The “Mind HK” online resource: Multiple transitions in information delivery in mental health care in Hong Kong

Abstract

This paper presents data from an on-going funded study of mental health services in Hong Kong. As is commonplace worldwide, mental healthcare in Hong Kong is largely under resourced. A growing number of diagnosed patients (and many, if not the majority, of patients still going undiagnosed), the limited available infrastructure and the workforce put a huge strain on the existing public and private healthcare systems. According to media reports there are approximately 1.7 million Hongkongers suffering from mental illnesses of different severity (Breaking Point, 2016), and there are only approximately 400 registered psychiatrists to cater for this group of the population. Proportionally, this is less than half of the staffing levels of Australia and less than a third of those in the UK (World Health Organisation, 2014). The built and social environment of urban areas can significantly impact mental health (Galea and Vlahov, 2005); with its high population density and pressures of limited space, this is particularly pertinent to Hong Kong. While it is commonly acknowledged that unresolved mental health issues lead to serious social, psychological, health, etc. consequences in individuals and in society as a whole, in comparison to other countries (e.g. the UK, the USA and Australia) there are still very limited efforts on the part of private and public organizations and researchers to address these issues in the specific context of Hong Kong. Discourse-oriented research has much to contribute to this gap for much of the work of mental healthcare professionals is done through language and communication. While in other countries, discourse scholars have been actively engaged in research into mental health issues (see, for example, Brown et al, 2014; Crawford et al, 2013; Leishman, 2004 in the UK; Lawn et al, 2016 and Mitchell, 2009 in Australia; and Mancini, 2011 in the USA), we believe that our discourse-based study of mental healthcare services is the first of its kind in the Region. To examine the specifics of mental healthcare provision in the context of Hong Kong we focus on the accounts of mental healthcare professionals who have received their professional training outside of Hong Kong and relocated to Hong Kong for work. These professionals comprise a significant proportion (around 1/7) of the workforce in Hong Kong. Using discourse analysis we analyse 10 semi-structured interviews with psychiatrists working in the private sector. In line with Arribas-Ayllon et al. (2011) we draw on a notion of accounts, understanding language use as action-oriented, situated and strategic. We explore the intersection of healthcare systems, cultures and practices and the challenges that the transitions overseas have brought to this professionals and reflect on how these more localized transitions of individuals contribute to global transitioning of mental health services in Hong Kong.