LCQ19: Mental health of students

     â€‹Following is a question by the Hon Elizabeth Quat and a written reply by the Secretary for Education, Dr Choi Yuk-lin, in the Legislative Council today (December 6):
     It has been reported that from July to October this year, there were a total of 22 suicide deaths or suicide attempts among primary, secondary and university students aged 19 or below in Hong Kong, arousing grave concerns in society about the mental health problems of students. In this connection, will the Government inform this Council:
(1) whether it has compiled statistics on (i) the numbers of suicide deaths or suicide attempts among primary, secondary and university students and, among them, the numbers of those with special educational needs (SEN) or a history of mental health problems in each of the past five school years, and (ii) the number of requests for assistance received by schools from students regarding emotional disturbance and mental stress problems, with a breakdown by type of issues pertaining to the requests for assistance;
(2) of the number of requests for assistance or complaints received from parents of students regarding their children being unable to cope with study pressure and the follow-up actions taken by the authorities in each of the past three years; whether the Government will consider promoting education reform to alleviate students' homework load and examination pressure;
(3) as there are views that even under the existing arrangement of "one school social worker for each school" or "two school social workers for each school", it is still difficult for school social workers to take care of each and every student in need, whether the Government will explore increasing the manpower of student guidance personnel; if so, of the details; if not, the reasons for that;
(4) as there are views pointing out that the existing mental health support measures for students are mainly targeted at primary and secondary students, of the measures the Government has put in place for university students to improve their mental health conditions and provide support for university students in need;
(5) as regards education to help students manage their emotions, of the short and long-term measures the Government has taken to (i) ‍strengthen the resilience of primary, secondary and university students and "positive thinking" education, and encourage students to face up to their emotional problems; (ii) assist schools, teachers and parents in dealing more effectively with students' emotional problems, and enhance the dissemination of information to parents on mental health support for students and parenting; and (iii) support students with SEN or a history of mental health problems; and
(6) as there are views that there is a serious shortage of child and adolescent psychiatric doctors in public hospitals, whether the Government knows the actual number of child and adolescent psychiatric doctors employed and the number of vacancies at present; of the measures in place to increase the number of child and adolescent psychiatric doctors, so that students suffering from emotional disturbance can receive early treatment?
     The Government attaches great importance to the mental health of young people. We have been assisting schools in adopting the Whole School Approach at three levels, namely "Universal", "Selective" and "Indicated", to promote mental health among students and enhance support for those with mental health needs. Regarding the question raised by the Hon Elizabeth Quat, after consulting the Health Bureau (HHB) and the Social Welfare Department (SWD), the comprehensive reply is as follows:
(1) The Education Bureau (EDB) has been requiring primary and secondary schools to report suspected student suicide cases so that appropriate professional support to the schools concerned can be provided. In the past five years (i.e., 2018 to 2022), the numbers of suspected fatal student suicide cases reported by all primary and secondary schools in the territory were 14, 23, 21, 25 and 25 respectively, while the number as of November 2023 is 31. It is believed that the upward trend may be affected by the epidemic and the greater challenges students faced after the resumption to normalcy. The EDB does not collect from schools or keep data on attempted student suicide cases or statistics of student with emotional and mental problems seeking assistance. The EDB does not collect from the schools or families concerned on the medical history of the suspected fatal student suicide cases. As for universities, the EDB and the University Grants Committee (UGC) Secretariat do not have relevant figures.
(2) According to EDB's records, in the past three school years (i.e. 2020/21 to 2022/23 school years), there were a total of three complaint cases from parents that are related to academic pressure. Upon receipt of the complaints, the EDB took follow-up actions in accordance with the established complaint handling mechanism. These complaints were about the school-based professional arrangements (such as homework as well as promotion and repetition). In the contact with the schools concerned, the EDB requested the schools to conduct investigation, in order to obtain more details about the school-based measures including communication with the stakeholders and arrangement for learning support. The EDB would provide professional advice and support to the schools to facilitate their continuous improvement and development.
     Regarding the number of cases for which parents sought assistance in relation to their children's difficulty in handling academic pressure, the school stakeholders (including parents) would contact EDB officers through different channels from time to time to enquire about various issues or seek assistance, EDB officers would render appropriate support to the enquirers based on the nature and circumstances of each case. The EDB does not collect relevant information on such cases.
     The purpose of the implementation of whole-day primary schooling is to enable schools to have more time to arrange tutorial or homework guidance sessions to provide individual guidance for students or to allow them to complete part of their homework at school. Students also have more time and opportunities to interact with teachers and participate in extra-curricular activities. In the meantime, the EDB has all along been concerned about schools' assignment arrangements. We issued clear guidelines, including the Primary Education Curriculum Guide (PECG) (Pilot Version) (2022), the Secondary Education Curriculum Guide (2017) (Booklet 4: Assessment Literacy and School Assessment Policy), EDB Circular No. 18/2015 "Guidelines on Homework and Tests in Schools – No Drilling, Effective Learning", and reiterated that the quality of homework is more important than the quantity through various channels, such as the PECG video series, theme-based articles and comics for parents. Schools should continuously review their school-based assessment and assignment policies, to avoid excessive, meaningless and mechanical drilling and copying tasks, review the quantity and frequency of assessments and assignments, explore other means to replace traditional written assessments, reduce the frequency of dictations, tests and examinations, or cancel term examinations at certain levels. This will enable students to have sufficient time for rest, play, entertainment and personal growth, develop their personal interests and build up healthy lifestyles.
