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The Government established the Review Committee on Mental Health in 2013, which
subsequently released the Review Report in 2017 that set out key directions and
suggested initiatives needed to enhance the local mental health service landscape.
These efforts have been spearheaded by the Advisory Committee on Mental Health
(ACMH). Notably, the Review Report called for more persons (particularly adults) with
CMD to receive care at the primary care level, to offload pressure from PSY SOPCs.
Our report leverages this momentum, explores how this can be actualised, and
further considers how the focus of care can be broadened towards more upstream
services, such as prevention and early intervention for the general population.

A fit-for-purpose mental health system
requires structural changes across sectors
at all levels

In line with OHKF’s advocacy for a fit-for-purpose health system, we envisage the
city’s mental health system to be more person-centred, primary care-led, and
integrated. Keeping with the Government’s latest efforts in strengthening and
promoting a primary healthcare reorientation of the health system, mental health
must also be anchored as a core component of primary healthcare. We
propose that mental health system integration happens along four key axes:
between primary and secondary care, psychosocial and medical services,
public and private sectors, and physical and mental health. Realising the vision
requires changes to existing system structures and innovating models of care.
In particular, to leverage the momentum created by the ACMH, more timely and
effective initiatives are needed to address ever-increasing mental health needs,
especially among persons with CMD and the at-risk population. The Government
should take on an evidence-based, innovative approach to mental health policy
development. This involves proactively designing transformative solutions to meet the
city’s mental health needs, conducting large-scale trials for promising projects, and
rigorously evaluating such programmes for cost and clinical effectiveness.

Through interviewing 77 key stakeholders across medical, social, academic,
government and other sectors, conducting two focus groups with mental health
service users, and collecting opinions from key service providers in the community
through questionnaires, we map the landscape of mental health services, identify
the service gaps and challenges in accessing suitable services, and analyse how
capacity in the community particularly at the primary care level can be better
leveraged for mental health service provision in Hong Kong. We put forward
five policy directions and 14 key recommendations that contribute to the
transformation towards a fit-for-purpose mental health system.

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