Out of the shadows: Making mental health a priority for Hong Kong employers

mental health article

Mental health issues are pervasive across the world, in virtually every population; affecting all of us either directly or indirectly. Hong Kong, with its frenetic and competitive work culture, is no stranger to this phenomenon. In fact, it has been estimated that about 32 percent of employees in 2016 were classed as having unsatisfactory mental health – up from 29 percent in 2015.

A 2014 survey commissioned by the Mental Health Association (MHA) further found that a whopping 60 percent of Hong Kongers report job-related stress and anxiety. Despite these alarming figures, there still remains widespread social stigma towards those battling with mental illness, leading many in the city to suffer in silence.

To that end, this article by Pacific Prime and healthcare advisory firm Asia Care Group looks at the state of mental health and illness in Hong Kong, its implications for employers, and what companies can do to address the issue of mental wellbeing and health in the workplace.

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State of mental health in Hong Kong

Talking about and addressing mental health in Hong Kong is something many don’t do, or refuse to acknowledge. Candace Albert from the Asia Care Group further explained, “Fear drives discrimination and myth, and prevents people from seeking care. Encouraging an open dialogue on these subjects and increasing the level of mental health literacy among the general public are established strategies to drive change. At a societal level, increased openness about mental health will reduce stigma, promote earlier identification of common mental disorders, and enhance the likelihood that individuals explore health resources”.

This stigma has only recently started to be addressed by the government, who conducted their first-ever territory wide survey of mental illness in 2010. The report’s final study findings, which were published in a peer-reviewed journal in 2015, found that the prevalence of common mental disorders among adults aged 16 to 75 was 13.3 percent.

Given these findings, Dr. Chan Chung-mau, Chairman of the Hong Kong Association for the Promotion of Mental Health, wrote in his EJInsight article that it is possible that well over one million people in Hong Kong are in need of some form of mental healthcare. Healthcare, which in many cases, is under-supported.

Mental illness support: How Hong Kong compares with other Asia-Pacific countries

In addition to the above mentioned findings, a 2016 Mental Health and Integration report by The Economist Intelligence Unit gave Hong Kong an overall score of 65.8 out of 100 with regard to  their effort to integrate those suffering with mental health illness into the community.

Hong Kong’s worst performance was in the area of governance – including efforts to reduce stigma and promote human rights of mental healthcare patients, where Hong Kong is said to lack “a formal overarching mental health policy”. While the Hospital Authority’s 2010 Mental Health Service Plan helps fill the void in bringing coherence to the service provision, “coordination remains spotty”.

mental health index

Source: The Economist Intelligence Unit

For example, the Food and Health Bureau handles medical care of mental illness patients, whereas community support is managed by the Labour and Welfare Bureau. This fragmentation has led to a key support structure, trained psychiatrists, being largely understaffed.

Shortage of psychiatrists in Hong Kong

As of the time this article’s writing, the patient-psychiatrist ratio here is about 4.5 per 100,000 people, whereas the UK has 14.63 psychiatrists per 100,000 people, and Australia has 9.16 psychiatrists per 100,000 population.

The low number of psychiatrists in Hong Kong hurts access to mental healthcare services. This is especially true in the public sector, where people wait as long as 166 weeks for an initial visit. This, coupled with short appointment times of around 5 to 10 minutes per patient, and hiking demand for mental healthcare services, all point to the fact that it is getting harder for public sector doctors to invest their time into treating and supporting patients and their families.

In November 2016, this pressing situation led the government to announce their intentions of further extending their public-private partnership model, which has been in place in general outpatient clinics to handle “suitable and stable” follow-up patients in order to relieve the overburdened public system. As the private sector currently handles about 10 percent of psychiatric patients in Hong Kong, many see the potential in private doctors taking up more patients.

The issue of stigma and mental illness in Hong Kong

Another important issue to address here is the pervasive stigma that still surrounds those with mental illness conditions in Hong Kong and much of Asia. As this issue is multi-faceted, it can be very complex.

To reduce this stigma, in 2010 the Hong Kong government invested HKD 135 million into setting up a community network for people suffering from mental illness. A number of public programs were organized to promote mental well being and foster a greater understanding of mental illness.

On the success of these programs, Candace Albert commented, “The investment initiative to expand the Integrated Community Centres for Mental Wellness is a positive first step. The programs can be enhanced over time by clearly defined referral pathways, both with the existing Hospital Authority services for current and ex- mentally ill patients, and with primary care. The value of community-based programs is strengthened when they operate alongside other services, in an integrated health system.”