(3) Regarding guidance and support for students, the EDB provides comprehensive student guidance and support services in primary and secondary schools through the Whole School Approach (WSA) and multi-disciplinary collaboration. This includes early identification and support of students with mental health needs through collaboration among teachers and professionals from different disciplines in schools, such as guidance personnel, school social workers and school-based educational psychologists. The Government continues to allocate resources to enhance guidance services in schools. The EDB has been implementing the policy of "one school social worker for each school" in primary schools. A school may, having regard to its own circumstances, employ at least one school-based registered graduate social worker with professional qualifications. Moreover, the EDB also provides additional resources to subsidise schools to procure consultation service, supervisory or other support services to school social workers. As for secondary schools, the SWD has implemented the measure of "two school social workers for each school", and enhanced the supervisory and administrative support.
     Under the WSA, student guidance work is not only the responsibility of individual teachers, school social workers or student guidance personnel, all school personnel should work collaboratively, with the joint efforts of the professionals from different disciplines, to provide students with comprehensive guidance services. The need of guidance and social work services of individual schools varies, schools should, according to students' needs, flexibly deploy grants provided by the Government or pool together other school resources to employ student guidance personnel or procure related services from organisations to strengthen the support for students.
(4) to (5) For the UGC-funded universities, they can flexibly deploy the recurrent grants which are disbursed in the form of block grants to support students in need. Moreover, the UGC has been supporting the universities to promote mental health and positive education. During the COVID-19 pandemic, noting that some university students were affected by increased stress and anxiety due to difficulties in their academic studies and job searches as well as reduced social activities, the UGC allocated a total of $100 million in two tranches to further support the UGC-funded universities in strengthening various student support services, including psychological counselling and mental health support. In addition, in 2021, the UGC presented the Teams award of the annual UGC Teaching Award to the Joint University Mental-Wellness Project led by the City University of Hong Kong to propagate the concept of positive education. The aforementioned project benefitted over 1 100 staff members and professionals, around 4 000 university students and around 1 500 community individuals during its implementation. Apart from recognising outstanding teaching staff, the award is also conducive to the promotion of positive education at inter-institutional level. With the pandemic gradually subsiding, the UGC also additionally allocated $30 million to establish the Whole-person Development Fund at the beginning of this year to support each UGC-funded university to arrange projects to enrich the learning experience of students outside the classroom, thereby promoting whole-person development among the younger generation. The promotion of positive education and psychological well-being is one of the four key areas. Apart from deploying the allocation to conduct different activities and peer support programmes, the universities have also made use of the funding to strengthen the manpower for psychological counselling to meet the additional service demands from students returning to the campus. This initiative will continue to be implemented until June 2025.
     As for assisting students with special educational needs (SEN), the UGC has further allocated additional resources to the UGC-funded universities in the 2022-25 triennium by granting a special allocation of $67.5 million so as to facilitate the universities in improving the learning experience of students with SEN, strengthening the training of faculty and staff, and promoting campus integration, thereby benefitting all students with SEN.
     For primary and secondary schools, the EDB has been organising diversified programmes on student growth, adventure-based, team building and problem-solving training, with a view to enhancing students' resilience and developing students' optimistic and proactive attitude in facing challenges with courage. From the 2023/24 school year onwards, the EDB will launch the "Mental Health Literacy" resource packages for students at different learning stages by phases, so as to facilitate the promotion of mental health literacy in class by school personnel, strengthening students' awareness of mental health. Furthermore, the EDB has commissioned an NGO to launch the "Peer Power–Student Gatekeeper Training Programme" which aims to enhance students' understanding of mental health and skills in coping with their stress and emotions, equip them to identify and help their peers in need, and promote positive coping and help-seeking culture in schools. The number of participating schools has increased to 50 in the 2023/24 school year.
     On teacher training, the EDB provides teachers with a 60-hour thematic training course targeting students with mental illness, thereby enhancing their ability to early identify and support students with suicide warning signs. Up to the 2023/24 school year, the number of training places has increased to 760. Basic "gatekeeper" training is also provided for newly-joined teachers. In addition, the EDB will provide a series of workshops for teachers, social workers and school guidance personnel in the 2023/24 school year, with the focus on enhancing their related professional knowledge and skills. The EDB provides teachers and student guidance personnel with professional training on an on-going basis, including certificate courses on student guidance and discipline, related seminars and sharing, to facilitate the implementation of guidance work at schools and encourage exchange among the schools.
