Fifth wave offers lessons for improving Hong Kong’s healthcare system, but we must not forget about mental health
This article appeared originally in the SCMP on 15 April, 2022.
Authors: Dr. Pamela Tin, Assistant Research Director and Head of Health Care and Social Development, and Dicky Chow, Assistant Researcher at Our Hong Kong Foundation
Since the beginning of Hong Kong’s fifth Covid-19 wave, more than 1 million people have tested positive and over 8,000 lives have been lost. Among the many system failures exposed by the pandemic, residents’ mental well-being deserves urgent attention.
A 2020 study by the University of Hong Kong show that the proportion of Hongkongers suffering from probable anxiety and depression is close to 14 per cent and 19 per cent, respectively. The Hong Kong Jockey Club Centre for Suicide Research and Prevention has recorded a rise in the suicide risk index to “crisis” level during the fifth wave. The outbreak has gradually morphed into a mental health crisis which cannot be ignored.
Various sectors of the community, with the help of the government, have worked to mobilise resources and provide flexible services to support the mental health needs of Hongkongers. The government’s “Shall We Talk” initiative provided tips and seminars; HKU’s “Headwind” offered remote mental health intervention and free consultations with psychiatrists; Mind HK offered free online support for vulnerable groups; while various organisations such as the Richmond Fellowship of Hong Kong and Caritas Hong Kong provided remote services such as telephone counselling.
Yet Hong Kong’s overall approach to the pandemic and the allocation of resources depend on clear direction from the government to ensure that services are reaching those who can benefit from them.
Looking forward, the government will need to identify vulnerable groups in need of immediate and post-pandemic mental health support, coordinate with different service providers, and strategically allocate resources according to needs.
Those most at risk include but are not limited to the elderly – particularly those living in care homes – children, their families and frontline workers. Needs could range from information resources or financial support to longer-term policy-level initiatives that support the development of mental health support infrastructure. Regardless, prompt planning and action will be necessary.
Culturally taboo, death has become a topic of reluctant discussion in the city. Focus has been fixed on the ineffectiveness of practical and administrative procedures. Not to be forgotten, though, is that social isolation measures have also prevented people from providing end-of-life care for dying relatives.
Such provisions can alleviate negative emotions during the last stages of life, both for the patient and for their loved ones. However, circumstances have meant that patients have spent the last stages of life alone, with their loved ones unable to say goodbye.
The resulting mental health impact is real and deserves extra attention as society works towards providing timely support to the most vulnerable. In acknowledging that end-of-life care extends beyond the death of an individual, support for bereaved relatives becomes especially crucial.
Again, community initiatives have extended support to patients, their families, and the bereaved during the pandemic. Worth noting, however, is that although the government conducted a public consultation on the legislative proposals for end-of-life care in 2019 that resulted in a consultation report, past discussions on the topic have mostly remained at the legislative level.
There remains room for discussion beyond legislation for end-of-life care arrangements in Hong Kong, particularly in relation to the coordination of different community sectors to provide support. Moreover, this support should extend far beyond the pandemic.
The impact of Covid-19 on mental health can vary significantly over time and across populations, and the government needs to plan ahead. In October 2020, Singapore had already recognised the emotional toll Covid-19 was taking on its citizens and set up an interdepartmental Covid-19 Mental Wellness Taskforce. In its report released last September, the taskforce pointed out major gaps in mental health services and gave recommendations for long-term mental health policies and strategies.