Why employers should address the mental health of their employees

The issue of mental health can be a touchy subject that many employers might not be willing to address openly. After all, many hold the widespread opinion that an employer has no business getting involved with their employees’ mental state in the first place. That being said, while employees have every right to maintain their privacy about personal / sensitive issues, it doesn’t mean that companies should completely ignore their employees’ psychological wellbeing.

The reason is clear: an employee’s mental state, if poor and left unaddressed, will likely permeate into the workplace. In fact, its impact is wide-reaching and can be detrimental not only to the employee, but also the employer and society at large. A 2017 Deloitte UK report, titled: At a tipping point? Workplace mental health and wellbeing, delved into this point further and discussed the following key findings:

  • Impact on employees: 85 percent of employees reported symptoms of poor mental health attributed to work-related stress. Demanding jobs increase the chances of physician-diagnosed illness by 35 percent, and long work hours increase mortality by nearly 20 percent.
  • Impact on employers: Poor employee mental wellbeing also results in loss of productivity. The report found that job insecurity increases the odds of reporting poor health by about 50 percent. Absence, however, is not the only cost. Other costs to the business include presenteeism (the loss in productivity from working at less than full capacity), and turnover.
  • Impact on society: Poor mental wellbeing is also costly to society. According to the WHO, the global cost of mental disorders is expected to reach USD 6 trillion by 2030. This primarily includes the costs and strains to the public healthcare sector. In Hong Kong, for example, demand for psychiatric care has grown from 39,770 cases in 2009/2010 to 47,958 cases in 2014/2015, thus leading to an increasingly overburdened public system.

In addition to the above, the University of Hong Kong found in their new study of mental health conditions in the workplace that 90 percent of respondents (both employees and managers) said they needed better support at work. What’s more, 60 percent of respondents believe that mental health issues in the workplace play a large role in pushing away talented staff. “With productivity losses in workplace settings being as high as they are, there’s a strong business case for reducing mental health stigma. Forward-thinking employers stand to benefit by investing in employee mental wellness initiatives because these programs result in reduced staff turnover, lower sick leave, and better employee performance.”, said Candace Albert.

What employers can do to address employee mental health

By addressing and opening up discussion about mental wellbeing in the workplace, employers can offer the support and tools employees need without intruding on their privacy; not to mention create a more positive and productive work environment overall. Here, we’ve included several key ways to address employees’ mental wellbeing and health in the workplace:

Educate your staff

Given the prevalence of mental health issues in Hong Kong, chances are a significant proportion of your staff are already struggling with a problem. A general lack of awareness and pervasive stigma at the workplace, however, can mean that many employees are not willing to acknowledge their problem, or are confused about how they want to deal with it.

To add to this confusion, “mental health” is a broad term that not only refers to disorders and illnesses like schizophrenia or bipolar disorder, but also a construct similar to physical health. What this means is that, similar to how we take care of our physical wellbeing by eating well and exercising regularly, mental health is not only about treating mental illness, but also about taking care of our bodies, getting enough sleep, stimulating our brain, and managing our emotions.

As part of your employee wellness strategy, one solution is to bring in a qualified mental health professional to educate your employees about the wide range of mental health topics. Topic examples include:

  • Spotting signs and symptoms
  • Supporting colleagues
  • Coping with, reducing, and preventing stress
  • Getting quality sleep
  • Building and enhancing emotional resilience
  • And more

The key is to encourage open discussion that allows employees to feel comfortable and ask questions, so that stigma at your workplace will begin to fade. “It’s not enough just to hang up posters with a helpline or website to encourage people to get help,” Candace Albert commented. “We need to encourage people to think and talk about the issue in a workplace setting, such as through educational sessions and workshops. Many employees are afraid to seek help early on, but the majority of common mental disorders can be treated. With appropriate support, individuals can remain productive and efficient members of the workforce.”

Provide a range of mental health management resources

While putting mental health professionals on site can be very beneficial to your staff, some employees could feel too anxious or embarrassed to talk or open up about their issues. Offering additional resources like telehealth (e.g. online counselling services) can, therefore, be a good way to further support employees. By offering these extra resources, not only are more mental health treatment and/or management options available, but they also enable employees to feel more comfortable in reaching out to get the help they need.

Partner with an employee benefits and wellness specialist

From the above, it is clear that there are many advantages to supporting and addressing mental health in the workplace. With that said, there’s no such thing as a one-size-fits-all mental wellness benefits approach, which is why it can be beneficial to partner with an expert like Pacific Prime, who has the skills and experience to identify, devise, implement, and manage your company’s benefits and mental wellness solutions.