     For parents, apart from organising activities and seminars for parents in collaboration with the Committee on Home-School Co-operation every year, the EDB has been running the territory-wide Positive Parent Campaign, with a view to fostering positive thinking among parents to help children grow up happily. Besides, the EDB organises "Parent Workshop on Gatekeeper Training" and thematic "gatekeeper" online workshops every year and produces videos, factsheets and pamphlets for parents, and has uploaded them onto the "Mental Health@School" website and "Smart Parent Net" website, providing parents with information related to mental illness and prevention of youth suicide. Besides, the EDB launched the Curriculum Framework on Parent Education (Kindergarten) and the Curriculum Framework on Parent Education (Primary School) in 2021 and 2022 respectively. One of the core strands of the curriculum frameworks is the promotion of healthy, happy and balanced development of children (including whole-person development and mental health). The EDB has started to develop the curriculum framework for parents of secondary school students.
     Moreover, we urge schools to launch "Spread the Love, Care and Shine" Campaign in November 2023, advising schools to free up more time and space to care for students. In order to support schools to promote mental health effectively and flexibly, the EDB will be providing the "One-off Grant for Mental Health at School" and "One-off Grant for Mental Health of Parent and Students" to all publicly-funded primary and secondary schools and their Parent-Teacher Association, so as to help them organise related programmes or procure related services or materials for supporting students' mental health.
     The promotion of students' mental health requires joint efforts of the education, medical and social welfare sectors. The HHB, in collaboration with the EDB, the Hospital Authority and the SWD, has launched the Student Mental Health Support Scheme. A multi-disciplinary team is formed in each participating school to provide multi-disciplinary support services to students with mental health needs in the schools. In the 2022/23 school year, the number of participating schools has increased to 210. Moreover, in view of recent student suicide cases, the Government has implemented the Three-Tier School-based Emergency Mechanism (Note) through cross-departmental collaboration of the HHB, the EDB and the SWD from December this year to January next year in all secondary schools in Hong Kong, working together with schools, parents and other stakeholders in society to early identify and support students at higher risk.
     As for helping schools cater for students with SENs, on top of regular subvention for all ordinary schools, the EDB has also been providing public sector schools with additional resources, including the Learning Support Grant (LSG). Starting from the 2017/18 school year, the LSG covers students with mental illness (MI) so that schools can enhance their support to cater for these students' learning, social, emotional and behavioural needs. Schools may make use of the LSG to employ additional staff to assist teachers in designing learning activities and materials and supporting students in classroom learning activities, or to procure professional support or guidance services, thereby providing behavioural or emotional intervention, social skills training, or to implement school-based teacher training, parent education, etc, to help students with MI adapt to school life. Schools can also make use of the LSG to promote home-school collaboration in taking care of students' growth.
(6) The Hospital Authority (HA) delivers mental health services using an integrated and multi-disciplinary approach with a multi-disciplinary team involving psychiatrists, psychiatric nurses, clinical psychologists, medical social workers and occupational therapists, so as to allow flexible deployment of manpower to cope with service needs and operational requirements. As healthcare professionals of the HA would usually need to provide support for a variety of psychiatric services, the manpower for supporting individual psychiatric services cannot be separately quantified. In 2022-23 (as at 31 March 2023), there are 381 psychiatrists in the HA.
     The HA attaches great importance to the manpower situation in public hospitals and has proactively launched a series of measures to attract and retain manpower. The HA also makes use of different channels to actively recruit non-locally trained doctors, including promotion events in various countries and regions, recruiting more eligible non-locally trained doctors through special registration or limited registration to join the public healthcare system of Hong Kong to meet the growing service demand.
     To further increase the manpower of local doctors, the Government has further increased the number of medical student places to 590 in the 2022/23 to 2024/25 UGC triennium. Compared with the 320 medical student places in the 2009/10 to 2011/12 triennium, the number has significantly increased by more than 84 per cent. Earlier, the Legislative Council also endorsed the Medical Registration (Amendment) Ordinance 2021 to create new pathways for non-locally trained doctors to practice in Hong Kong. Since the Ordinance came into effect, more than 130 non-locally trained doctors have been recruited by the HA, including psychiatrists.
     At the same time, to manage the waiting time of psychiatric specialist outpatient (SOP) clinics, the HA has since mid-2022 introduced the Co-care Service Model in the General Outpatient Clinic Public-Private Partnership Programme, which provides the alternative of receiving private medical services in the community to HA psychiatric SOP patients clinically diagnosed to have stable conditions and suitable to receive primary healthcare services in the community.
Note: The first-tier mechanism is to assist schools early identify students with higher suicide risk or mental health needs, with a view to giving priority to provide timely and appropriate intervention to them. The second-tier mechanism is to organise an "off-campus support network" through cross-departmental, cross-professional and cross-sectoral co-operation to enhance "external support" for schools that have difficulty in deploying manpower to meet the needs of students. For the third-tier mechanism, school principals can refer students with severe mental health needs to the psychiatric specialist services of HA and HA will give priority to those students.

Ends/Wednesday, December 6, 2023
Issued at HKT 15:00