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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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