Two stories on the same day nicely illustrated Hong Kong’s attitude to mental illness.
One concerned a legislator (no names or party affiliations, not to protect the guilty but because I have sworn off politics) who suggested that “recovering mental patients” could be shipped across the border to the Greater Bay Area to complete their recovery in the bosom of the motherland.
This was too much even for The Standard’s anonymous editorial writers, who generally approve of suggestions from pro-government legislators – virtually the only kind we have these days.
Whoever “Mary Ma” was on the relevant day, she was quite scathing about the idea: violation of “one country two systems,” example of misguided patriotic “babyism”, mental health entirely a matter for Hong Kong, and the public wished mentally ill people to be cared for close to — or better still where possible — by their families.
A more entertaining report said that you could now buy on the usual internet shopping sites tote bags and T-shirts decorated with the logos of the Castle Peak Hospital and the Siu Lam Psychiatric Centre. The latter is run by the Correctional Services Department and accommodates mentally ill prisoners, including those so ill as to be indigestible by the legal system.
Under the logo, in Chinese, are the words “discharged patients’ souvenir”. I find it difficult to believe that people would take this seriously. Would a discharged patient really want a “souvenir” of what is rarely a pleasant experience? Having been given such a thing, would they wish to flash it in the street?
Still, purchasers reported interesting effects from carrying a bag of this kind. Several claimed that colleagues started treating them more civilly. Some said they felt “safer.” One user was reported as saying that “People gave me their seats on public transport and police would escort me on the streets.”
In fairness to netizens, who are often portrayed as boundlessly gullible, some people thought the bags were a parody. However the government is reportedly taking them seriously. The Customs department warned of possible criminal liability for trademark abuse, the Equal Opportunities people waved the Disabilities Discrimination Ordinance and the hospital management said the public should “understand mental health issues in a positive manner.”
But there we have Hong Kong and mental illness in a nutshell: the wish that the whole problem would go away, preferably to Shenzhen, and a lingering fear of anyone who has a problem of this kind.
These attitudes go back way beyond the Handover. Late-period colonial governors understood that their duties included turning Hong Kong into a respectable facsimile of a European social democracy: a colony of which citizens of a welfare state need not be ashamed.
So with varying degrees of reluctance colonial civil servants constructed a rather sketchy social security system: public housing, public hospitals, government schools, money for poor people…
And after the Handover, when the pressure was off, the same people started surreptitiously dismantling the whole thing. Public housing construction ceased, hospitals started charging for some medicines, universities charged the full cost of some courses.
But there was no need to curtail the provision for mental health because this had simply been missed out in the first place. Hong Kong has, for example, fewer than 400 psychiatric doctors, about half the number the World Health Organisation recommends for a population of our size.
In official theory we will catch up with the WHO’s recommendation in about 20 years. But given that doctors generally, and psychiatrists in particular, are warmly welcomed in all the most succulent emigration destinations, a more realistic timetable would involve the word “never.”
We also have 600 clinical psychologists, who aspire to help. But they are not doctors, and consequently are not allowed to prescribe drugs. As the treatment regime for the more serious kinds of mental illness usually involves suppressing the symptoms with drugs for a year or two in the hope that the ailing brain will sort itself out, the heavy lifting falls to the psychiatric doctors.
As a result the wait to see one of these people can be up to two years, and the average “consultation” lasts eight or nine minutes. For what this feels like at a personal level I recommend The Impossible City, a Hong Kong memoir, by Karen Cheung. Unfortunately you are unlikely to find this in your local library.
For comparison, while we have about 1,000 mental health professionals, we have 15,000 medical doctors of the conventional kind, 25,000 social workers, and 34,000 police people. Priorities?
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