A review of child and adolescent mental health services in Hong Kong

Abstract

Background and Objectives The prevalence of child and adolescents mental health problems has been increasing in Hong Kong and is comparable to that of the world. It is estimated that the mental health problems of the future generations would account for 15% to 30% of their disability-adjusted life years (DALYs) and become a healthcare burden on societies in the near future. Therefore, it is necessary to address their mental healthcare needs now. The objective of the project is to review how the mental health services for children and adolescents have been changing in Hong Kong throughout the past few decades and to assess whether the local services have improved. While the service advancement in adult and old age (for example dementia) psychiatry has been significant, the children and adolescent mental health services would be reviewed by using the Donabedian framework. Based on some local and western models, the project will also address what the local healthcare providers can do for the children and adolescents with the capacity of developing multi-disciplinary and community-based integrated care as well as primary care and prevention. Service gap and areas of improvement on addressing the healthcare needs would be identified for the consideration of policymakers.

Methods This project is a literature review. Archives of the Hong Kong College of Psychiatrists and Paediatricians, PubMed, PsycInfo, World Psychiatry, Lancet, etc have been searched with keywords including “children”, “adolescents”, “mental health services”, “child psychiatry” and “Hong Kong”. Journals from 1991 to 2011 have been retrieved. Publications and official sites of Hospital Authority and government organizations have also been searched.

52 journals, articles and online sources have been searched. 38 papers are identified and 19 are providing relevant materials. Studies with aggregated population level data rather than clinical studies which focus on symptoms and treatment of individuals are much more useful and providing more relevant information to this project.

Results Secondary and tertiary care, in terms of screening, detection, in-patient and out-patient setting and rehabilitation services have been developed in Hong Kong since the 1980s whilst there are rooms for further development on primary care and prevention. An integrated approach, which emphasizes early identification and treatment by specialists-led multi-disciplinary professionals, has been more prominent. The stigmatization, which would result in reluctance of treatment, should also be addressed by enhancing the public understanding and awareness on the mental healthcare needs of children and teenagers.

Conclusions It is necessary to work on the improvement of child and adolescent mental health in the primary, secondary and tertiary care in Hong Kong at present. Policymakers shall consider strengthening the support for child and adolescent psychiatry services in addition to the adults’.