Using technology to improve HK's mental health services

This article appeared originally in the China Daily on 3 February, 2023.
Authors: Pamela Tin, Head of Healthcare and Social Development, and Bubble Lui, Assistant Researcher at Our Hong Kong Foundation.
 

‘There is no health without mental health,” according to the World Health Organization.

Mental health is crucial to one’s well-being. However, Hong Kong residents’ mental health has steadily worsened in recent years, especially since the COVID-19 pandemic. A local study surveyed 1,000 adults in March 2022 and found that nearly half of them (49.4 percent) showed depressive symptoms, and 41.3 percent showed anxiety symptoms.

Despite the mental health problems, the Hong Kong Mental Morbidity Survey 2010, the first and only communitywide epidemiological study of mental disorders among people aged 16-75 in Hong Kong, found that the majority (74 percent) of those with common mental disorders, such as depressive and anxiety disorders, did not seek help from mental health services.

There are perceivably several barriers preventing individuals from seeking mental health care. Some individuals could be restricted by their busy work schedules. Mental health remains a taboo topic in many societies and in the Asian culture; mental disorders are sometimes perceived as a forbidden and shameful topic associated with danger and weakness. These challenges and considerations make it hard for individuals to take the first step and seek appropriate mental health care, which doesn’t only negatively impact their quality of life but also society, such as being absent from work and affecting productivity, as stated by the Organization for Economic Cooperation and Development. To encourage individuals to take the first step and seek help, there is a need to investigate ways to alleviate the problems brought up by these barriers.

An accessible and less stigmatizing platform

Digital mental health care uses technology to deliver a full spectrum of care, including mental health prevention, assessment, treatment, and management services. Our Hong Kong Foundation’s (OHKF’s) 2022 mental health research report “Towards a Fit-for-purpose Mental Health System” recommends digital mental health care as a way to enhance service accessibility beyond the formal care system in everyday life settings that should be normalized in Hong Kong.

In fact, digital mental health care is easily accessible and sometimes anonymous, making it an accessible and less-stigmatizing mental health service platform that can alleviate the above-mentioned barriers and encourage individuals to take their first step and seek help.

Although digital mental health care is continuously developing in Hong Kong, there are already plenty of established digital mental health services available in Hong Kong. Some services are of a lower intensity but greater in flexibility, such as self-administered internet-based cognitive-behavioral therapy, 24/7 support hotline services provided by various NGOs in Hong Kong, and mobile app-based programs. Simultaneously, there are services with higher levels of intensity that are more like traditional face-to-face treatments but in virtual form, such as telepsychiatry and teletherapy provided by psychiatrists and clinical psychologists in the Hospital Authority and Social Welfare Department.

Digital mental health care is an ideal platform for many individuals, but a lot of them might not know where to seek help due to the availability of a wide range of services. Imagine an individual feeling depressed and willing to take the first step and seek help. He, or she, might be overwhelmed by the abundant availability of services and wonder whether to call NGOs’ 24/7 support hotlines or seek digital help from psychiatrists, clinical psychologists, or social workers.

Therefore, to encourage those seeking help, it is important to think from the user’s perspective and make the process easier for the service user, such as helping to streamline the services suitable for them.

Leverage existing digital platforms for signposting

OHKF’s mental health report looked into the possibility of digital signposting and recommends leveraging existing platforms such as the government-led digital mental health initiative Shall We Talk.

Shall We Talk is a government-led digital mental health initiative set up in 2020, which aims to increase public awareness of mental well-being, reduce mental health stigma, and encourage help-seeking behavior and early intervention.

Shall We Talk enables users to assess the extent of their psychological distress by filling out the Kessler Psychological Distress Scale on their website anonymously. Separately, it offers comprehensive information on the available in-person and digital mental health services in Hong Kong.

Since the information and assessment are already available on the Shall We Talk website, the next step is to make the information easier for service users and help them seek the type of care they need. As an example, enhancement can be made to the platform’s signposting function by including an anonymous online assessment that functions as a self-referral tool, where the user can be informed on what digital or in-person services are most appropriate based on the results of the self-assessment. This process helps simplify the options for individuals and refers them to services that can optimally address their needs.

It is exciting to see the continuous development of digital mental health care in Hong Kong, such as the special administrative region government launching a novel mental health support hotline as indicated in the 2022 Policy Address. However, to fully realize the benefits of this accessible and less-stigmatizing platform, it is crucial to look at the problem from the user’s perspective and make the process easy for them, including proper service information organization and individual self-referral, to truly achieve the goal of encouraging individuals with mental health problems to seek help and move toward a city with better mental health.