Replies to LegCo questions

LCQ13:Psychological counselling for young people

Following is a question by the Hon Lau Kong-wah and a written reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (February 18):

Question:

Regarding the seeking of psychological counselling by young people in Hong Kong, will the Government inform this Council:

(a) whether the number of cases involving young people aged below 30 seeking psychological counselling has shown an upward trend in Hong Kong in the past three years;

(b) of the percentage of young people receiving psychological treatment among people in the below-30 age group, and the percentage of such young people suffering from serious emotional or mental disorder;

(c) whether the authorities have reviewed the adequacy of the private/public sector psychological counselling services available to young people in Hong Kong, and whether they have assessed if the future demand for such services will increase; if they have made such a review and assessment, of the respective results;

(d) of the average waiting time for young people to receive psychological counselling services at present, and the measures in place to alleviate the shortfall of services; and

(e) whether the authorities will step up publicity to encourage young people under mental stress due to work or family problems to care for their mental health and seek professional assistance?

Reply:

Madam President,

(a) A wide spectrum of psychological counselling/treatment services is generally provided by the Social Welfare Department (SWD), subvented non-governmental organisations (NGOs) and the Hospital Authority (HA)(*1). The clinical psychologists of SWD and NGOs provide services to clients referred to them mainly by social workers of agencies providing social welfare services. The clinical psychologists and psychiatrists of HA provide services to clients referred to them mainly from within the medical setting. The current system of collating information is based on service figures from various units. Since a client may receive service from more than one agency at different point in time, there may be some overlapping of the numbers of clients across sectors.

The following service figures for the past three school years (i.e. 12 months ending August) are available:

(i) The number of clients aged 6-30 referred to clinical psychologists of SWD was 1,107, 1,063 and 1,053 in the school years 2000/01, 2001/02 and 2002/03 respectively(*2);

(ii) The number of out-patients(*3) aged 6-30 treated by clinical psychologists of HA was 4,912 for the six month period from August 2003 to January 2004. As the data was not computerised before then, the figures available were only the number of new patients(*4) (including in-patients and out-patients) for all age groups (separate breakdown by the age group of 6-30 was not available) treated by clinical psychologists of HA, and stood at 14,922, 15,834 and 14,222 in the school years 2000/01, 2001/02 and 2002/03 respectively.

Based on the limited statistics available as presented, there is no indication of an upward trend for referrals of young persons aged 6-30 for psychological counselling/psychotherapy.

(b) Since a client may receive service from more than one agency, there may be overlapping of cases. It is therefore not appropriate to derive from service statistics the proportion of young people aged 6-30 who have received psychological counselling/psychotherapy.

As regards the number of service recipients who have been diagnosed with more serious psychiatric/emotional problems, the following statistics are available:

(i) Of the figures in (a)(i) above, the number of clients aged 6-30 with diagnoses listed under the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition [DSM-IV] (a commonly used diagnostic classification system used in the mental health field), i.e. considered serious enough to warrant treatment by clinical psychologists of SWD, was 599, 576 and 554 in the school years 2000/01, 2001/02 and 2002/03 respectively. These clients represent 54.1 per cent, 54.2 per cent and 52.6 per cent of the referrals in the same age group to SWD's clinical psychologists in the respective years;

(ii) Of the 4,912 figure in (a)(ii) above, 3,937 were suffering from serious emotional and mental disorders; and

(iii) Generally, there were about 7,500, 8,400 and 9,000 patients aged 6-30 suffering from serious emotional or mental disorders (classified under the International Classification of Disability [ICD-10]) treated by HA psychiatrists in the school years 2000/01, 2001/02 and 2002/03 respectively. The increase observed was due to the implementation of the Early Assessment Service for Young Persons with Psychosis. This service run by HA proactively screens youngsters aged 15-25 referred to it by schools, NGOs, parents, social workers and doctors etc., for psychotic symptoms and treatment.

(c) Psychological treatment provided by clinical psychologists are mostly available from SWD, HA and NGOs. There are only a small number of clinical psychologists in private practice. SWD and HA review and monitor the demand for psychological services for all ages regularly. At present, it is envisaged that the current system will be able to cope with the demand for psychological services from young persons aged 6-30 in the near future, and we will keep this under review.

(d) At present, the waiting time for all age groups for the first appointment with clinical psychologists of SWD is eight to 10 weeks. For cases with urgent needs such as trauma victims and those who are severely disturbed, priority appointments would be arranged. Similarly, clients requiring services from clinical psychologists of HA are triaged according to clinical conditions; the average waiting time for all age groups for the first appointment with clinical psychologists of HA is six to 10 weeks but clients with urgent needs are seen within two weeks. The service demand is kept under review, and treatment plans and strategies may be revised (e.g. replacing individual therapy with treatment groups for suitable cases, using alternative theoretical models for different problems) as appropriate.

(e) The comprehensive range of mental health services targetted at the youth is publicised through talks, seminars, radio programmes, printed materials, advertisements in the MTR, mini-buses, the media, family life education programmes and other youth programmes run throughout the year. Examples include exhibitions organised by DH's Central Health Education Unit, the Adolescent Health Programme which promotes the psychosocial health of adolescents in secondary schools, and SWD's Operation Silver Lining which educates the public on seeking professional help. There are also thematic publicity/education campaigns such as the territory-wide campaign named 'Mental Health Month' run annually by the Health, Welfare and Food Bureau, NGOs, district-based bodies and government departments, to raise public awareness and knowledge in mental health.

Some of the programmes also target at those who have constant contact with young persons. For instance, public education targeting at school teachers, social workers and parents forms an important component of HA's Early Assessment Service for Young Persons with Psychosis.

All relevant parties would keep the momentum to encourage young people to seek early assistance when they have such needs. Our publicity and education programmes will also be reviewed from time to time to ensure that they are effective in bringing the message to our target audiences.

Notes:

(*1) The Department of Health has a small number of clinical psychologists, offering assessment services for referral purposes. Since only very limited psychological casework service is involved, statistics on such psychological casework services have not been included.

(*2) Separately, seven non-governmental organisations (NGOs) offering family welfare services have clinical psychologists, of which four NGOs indicate that they have handled 160, 135 and 174 cases (involving young people aged 11-30) in the school years 2000/01, 2001/02 and 2002/03 respectively.

(*3) The figures are patient headcounts.

(*4) "New patients" are defined on an episodic basis. The figures are not patient headcounts.

Ends/Wednesday, February 18, 2004
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