Let us help those with mental health conditions

Fortunately, the impact of global influences has led to an increase in awareness of mental health in Hong Kong. Campaigns such as Joyful@HK and Joyful@School promote an awareness of a variety of mental health conditions. Psychological services are available in Hong Kong, for the right price of course. But as a society, are we really accepting of those with mental health conditions that deviate from the societal ideal?

The Hong Kong mental morbidity survey, a government funded study, suggests one in 10 individuals exhibit mental health symptoms that are likely to affect their daily lives. Other reports suggest as many as one in two individuals suffer from various degrees of depression, while there are around 300,000 clinical cases of major depressive disorder presently in Hong Kong. The most common mental health conditions in Hong Kong are co-morbid interactions of anxiety and depressive disorders. Distressingly, these are only the reported cases. Many cases go undiagnosed and untreated. It’s difficult to imagine why anybody wouldn’t want to seek treatment for a complaint. We must examine what societal pressures we inflict upon ourselves that discourages us from seeking treatment for mental health problems. It is clear our societal norms surrounding mental health need updating.

To illustrate public apathy and avoidance of mental health issues, would you be shy about seeking treatment if you were diagnosed with influenza? Unlikely. Now, contrasted with a diagnosis of a mental health condition, would you be as proactive in seeking treatment for something that is just as common? Not to mention discussing it openly with family members, colleagues and friends?

But this is understandable, considering there is still prevalent discrimination against patients (yes, mental health classifies as a medical condition and is normally very treatable) diagnosed with mental health issues. Until this discrimination is addressed, it would be difficult to achieve major breakthroughs in the treatment of patients with mental health problems. The status quo would keep adding to the logjam of undiagnosed and untreated mental health cases.

Would you tell your employer if you had a mental health condition? Research by the University of Hong Kong found 63 percent of employers believe hiring someone with a mental health condition could negatively impact their business. It’s just another strong evidence of the negative stigma associated with mental health in the workplace. Interestingly, countries such as the United Kingdom promote the use of a “mental health sick day” allowing workers to take time off for mental health related circumstances. The purpose of this policy is to raise public awareness of the importance of mental well-being and to eliminate all unwarranted stigma attached to it. Having support from employers and colleagues alleviates mental health sufferers and it can have a tremendous positive impact on their well-being and also work performance.

I have observed, in clients, very common thinking patterns such as, “I am the only one experiencing these feelings and I am alone”. But as experienced mental health professionals will tell you, this is far from reality. Untreated persistent negative mental thought patterns can develop into adverse health issues, including suicidal tendencies. Cognitive

behavioral therapy (CBT) can be a useful treatment approach as thoughts and behaviors are recognized in patterns. And with knowledge, these patterns can be changed, improving our overall feelings. Mental health conditions are very treatable. In fact, CBT has less relapse rates compared with medication.

There has recently been an increase of extreme social isolation in school children. We all know Hong Kong is a harsh and competitive city. Likely, this results in societal pressures for our children to excel, if not be the best. But have we considered how this might affect their psychological well-being? The pressures of exams, peer pressure, future planning and parental expectations make it difficult for students to navigate successfully through school. This can leave students feeling overwhelmed and isolated. Such difficulties can develop into depressive disorders, social anxiety or generalized anxiety disorder which may manifest later in life. Research by the Chinese University of Hong Kong found students’ academic performance was higher in Health Promoting Schools. This is food for thought for all educators and parents.

Perhaps the most challenging constructs are cultural views. I have had distressing conversations with clients concerning the shame they would bring to their families, should they disclose their mental health condition. While I understand there is a cultural obligation and moral conformity to family honor, that certainly has wonderful benefits, we need modern flexibility in interpreting ancient Confucian teachings to help mental health sufferers recover. Inner strength is not determined by remaining stoic about your suffering and isolating yourself in shame. Inner strength can be expressed by opening up honestly, sharing difficulties, and experiencing growth together with your loved ones. This misunderstanding is reflected in the aberrant higher male suicide rates. We need to break these machismo stereotypes of men suffering in silence and disassociate seeking help as a sign of weakness.

Awareness can only be achieved with more effective public education. Perhaps starting with school children to build up awareness of mental health and to eliminate discrimination against such patients. Young people are very perceptive and they can help identify such sufferers and spread the right message concerning mental health. Programs in the UK, over the years, achieved raised mental health awareness through ongoing public education programs which led to substantial changes in the way society, friends, family and employers view mental health. Hong Kong must design its own such program with input from practicing mental health care professionals.

Until this discrimination is addressed, it would be difficult to achieve major breakthroughs in the treatment of patients with mental health problems.