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challenges substantiate the majority opinion (over 79%) of ICCMW operators that
a reassessment of ICCMW services is needed. In particular, given the increase in
demand for evidence-based psychological interventions in the community, the Social
Welfare Department (SWD) should re-evaluate the role of ICCMWs in delivering more
evidence-based psychological services and to provide training and support
as necessary.

As a key primary healthcare initiative that functions as a service and resource hub for
health promotion and disease management, District Health Centres (DHCs) should
be better leveraged in the coordination of mental health support. Currently, DHCs
almost exclusively focus on physical health. The Health Bureau (HHB) should explore
incorporating more mental health services into the DHC service model to enable
integrated physical and mental health care, to reduce mental health stigmatisation,
and to facilitate early detection and early intervention. To understand the attitudes of
DHC operators in relation to the delivery of mental health care, OHKF invited all
18 DHCs and DHC Expresses to participate in an online survey, receiving 15 responses.
Most respondents agreed that DHCs should provide psychological support (60%).
The HHB should review the DHC/DHCE service model with consideration for
enhancing capacity in coordinating mental health support, including the provision
of mental health services by network medical providers and community-driven
services. Additionally, the HHB should ensure clear role delineation in the provision of
mental health services, and consider creating a formal relationship and case sharing
protocol between DHCs and ICCMWs.

Policy direction 2:

Hong Kong should strengthen formal care models for
diverse mental health needs

To mediate the service bottleneck in the public sector, beyond exploring how existing
professionals and services at the primary care level and community settings can be
leveraged, revisiting and enhancing the overall service models for formal and informal
mental health care is also needed. Interviews with stakeholders have revealed that
persons with CMD have narrow access to psychological services in the public sector,
with most psychological services catering to persons with more severe mental
health issues, and most psychological therapies being specialist-level interventions.
Generally, psychological therapies are observed to be under-provided for persons
with less severe mental health needs in the public sector.

The Government should optimise stepped care, which applies the appropriate
intensity level of psychological therapies based on risk stratification of patients,
in the provision of mental health services with a view to improving accessibility of
low-intensity interventions. Stepped care services have been adopted to some
extent by the public sector and some NGOs in Hong Kong, which show promising
preliminary clinical effectiveness, however, without a more top-down approach, these
projects suffer from a lack of sustainable funding and provider interest. To implement
accessible stepped care services, the Government should consider piloting stepped

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