Mental illness among youth
By Charis Ma
Charis Ma Stressful and crowded living environments contrivute to mental illness.
A general household survey conducted by the Census and Statistics Department in 2000 shows
there are about 50,000 mentally ill people in Hong Kong.
Compared to 10 years before, the number of psychiatric patients in hospitals, including drug abusers and alcoholics, has doubled from 16,296 to 34,768. The figures come from the Department of Health.
Prof. Daniel Shek in the Social Work Department at The Chinese University of Hong Kong attributed the rising trend to social changes during the past decade.
"The social events - skyrocketing flat prices before 1997, emigration, the handover of Hong Kong to China, financial crises, economic turmoil and negative assets – have brought much stress to Hong Kong people," said Prof. Shek.
He said that there is an atmosphere of insecurity in society. Most Hong Kong people have low expectations about their future. Teenagers are no exception, he added.
The Hospital Authority's figures indicate that the number of mentally ill patients below 15 years old nearly doubled, from 1,355 to 2,321, in the past three years.
"Most of them encounter emotional and behavioral problems," said Prof. Kelly Lai, associate professor in the Department of Psychiatry at The Chinese University of Hong Kong.
The emotional problems include depression, anxiety, insomnia, loss of appetite and being unable to concentrate. In extreme cases, teenagers may show suicidal tendencies.
The behaviourial problems include stealing, challenging authority, running away from home and playing truant.
These problems are different from emotional instability and teenage rebellion in terms of persistence and frequency.
"If the problem persists over a long period of time and affects the daily lives of teenagers, then it is an indicator of psychiatric problems," said Prof. Lai.
Prof. Shek added that the mental problems of teenagers are often associated with their family problems.
Mentally ill peoople usually suffer from family quarrels and poor family relationships.
"For Chinese people, family harmony is of the utmost importance," he said. "The family is the source of security for teenagers."
A broken family causes anxiety in teenagers. They are distressed by the lack of family support, he added.
He said the disintegration of traditional culture also contributes to the rising trend of adolescent mental illness.
"The growing number of nuclear families implies diminishing social networks and support.
"On the other hand, the craving for sensory stimulation among teenagers overwhelms the meaning of life," he said. "They are easily depressed when they fail to materialize their desires."
In addition, if they are isolated by peers, they become distressed and have low self-esteem.
"Stress alone does not trigger mental illness," said Prof. Lai. She pointed out that everyone faces life changes that induce stress.
"The crux of the problem is whether an individual has sufficient coping resources."
Prof. Shek said that whether stress is destructive depends on the way teenagers are raised by their parents.
He said that today's teenagers are more vulnerable to stress since they are spoilt by their parents.
"Nowadays, teenagers are grown in a 'greenhouse'. They are well protected by their parents."
Therefore, they should build up coping skills such as seeking help from others and viewing problems in a more positive manner.
Prof. Lai said that adolescent psychiatric problems should be detected and referred for treatment at an earlier stage. This would expedite recovery.
"The problem will worsen and persist into adulthood if it is untreated," she said.
Prof. Shek said that perfectionism, a rigid personality and lack of coping skills are also risk factors.
Recently, there hs been growing concern over the detection of early psychoses.
Prof. Lai said that this aims at identifying high-risk group of schizophrenia patients.
Patients suffering from early psychoses will have symptoms similar to those of schizophrenia.
These include delusions, hallucinations and disorganized behaviours. The incidence of early psychoses among young people aged 15 to 25 is particularly high.
The Hospital Authority launched a pilot programme last year to assess 1,400 teenagers for the purpose of identifying those suffering from psychosis, a mental condition involving distorted perceptions of reality. These patients are unable to function in most aspects of life.
Prof. Lai said that more effort should be put into the prevention and early detection of mental illness.
"Social workers and teachers should do more in cultivating the all-round development of teenagers and building up their self-confidence," she said.
Prof. Shek emphasized the need for parent education. "Parents significantly influence the values and beliefs of teenagers," he said.
He said that parents should learn how to support their children and set a good coping model for them. Moreover, more communication is needed to bridge the gap between them.
In addition, he said that the high unemployment rate in recent years may result in an increase of adolescent psychiatric patients.
He stated that jobs provide teenagers a chance to develop their potential.
"Being unemployed gives them a sense of uselessness and despair, especially when they are no longer sheltered by schools," he explained.
According to statistics from the Census and Statistics Department, persons in the 15 to 19 age group had an unemployment rate of 21.2 percent in 2001. This was the highest of all age groups.
