfied that he has been awarded a Fellowship of the Hong Kong Academy of Medicine, or has been certified by the Academy that he has achieved a professional standard comparable to that recognised by the Academy for the award of its fellowship and fulfilled the relevant statutory requirements.  As at March 31, 2013, there were a total of 280 psychiatrists listed in the Specialist Register of the MCHK.

     As there is no statutory registration system for counsellors and psychologists, we do not have information about their registration and practice.  

(c) The number of student intakes and the total number of students enrolled in psychology and counselling programmes (including funded and self-financing undergraduate programmes and taught postgraduate programmes) offered by the University Grants Committee (UGC) institutions in the past three years (i.e. from 2010/11 to 2012/13 academic years) are set out in Annex 1.  Statistics on the employment situation of graduates from UGC-funded programmes from 2010 to 2012 are set out in Annex 2.  The Education Bureau does not have information on the employment situation of graduates from the relevant self-financing programmes.

(e) All local post-secondary programmes, including psychology and counselling programmes, are required to undergo quality assurance before they can be offered in Hong Kong.  UGC-funded and self-financing programmes offered by institutions with self-accrediting status are subject to the internal quality assurance procedures stipulated by the institutions concerned, whereas programmes offered by other institutions are accredited by the Hong Kong Council for Accreditation of Academic and Vocational Qualifications (HKCAAVQ).  However, it should be noted that neither successful self-accreditation nor accreditation by the HKCAAVQ could be deemed as being equivalent to professionally recognised.

(f) The UGC institutions normally conduct academic planning on a triennial basis.  Generally speaking, the UGC-funded sector enjoys a high degree of autonomy. An institution can offer programmes on different academic disciplines according to the needs of the community as well as its own development direction.  It may, after discussions among its faculties, departments and colleges, propose expansion of and adjustment to individual programmes.  However, the Government will make specific manpower requirement targets for a few disciplines such as medicine, nursing, paramedical profession and teacher training because their graduates are mainly employed by the public sector and the major training body is the UGC-funded sector.

     Since the UGC-funded undergraduate programmes in psychology are not subject to a specific manpower requirement target, the UGC-funded sector has the right to decide the number of places offered.   However, specific manpower requirement targets are set for the taught postgraduate programmes in clinical psychology and educational psychology.  In this regard, the number of places for the taught postgraduate programmes in clinical psychology increased from 12, 31, 12 in the respective years of the 2009-12 triennium to 38, 19, 38 in the 2012-15 triennium.  As regards the taught postgraduate programmes in educational psychology, the number of places was maintained at 15 and 25 in alternate years in the 2009-12 triennium and remains so in the 2012-15 triennium.  The Government will continue to assess and monitor the relevant demand with a view to determining the number of places for the relevant programmes after the 2012-15 triennium.

Ends/Wednesday, November 20, 2013
Issued at HKT 17:57

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