We’re also experts in all things insurance, and are able to deliver employee health insurance solutions that includes considerations for mental health. By offering these extra mental health support benefits, employers can ensure that their valued employees are both physically and mentally healthy, and are never left feeling like they don’t have the support they need.

Do you have any more questions? Contact our team today to get the answers to all your questions, as well as a no-obligation free quote.

About Asia Care Group

Asia Care Group Limited is a boutique healthcare advisory firm that focuses on major strategic change projects in the Asia-Pacific region. ACG works across the industry spectrum, with Governments, Public and Private Providers, Health Insurers and Development Organisations in pursuit of more effective and efficient healthcare systems.

About Candace Albert

Candace Albert is a Managing Consultant with ACG, based in Hong Kong. She holds a BA in Public Health Studies from Johns Hopkins University and a dual MPH and MSc in Sustainable Health Systems. She has spent several years working in the areas of chronic disease, health systems strengthening, and strategic planning at previous posts with the Department of Health (US), OECD (Paris), and the Johns Hopkins School of Medicine.

Mental health and insurance

Doctor talking about mental health

According to the National Alliance for Mental Illness (NAMI), “One in four adults experiences mental illness in a given year. One in 17 − about 13.6 million − live with a serious mental illness such as schizophrenia, major depression or bipolar disorder.” With revealing numbers like this, it is clear to see that mental health has become one of the most important health concerns of the past decade. Long considered to be a somewhat taboo subject in much of the world, Asia included, mental health has started to see an emergence as a true concern that needs to be addressed, studied, and treated much like any other illness would. This exact issue was recently raised in an intriguing article published in the International Travel & Health Insurance Journal (ITIJ), which features insight from Pacific Prime’s Darren Counsell. 

Stigma still surrounds mental health

The problem is, many countries simply are not giving mental health the support required. For example, here in Hong Kong, the SCMP reported last September that, “There are under 200,000 such [patients receiving psychiatric help for a mental illness like depression] in the Hospital Authority (HA) system. According to an official assessment, the average queuing time for a first appointment with a psychiatrist jumped from three to seven weeks between 2000 and 2012.” The article went on to note that there are only around 300 psychiatrists working in the public system, which is far short of the recommended number set by the WHO.

Singapore does not fare much better, with resources and statistics from the government being relatively hard to find when compared with other diseases, and a somewhat low number of professionals working in Mental Health with 2.81 healthcare professionals employed per 100,000 people in 2011, according to the WHO (compared to 4.39 per 100,000 in Hong Kong).

The cost of mental health

The SCMP article linked above highlighted a common issue many countries and cities around the world are facing: The public health sector can not fully cope with the demand for mental health care. To receive the care people need, many are turning to the private health sector. While this sector will usually have much lower wait times, it does come at an increased cost. For example:

  • The Hong Kong Society of Psychiatrists notes that, “Fee charges range from about HKD 500 (USD 54) to HKD 2,000 (USD 257) per consultation.”
  • The Australian Psychological Society states that for a 45-60 minute consultation with a psychologist you will be charged AUD 238 (USD 172).
  • The Noble Psychological Wellness Center charges SGD 90 (USD 64) for a 15-minute session.

Add the cost of psychological care and medicine on top of that, and it is clear that mental health care is not cheap. In order to afford the mental health care many need, many will turn to private health insurance. While plans like international health insurance plans will offer strong coverage elements with high limits, there is a caveat you need to be aware of: Some insurers may not cover specific mental illnesses.

Pacific Prime discusses mental health and health insurance

In a recent article which addressed mental health published by the International Travel & Health Insurance Journal (ITIJ), Darren Counsell, Director at Pacific Prime, discussed mental health from an insurance standpoint, as well as what you need to know about when it comes to whether your health insurance covers mental health care.

Some of the important information shared by Counsell included the most valuable piece of information anyone receiving care for mental health needs to know: “While the best insurers offer cover for diagnosed psychiatric conditions, many exclude self-harm, along with alcohol and drug misuse, even if they can be attributed to mental health issues.” He also explained that, “In short, many popular international insurance companies do actually cover psychiatric conditions, but often insurers impose low limits and caps for coverage related to treatment of these conditions.”

The article itself provides an in-depth look into mental health and health insurance, and is well worth the read – especially if you are looking to learn more about how the two topics are intertwined. The full article can be found on the ITIJ website.  

In order to learn more about whether your health insurance plan covers mental health care, please contact us today.

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