Conditions are no better when it comes to psychiatric rehabilitation services. Peter Hui Wai-chun, a registered social worker who has worked for the Concord Mutual-Aid Club Alliance, a patients’ group for seven years, says: “A social worker has to handle 70 to 80 cases. On average, they see a patient once every one to two months, most of them just contact patients via phone calls.”
Hui says the lack of manpower creates high pressure and stress for social workers. Many of his peers and colleagues in psychiatric social work and community mental health services leave the field or transfer to other social work sectors.
The shortage of frontline mental health professionals also affects the quality of care received by each patient. 55-year-old Ching, who does not wish to disclose her full name, suffers from depression. In her experience, public hospital doctors have no time to explain the side effects of psychiatric drugs and conduct non-drug counselling.
“The time given is not enough, but I know they [doctors] have to handle a lot of cases. I feel I should not take up so much time, so, I will automatically not to talk too much with them,” she says.
Michael Mak Kwok-fung, president of Hong Kong College of Mental Health Nursing, thinks the poor human resources planning and management in this area shows the government has adopted a piecemeal and reactive approach to handling mental health care. Mak says the administration only allocates resources to a certain area when there is a problem, such as when there is an incidence of violence committed in the community.
Mak thinks the government pays little attention to mental healthcare planning because people with mental illness and mental health problems do not have much of a voice in society. They are afraid to speak out because of social stigma. “Stakeholders are being discriminated against; whoever helps to voice their opinions faces discrimination too. For many years, we have cast these people into a corner, so no one knows about the problem,” says Mak.
As long as the faces of those with mental health issues are hidden, they have little bargaining power when fighting for greater allocation of resources. Mak says that only those with strong public voices will be given more resources.
The lack of mental healthcare resources in general has also exacerbated a persistent perception that public hospitals in Hong Kong only prescribe older psychiatric drugs because they are cheaper.