LCQ1: Psychiatric specialist services
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Question:
Quite a number of patients with mental illness and concern groups have relayed to me that the healthcare manpower and beds in the psychiatric service of public hospitals are now in short supply. This situation, coupled with the inadequate community support, has made it difficult for the mentally ill and the ex-mentally ill persons to integrate into the community. In this connection, will the Government inform this Council:
(1) whether it knows the number of psychiatric healthcare staff members, the attendance of each type of psychiatric service, and the number of acute psychiatric beds, in respect of each hospital cluster under the Hospital Authority (HA) in each of the past five financial years; whether HA has plans to increase the psychiatric healthcare manpower and the number of acute psychiatric beds in the coming five years; if so, of the details and implementation timetable; if not, the reasons for that;
(2) whether it knows if HA has issued clear guidelines to its psychiatrists setting out the circumstances under which the cases of patients with mental illness are to be referred to the relevant department for provision of community support services to them; if HA has, of the details; if not, the reasons for that; of the details of the referral mechanism; and
(3) as some working persons with mental illness have pointed out that since the psychiatric specialist outpatient clinics of public hospitals currently provide only daytime services, it is necessary for them to take leave for follow-up consultations, making their supervisors and colleagues aware that they are receiving psychiatric treatment, who then discriminate against and ostracise them by depriving them of promotional opportunities or even dismissing them, whether the Government will request HA to provide additional psychiatric specialist outpatient service in the evening or during weekend; if so, of the details and implementation timetable; if not, the reasons for that?
Reply:
President,
The Hospital Authority (HA) adopts a multi-disciplinary approach in its provision of psychiatric specialist services. Medical teams comprising psychiatric doctors, psychiatric nurses, clinical psychologists, occupational therapists, Medical Social Workers, etc., provide patients, according to their conditions and clinical needs, with the appropriate treatment and follow-up care, including in-patient, specialist out-patient (SOP), daytime rehabilitative training and community support services. My reply to the various parts of the question is as follows:
(1) The numbers of psychiatric doctors, psychiatric nurses, community psychiatric nurses, clinical psychologists, medical social workers and occupational therapists providing psychiatric services in HA in the past five years by hospital cluster are set out at Annex 1.
The numbers of attendances for in-patient (note 1), SOP, daytime rehabilitative training (note 2) and community psychiatric services in the past five years by hospital cluster are set out at Annex 2.
HA does not classify psychiatric beds into acute or non-acute ones. The number of beds in psychiatric wards of HA in the past five years by hospital cluster is set out at Annex 3.
In 2017-18, HA will further strengthen its psychiatric services. Details are set out as follows:
(1) Psychiatric SOP services in the New Territories East Cluster (NTEC) will be strengthened by recruiting one additional doctor, three additional nurses (comprising one advanced practice nurse (APN) and two registered nurses (RNs)), two additional occupational therapists, one additional clinical psychologist and three additional supporting staff to provide services for patients with common mental illness;
(2) Psychiatric in-patient services in the Kowloon Central Cluster, Kowloon East Cluster and NTEC will be strengthened by recruiting 29 additional nurses (comprising one ward manager, six APNs and 22 RNs), one additional physiotherapist and 32 additional supporting staff;
(3) Clinical psychological services in all seven clusters will be strengthened by recruiting one additional clinical psychologist and eight additional supporting staff;
(4) The peer support element of the Case Management Programme will be strengthened by recruiting five additional peer support workers;
(5) Four additional APNs and four additional supporting staff have been recruited to support the implementation of a two-year pilot scheme named Student Mental Health Support Scheme. Under the pilot scheme, professional and multi-disciplinary platforms are established to enhance cross-sectoral co-ordination and collaboration among the medical, education and social sectors, in order to provide more effective support for students with mental health needs at schools; and
(6) Eight APNs and four supporting staff have been recruited to support the implementation of a two-year pilot scheme named Dementia Community Support Scheme. Under the pilot scheme, community support services are provided to elderly persons with mild or moderate dementia through 20 District Elderly Community Centres based on a medical-social collaboration model.
HA will continue to review and monitor its services to meet the needs of patients.
(2) The Community Psychiatric Services of HA provides a range of community psychiatric services, including Standard Community Psychiatric Services, Case Management Programme, Intensive Care Teams and Mental Health Direct hotline, for needy patients according to their conditions, clinical needs and risk levels. Psychiatric doctors of HA will, depending on patients' conditions, clinical needs and risk levels, decide whether patients should be referred to the Community Psychiatric Services for follow-up treatment according to the established guidelines of HA. Details of the guidelines are at Annex 4.
(3) HA provides multi-disciplinary services at its psychiatric SOP clinics for patients with mental illness according to their clinical needs. Comprehensive multi-disciplinary support is provided during daytime on weekdays by SOP clinics. Given the fact that the provision of evening or weekend services will inevitably require re-deployment of resources from the weekday daytime SOP clinics and hence affect the overall services provided for patients with mental illness, HA has no plans at present to provide psychiatric SOP services in the evenings, on weekends or public holidays. Nevertheless, HA has set up designated depot clinics in all seven clusters to provide depot injection treatment during non-office hours to facilitate the use of the service by patients in need.
Note 1: including in-patients and day-patients
Note 2: conducted in day hospitals
Ends/Wednesday, June 28, 2017
Issued at HKT 16:02
Issued at HKT 16:02
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