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Policy direction 1:
Hong Kong must optimise service accessibility
through current care models, particularly in
non-hospital settings
Hong Kong’s mental health support system is mismatched to population needs. Of
the people willing to seek professional mental health support, over half (53%) see a
psychiatrist, showing that the majority default to seeking specialist care even if their
needs could potentially be met in lower-level non-specialist care settings (Lam et al.,
2015). A shortage of care professionals coupled with underutilised providers fuel this
mismatch, but simultaneously offer potential opportunities for optimising existing
service providers to right-site patients for a more timely and appropriate level of care.
Psychiatrists and clinical psychologists (CPs) are core mental health service
providers within Hong Kong’s existing service landscape. Hong Kong’s psychiatrist-
to-population ratio is currently 7.55 per 100,000 persons, trailing behind the OECD
average of 18.00 (FHB, 2022; HKCPsych, 2022; OECD, 2021). Similarly, the local CP-
to-population ratio is 8.15 per 100,000 persons, which lags behind the OECD average
of 53.00 (OECD, 2021). The Government should continue to address the observed
shortage of psychiatrists and CPs to ensure adequate support for mental health
service provision. To better understand the challenges associated with manpower
supply, the Government should stratify the projected healthcare manpower supply
by specialty to better estimate the shortage situation and subsequently mandate
additional headcount according to the estimations. Additional studies into the local
CP supply should be conducted to offer insight into CP supply gaps.
To achieve a community-centric vision in mental health service provision, while
putting emphasis on the importance of multidisciplinary care teams, general
practitioners (GPs) and/or family medicine specialists (FMs) should be better
leveraged in the provision of mental health care. The Government should continue
developing a public-private partnership (PPP) between PSY SOPCs and private
practitioners, and consider using strategic purchasing as the key design and
implementation framework. This strategic approach should include consideration for
targeting persons with CMD assessed to be in a stable condition, and mobilising GPs
and FMs with demonstrated clinical competency in mental health care and who have
received additional training where appropriate.
In keeping with the need to build up community-centric mental health support
particularly within the primary care level, the Government should also look toward
reassessing the role of Integrated Community Centres for Mental Wellness (ICCMWs)
in supporting persons with CMD. To better understand the present challenges
experienced in service provision at ICCMWs, OHKF conducted a survey that was
completed by all 24 ICCMWs in Hong Kong. Survey results point to challenges
experienced in service provision within ICCMWs, such as a shortage of social
workers, mismatched ICCMW service target group, limited physical space, and
inadequate training for evidence-based interventions, despite recent efforts to
boost manpower supply and increase physical space accessibility. These reported
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