A recent exhibition from the Society for Community Organisation (SOCO) aims to open up the world of the mentally ill in Hong Kong. In meeting them we learnt more about the failings in this Asian superpower that allow vulnerable and victimised members of society to fall through the cracks. Immigrants, the mentally ill, prostitutes (who are often also illegal migrants) and anyone struggling under poverty’s grip are an inconvenient truth for Hong Kong’s government and elitist society and one that it is ignoring at their peril.

 


‘Under the surface of prosperity lives a community that has fallen into oblivion’.


 

In a small and overcrowded city like Hong Kong it is incredibly hard not to see people, with everybody living on top of each other. Bedroom windows peek into the bathrooms, kitchens and bedrooms of others and people avert their gaze when their line of vision from their balcony goes directly through to see their neighbour sitting in their pants reading. This looking away makes living in a congested society bearable, yet also allows for a society to ignore terrible suffering.

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Most urban developed societies have flaws in terms of human visibility. Amongst the glittering lights of newly opened stores, hotels and wine bars lurks the spectre of the vulnerable who in large cities can often remain hidden with no one to directly bear responsibility for them. This is the deep contradiction of most developed urban communities and one that most would prefer to look away from.

 


We hope that you can lend your hands to build a bridge to help the people with mental illness come back from their islands to the mainland.


 

I spoke with Tim Pang and Yuen Shuk Yan who are community organisers from the Society for Community Organization (SOCO). Asked how much of a problem they see mental health issues to be in Hong Kong  they responded; ‘The problem is big.  Nearly a million people in Hong Kong are suffering from some kind of mental illness.  People with mental illness face discrimination from the public and do not have adequate community support. There are several official figures with the Census and Statistics Department having conducted two surveys on people with disabilities and chronic illnesses in 2001 and 2008.  The number of people diagnosed with mental illness is estimated to be 50,500 and 86,600 accordingly.

In 2005, Department of Health released their “Population Health Survey’ report.  In it it was estimated that there were 200,000 people with various kinds of mental illnesses.  In 2012, a government funded territory-wide mental health survey revealed that 14.5% of the population, i.e. about 1 million people suffer from various kinds of mental illnesses.  These figures are a scientific estimation and the number of patients using public psychiatric services may give more exact figures.  In 2012/13, there were 197,600 psychiatric patients , but this figure only covers public patients.  Those consulting private psychiatric will easily go under the radar along with those seeking no help.

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SOCO’s latest investigation and work brings us stories from people of all sorts of backgrounds, all suffering from mental health illness and all subjects of common themes of isolation, poverty, inadequate housing and a gradual retreat from friends and family. Divorce, drug and alcohol use and a lack of employment are common aspects of their lives. There is a chronic lack of monitoring, a lack of money proportioned for medication and all subjects have spent some time living in what should be deemed subhuman standards. From my time spent with SoCO it became apparent that they are performing a crucial social service with absolutely no government funding. Without their work many of these people would be completely unaided, left alone often in slum dwelling to deal with their mental and physical health issues with no organisation checking in on them at all.

In a growing city with money being flung from side to side there is a common thread in Hong Kong of a lack of apportioning of that new money to the very people who so desperately need it. A lack of willingness for society in general to be honest about the community’s mental health issues, for the mental wellbeing of a city as a whole should be a priority for all, not just for grassroots organisations like SOCO. Each of Hong Kong’s 160 medical social workers have between 80 and 100 cases to handle.

 


‘Insufficient manpower in community support makes it difficult to serve an estimated 200,000 people in Hong Kong with mental illness problems’


 

Another issue is of that of poor coordination. SoCo explained, ‘The government has no over-arching mental health policy to guide the direction of service provision and development, as well as to coordinate the relevant services.  Different government departments are working separately on mental health issues, they are not coordinated together to work in the same direction.  Also, there is no designated authority to formulate relevant mental health policy and coordinate the existing services.’ When departments interacting with the same group of marginalised people in different aspects do not communicate adequately with one another there become gaps in services and a lack of overarching responsibility.

Job opportunities for those living in Hong Kong with mental health problems are limited largely to shelter workshops and supported employment. Whereas other countries have laws to enforce both public and private companies to maintain a certain ratio of disabled employees in Hong Kong, the HKSAR government employs 3478 disabled people on a full and part time basis amongst whom only 279 have mental health issues. Only 21 of the 369 statuatory bodies and government funded organisations in Hong Kong have set up guidelines for employment of the disabled.

Suicide in Hong Kong is highest amongst the elderly and is also high amongst middle aged women and young men. Professor Paul SF Yip, Director of HKJC Centre for Suicide Research and Prevention, has this to add, ‘the community should de-stigmatise suicidal behaviours and be more supportive to those suffering from mental illness and suicidal problems to encourage them to seek help’. The annual global age-standardized suicide rate is 11.4 per 100,000 population.  In Hong Kong, the rate is 12.3 in 2013 according to the centre for suicide research.  According to SoCO, ‘ The stigma surrounding suicide is incredibly negative within Chinese culture, surviving family members do not find it easy to admit their relatives committed suicide.’

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A comment from CY Leung (the controversial chief executive of Hong Kong) in early 2015 stated that democratic elections were impossible in Hong Kong, ‘as democracy would see poorer people dominate the Hong Kong vote.’ In a society where mental health is difficult to talk about, where the poor and vulnerable and mentally ill are being increasingly marginalized and where the government refuses to acknowledge that with their economic growth has come real civilian casualties, organisations like SoCO work as the sole source of aid for these people. The government and society must step up.

To support SoCO; http://www.soco.org.hk/news/one%20off_donation_form.pdf

To learn more about SoCO’s activities; http://www.soco.org.hk/

If you’re interested in seeing where your volunteer services might be most needed in Hong Kong; http://handsonhongkong.org/