LEGCO WORK

Motion on “Reviewing Hong Kong’s mental health policy”(2024.06.12)

Thank you, President. In recent years, tragedies related to patients with mental illness have occurred from time to time in Hong Kong, the most horrifying of which was the murder case in Diamond Hill. At that time, the Government introduced 10 measures to enhance support for patients. Despite achieving some success, due to the large number of patients and limited resources, it is still difficult to completely prevent violent incidents.

I would like to express my gratitude to Ms LAM So-wai for moving today’s motion. In the face of this ticking time bomb in society, the Government should introduce measures to enhance the manpower of doctors and social workers. At the same time, it should consider allowing more patients to receive long-acting injections, which have been proven effective in reducing the chances of relapse. As these injections are expensive and difficult to make widely accessible, the Government can consider seeking national support to join the Mainland’s drug bulk procurement mechanism to purchase drugs at affordable prices for the benefit of patients.

As of the middle of last year, there were approximately 290 000 patients with mental illness in Hong Kong but only 380 government psychiatrists, meaning that each of them has to take care of as many as 760 patients on average. Among the 50 000 new cases each year, some of the extreme cases have to wait for 81 to 99 weeks to receive treatment, which is far from satisfactory. Symptoms of mental illnesses may fluctuate at any time. While new patients with other illnesses can seek immediate assistance from hospitals in case of contingencies, patients with mental illness may not be able to seek help on their own if their condition worsens. Therefore, the Government should expeditiously increase the manpower of specialists and consider recruiting them from overseas when necessary.

rthermore, the Government has increased the manpower of case managers under the Case Management Programme (“the Programme”), and each case manager will only be responsible for no more than 40 patients. However, data shows that the Programme can only follow up on around 18 000 patients each year, while the number of cases with severe mental illness remains at around 50 000 annually in Hong Kong. Certainly, if the patients are able to attend follow-up consultations and take their medication on time, not all of them need to be followed up by a designated team. However, as the current follow-up rate is just over 30%, it may be necessary for the Government to review the effectiveness of the Programme on a regular basis, and increase the manpower of the case managers as far as possible if the results are not satisfactory.

Moreover, at the end of last year, the Health Bureau launched the Mental Health Support Hotline (“the Hotline”), which is, for the very first time, fully managed by the Government, to provide one-stop support for people with mental health needs. In the first three months, the Hotline answered a total of about 30 000 calls, of which 200 cases required follow-up actions and 2 cases required police intervention. In fact, the initiative has shown initial results. The Government can consider comprehensively optimizing the initiative in the future and even explore leveraging the convenience of the Hotline to proactively contact or reach out to those in need (such as new cases awaiting a long time or patients who have missed follow-up appointments), aiming for timely intervention and reducing the risk of potential crises.

Lastly, I must discuss the issue of long-acting injections. Regarding the so-called long-acting injections, the older generation of these injections only needed to be administered once every two weeks. The new generation can even be administered once a month or even once every three months to eliminate the need for daily medication. These injections provide great benefits for patients. It is stated that up to half of the patients failed to fully comply with the doctor’s instructions to take their medication, and some of them stopped taking medication on their own as soon as they felt slightly better. Their relapse rate reaches 90%. Additionally, according to research conducted by the University of Hong Kong, these injections can reduce the relapse rate by 48% and the suicide risk by 44%, which is quite remarkable.

However, long-acting injections are expensive. Currently, out of 50 000 severe patients, only 5 000 are prescribed the new generation of injections, and another 8 300 are prescribed the older ones. The usage of these injections is not yet widely accessible. In fact, in recent years, more and more patients have been going north for medical treatment because pharmaceutical products are more affordably priced in the Mainland than in Hong Kong. For example, the same cancer drug costs $60,000 per month in Hong Kong but only $16,000 in the Mainland. Dr KO Wing-man, a member of the Executive Council, once pointed out that with a relatively small market size, Hong Kong is no match for the Mainland in bargaining power for bulk procurement of drugs, resulting in significant differences in drug prices between the two places. I suggest that the Government should seek to join the Mainland’s drug bulk procurement mechanism, so that patients can purchase drugs at lower prices.

Since mental illness is a ticking time bomb in society, and the injections have been proven effective, they should be made widely accessible. If the price of these injections is indeed much lower in the Mainland, the Government should consider adopting this suggestion. Before successfully joining the Mainland’s drug procurement mechanism, the Government can also explore subsidizing stable patients to receive injections at hospitals in Shenzhen, thereby allowing more patients to receive injections as soon as possible.

Thank you, President.

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