Mental health is instrumental to quality living, yet mental health problems engender a host of personal, family, interpersonal, societal, productivity, and even physical adversities. Given the characteristics of life in metropolitan Hong Kong of rapid pace and high tension, unsatisfactory attitudes towards mental health, ongoing political, economic, educational and socio-cultural changes, there is definitely a need for timely intervention. Currently, most resources go to the treatment of mental disorders, less is assigned to rehabilitation, and a disproportionately small amount is placed on prevention. Nevertheless, mental health promotion is an important preventive strategy. Although much has been done, more is needed. It is never too late and will only get more costly. This article seeks to depict a longitudinal as well as cross-sectional account of the issue, and is intended to stimulate the thoughts and efforts of those concerned. An inter-sectoral and multi-level approach is suggested as the way forward.
Key words: Mental health education, Preventive psychiatry, Quality of life.
Experiencing a mental disorder is often a painful journey, yet only a minority of people with mental disorder seek proper treatment, largely due to myths and misunderstanding, stigma, and discrimination. Stigma stems from ignorance and fear while discrimination arises from hostility to those who are different.
The only cure is enlightenment of the population through promotion of understanding of mental health through education and timely management of mental disorders. Mental health promotion (aiming to enhance positive mental health and to reduce the burden of mental health problems and disorders) is an important step to improving quality of life for those we care about.
History of Mental Health Promotion in Hong Kong
As with the advent of any service industry, the history of mental health promotion in Hong Kong has gone through a process of change from a general need to specifics of knowledge and application.
Mental Health Promotion 20 Years Ago
Up to 20 years ago, psychiatric resources were limited and mainly targeted towards treatment, while proactive mental health promotion was scarce, apart from some sporadic responses reacting to psychiatric issues that caused public concern.
At the time, stigma and discrimination prevailed and ignorance among the population led to negative attitudes, not only towards mental disorders but also towards the psychiatric system. As psychiatric information for the public was mainly procured from the mass media in an emotive and skewed fashion, mental disorder was viewed as another name for insanity.
Psychiatrists were sometimes wrongly perceived as either "doctors evil" or omnipotent, being capable of controlling people's mind through special techniques such as hypnosis. Treatments were considered inhumane and institutionalisation was the destiny for patients with mental disorders. Castle Peak Hospital was often misrepresented as a punishment for those who acted unreasonably.
As a result, people tended to hide their mental problems, delay or reject treatment, and even distrust the psychiatric system. Psychiatrists at the time saw the need for public education but were often put off by the tight rules against self-advertising set by the medical council in their book Professional discipline. In addition, progress was hampered by the lack of epidemiological research data in Hong Kong and there was no agreed Chinese terminology for most mental disorders. Certainly more needed to be done for the promotion of positive mental health.
Mental Health Promotion in the late 1980s
Approximately 15 years ago, mental health promotion was still at an embryonic stage, but its growth was enhanced by changes occurring at that time. More qualified psychiatrists became available. …