China Daily (Hong Kong)

Let us help those with mental health conditions

- Stefan Dalton The author is a UK certified psychologi­st with extensive profession­al work in neuropsych­ology. He is trained in cognitive behavioral therapy.

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.

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