LCQ15: Treatment for depression
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Question:
There are views pointing out that patients with depression and treatment-resistant depression (i.e. those who have not shown significant improvement despite two trials of antidepressants at adequate doses, duration and adherence) face higher suicide rates if their condition cannot be controlled, and this will also have far-reaching and adverse impacts on the quality of life for both the patients as well as their families. Therefore, in order to render more effective support for patients with depression and promote mental health for all, it is crucial to provide appropriate treatments for depression and keep track of patients' data. In this connection, will the Government inform this Council:
(1) whether it knows the respective numbers of people admitted to public hospitals in each of the past three years due to depression and treatment-resistant depression, and their respective average numbers of days of hospitalisation; if there are no relevant statistics, whether the authorities will track such data in a systematic manner in the future; and
(2) given that in the reply to a question from a Member of this Council on March 13 last year, the authorities indicated that in 2023-2024 (as at the end of February 2024), only 17 patients had been prescribed the nasal spray medication, Esketamine, for treatment of depression, representing a significant disparity compared to the number of patients with depression and potential treatment-resistant depression in Hong Kong, whether the authorities know the reasons for the low usage rate of such medication by the Hospital Authority (HA), and whether the HA will increase the use of nasal spray antidepressants in the future?
Reply:
President,
The reply to the question raised by the Hon Chan Pui-leung is as follows:
(1) The Hospital Authority (HA) adopts an integrated and multi-disciplinary approach in providing mental health services. A team comprising psychiatrists, psychiatric nurses, clinical psychologists, occupational therapists and medical social workers provides a comprehensive range of medical services, including inpatient services, outpatient services, day rehabilitation training and community support services, to patients with mental health needs (including patients with depression) according to their medical conditions and clinical needs.
The table below sets out the number of discharges and deaths of hospitalised patients with principal diagnosis of depression (including treatment-resistant depression) from 2022-23 to 2024-25 (up to December 31, 2024) and their average length of stay in hospitals:
| Year | Inpatients with principal diagnosis of depression (including treatment-resistant depression) | |
| No. of discharges and death of inpatients | Average length of stay in hospitals of inpatients (day) | |
| 2022-23 | 3 279 | 19.9 |
| 2023-24 | 3 589 | 21.0 |
| 2024-25 (up to December 31, 2024) | 2 708 | 21.8 |
Note 1: In the HA, day inpatients refer to those who are admitted to hospitals for non-emergency treatment and discharged within the same day. Inpatients are those who are admitted to hospitals via Accident and Emergency Departments or those who have stayed for more than one day. The calculation of inpatient average length of stay does not include that of day patients.
Note 2: The HA does not maintain statistics relating to treatment-resistant depression.
Note 3: In view of the COVID-19 epidemic outbreak in Hong Kong in early 2020, the HA adjusted its services to cope with the outbreak. This should therefore be taken into consideration when comparing the service capacity of the HA in the respective years. With the subsiding of local COVID-19 epidemic situation and cessation of anti-epidemic measures in early 2023, the HA has been gradually resuming provision of all of its public healthcare services to tie in with the Government's normalcy measures.
(2) A number of drugs can be used for treatment of depression and different drugs have their efficacy and limitations. Nasal spray antidepressant (Esketamine) is one of the drugs. The nasal spray antidepressant (Esketamine) has been included in the HA Drug Formulary since July 2023.The respective numbers of patients prescribed with nasal spray antidepressant (Esketamine) in the HA in 2023-24 and 2024-25 (projection as at December 31, 2024) were approximately 20.
The HA currently provides drugs, Electroconvulsive Therapy and Transcranial Magnetic Stimulation for the treatment of depression. Healthcare professionals will arrange appropriate treatment to patients with depression according to their medical conditions, clinical needs and risks, as well as taking into the consideration the patients' preferences. The HA has been expanding the coverage of its Drug Formulary through an established mechanism to provide long-term sustainable, affordable and appropriate support to patients with mental health needs.
The HA will continue to review its mental health services and treatment options (including treatment of depression) according to latest scientific evidence and clinical needs to provide appropriate support to patients in need.
Ends/Wednesday, April 16, 2025
Issued at HKT 16:00
Issued at HKT 16:00
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