Academic journal article Hong Kong Journal of Psychiatry

A Century (1885 to 1985) of Development of Psychiatric Services in Hong Kong-With Special Reference to Personal Experience

Academic journal article Hong Kong Journal of Psychiatry

A Century (1885 to 1985) of Development of Psychiatric Services in Hong Kong-With Special Reference to Personal Experience

Article excerpt


The history of psychiatry in Hong Kong covers only approximately 130 years. Psychiatry started as a specialty in 1875 with a temporary asylum, which was replaced by the European Lunatic Asylum in 1885. This era ended in 1928 when the term 'lunatic asylum' was substituted with 'mental hospital'. The hospital had 23 beds. In 1938, part of the staff quarters in High Street were converted to treat women at the mental hospital, increasing the number of beds to 84. The main function of the hospital was to provide custodial care for disturbed mental patients until their transfer to China or repatriation to their own countries. In 1948, Dr PM Yap was appointed the medical superintendent of the mental hospital and he started planning the development of psychiatric facilities and training of psychiatric personnel. The opening of Castle Peak Hospital in 1961 and the availability of efficacious psychotropic medications revolutionised psychiatric care. Rapid urbanisation and industrialisation from the 1950s to the 1970s gave rise to high density living and changes in socioeconomic and family structures, resulting in an increase in psychiatric morbidity and a range of problems in young and elderly people. These events, together with a high expectation of care from a more enlightened and affluent society, made demands for more sophisticated and specialised services. This paper describes the development from the start in 1875 to the range of facilities and services available in 1985, with reference to personal participation in treatment and planning.

Key words: Facilities and services, Mental Hospital


The best description of the earliest development of the care for mentally ill people is contained in the annual report written by the Colonial Surgeon Dr Phillip Ayres in 1893, who wrote: "When I took office in 1873 no asylum existed. Chinese lunatics were sent to Tung Wah Hospital (opened in 1872) and European lunatics to Gaol. At the end of 1874, an European female lunatic was sent to Gaol. This young person was very noisy and slept little day and night. Her singing, laughter and shouting were to be heard if she was in good temper, which she usually was, but if she was not, her howling and screaming was something appalling. This kept most of the prisoners awake. But it annoyed the whole neighbourhood, among others two unofficial members of the Council who lived close by and who forcibly in Council backed my representation that the Gaol was not a fit place for the detention of lunatics. So the half of a building consisting two semi-detached houses was fitted up as a Lunatic Asylum...." (1)

The Asylum Era

This temporary lunatic asylum was opened in 1875. However, admissions were restricted to non-Chinese patients. Chinese patients continued to be sent to Tung Wah Hospital where they were, to quote Dr Ayres' report again "confined in dark and dreary cell under Chinese native doctor's supervision and those who were violent were chained like wild beasts". (1)

This temporary asylum which occupied the present site of the Hollywood Road Police Married Quarters (2) was in use for 5 years. Then, circa 1880, the building where the asylum was located had to be pulled down and the temporary asylum was relocated to half of a deserted old Chinese school house in Hospital Road, on the site which later became the new wing of the Government Civil Hospital. (1) This asylum remained in use until 1885.

I take 1885 as the start of the study period because the European Lunatic Asylum, which was a purpose-built institution, opened in 1885 at the present site of the David Trench Rehabilitation Centre in Bonham Road where my office was situated when I was the head of the Mental Health Service. It had a bed complement of 8, consisting of 4 for men and 4 for women. At its lower site and extending to High Street was the Chinese Lunatic Asylum, which is now used as the Eastern Street Methadone Centre. …

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