Mental health problems in Hong Kong have traditionally been an issue the city’s residents have elected to suffer in silence due to social stigma. In the past, many Hong Kong residents would attempt to downplay, or hide the extent of their own or a family member’s mental health issues. Openly addressing the taboo subject in wider society was frequently avoided, often with tragic consequences.
In 2015, the 15-year-old daughter of a British businessman fell to her death from the family’s Repulse Bay flat. The parents, soon after, were arrested on suspicion of ill-treatment when police discovered the teenager and her sister had not been issued birth certificates in the Hong Kong Special Administrative Region, nor had they possessed ID cards or been formally enrolled at any Hong Kong school, but rather, they were attending various learning centers in place of receiving a formal education. In essence, the parents had irresponsibly chosen to hide their daughters from the purview of any governmental entity, showing little thought for how negatively the girls’ eventual realization of their hidden status in the city might affect their mental health.
In August 2018, Cantopop star Ellen Loo, 32, shocked her fans when she fell to her death from her Happy Valley flat. It was later revealed that Loo had been diagnosed with bipolar disorder in 2013 and in her final social media post, wrote: “I am going to do something great today — it is one of the decisions I made for myself since I turned 30. I finally understand why people like to take selfies of themselves as you really want to take a picture of yourself when you have a high morale.”
Police found no evidence of foul play in Loo’s death, leading fans to the painful summation that her final social media message was, in fact, a call for help that purposely hid the mental anguish she was suffering, and perhaps, felt she needed to keep hiding. These two high-profile examples pale in comparison with the number of local student and adult suicides that have created hundreds of heart-breaking obituaries in this city’s newspapers for years.
However, a study of Hong Kong’s suicide statistics and the Chinese mainland’s progressive initiatives to deal with mental health issues paints a brighter outlook than the above examples suggest. Perhaps too, they can offer a modicum of solace to anyone recently suffering from losing a loved one due to mental health issues. According to the Hong Kong Jockey Club Centre for Suicide Research and Prevention’s yearly reporting on the HKSAR’s suicide rates, since 2003, the suicide rate in the city has been dropping consistently, following a sharp rise in the immediate years post 1997, reaching a high of 18 percent (per 100,000 people) in 2003, then dropping sharply to 15.5 percent in 2004 — an important year for China’s mental health initiatives, because after the 2003 high, what followed was a consistent reduction to 12.1 percent as of 2021. The initiatives that helped lower the suicide rate in China go back further than is commonly known.
During the Tang Dynasty (618-907), homeless widows, orphans and those suffering from various then-unnamed psychoses could find solace and humanitarian care in the Bei Tian Fang charity facility operated by Buddhist monks, long before US missionary John G. Kerr established and funded the
John G. Kerr Refuge for the Insane (now the Guangzhou Brain Hospital) in 1898. According to records kept in the Chinese Buddhist Cyclopedic Foundation based in Yongkang City in Zhejiang province, the mental health programs of the Tang Dynasty show that China has a much longer history of addressing mental health issues suffered by its people than the West does. As the collective West was adopting the findings of Sigmund Freud’s and Carl Jung’s psychoanalysis research in the late 1800s and early 1900s, China had already been progressively addressing the mental health of its people for almost a millennium.
From the humanitarian Tang Dynasty’s efforts to the West’s mental health methods arriving in China in 1898, when we fast forward to 2004, we find a progressive proposal on further strengthening mental health work being approved by China’s ministries of health, education, public security, civil affairs, justice and finance, showing an almost total agreement within the government that the mental health of all Chinese citizens is a priority.
Initially called the 686 Program, the initiative would in 2006 implement an intervention arm called the National Continuing Management and Intervention Program for Psychoses where four types of psychoses were targeted for special focus — schizophrenia, bipolar disorder, delusional disorder, and other schizo-affective disorders. A comprehensive training program for medical professionals in the mental health field was also developed by Peking University Institute of Mental Health in conjunction with the University of Melbourne and the Chinese University of Hong Kong, with the primary aim of training multiskilled case workers and doctors. The decline in the suicide rate from 2004 to 2021 suggests the 686 Program has been bearing fruit with its training and treatment approaches.
Notably, distinguished Chinese psychiatrist Wang Zhen, deputy director of the Shanghai Mental Health Center, has, for the last 20 years, been working diligently to maintain the spirit of the program’s progressive mental health reforms with his groundbreaking research into obsessive-compulsive disorder and other psychoses. His team’s research has led to the development of enhanced and holistic approaches to dealing with mental health issues in the mainland and Hong Kong.
The benefits of this continuing progressive policy shift have had a positive effect on attitudes toward mental health in Hong Kong. Previous stigmas are slowly being erased, especially in high-risk cases of students with potential mental illnesses and their parents’ growing willingness to openly address them. I work with educators who say local parents today are much more willing to openly address mental issues in their children than they were 12 years ago.
These statistics present a strong counterargument to the West’s narrative that China has a humanitarian problem when it comes to its own people. Numbers don’t lie and are immune to propagandist efforts by the collective West. What these statistics do show is the opposite of the West’s preferred narrative when it comes to China’s humanitarianism on mental health.
The author is a writer, columnist and historian based in Hong Kong.
The views do not necessarily reflect those of China Daily.