Mental health in Hong Kong
Updated: Jul 9, 2020
Possibly one of the first overt signs that the protests in Hong Kong (HK) were taking an emotional toll on those involved were reports of suicides. There were several deaths in June 2019 of young people linked to the protest movement. A clinical psychologist said on a radio programme at the time that young people may feel unable to express their emotions. Some find themselves embroiled in very tense and troubling conflicts. Although it came amid a massive and mysterious spike in apparent suicides, an October 2019 report suggests there have been nine deaths by suicide linked to the protest movement. To counter unsubstantiated claims of police involvement in the mysterious deaths, some protesters arrested by Police now purposefully leave notes with family, or declare on video that they will NOT kill themselves.
Now, it's six months since protests began, and a BBC expose on the HK social movement listed seven intense emotions it identified as fuelling the protests: "The textbook factors of politics, economics, demographics, even democratic ideals, ideology and identity cannot fully explain this [movement]- but the emotional intensity generated by the interplay of it all completes the picture." Those emotions were: anger, fear, love, sorrow, loneliness, determination, exhilaration.
Does that list seem complete? How does one capture the mental health issues of millions engaged in a nation's crisis, either actively or passively? Other than your own personal observations, the views of frontline social workers and medical practitioners must be a starting point. One academic refers to the notion of 'collective trauma' in which there is widespread upheaval and transformation in society, emphasising the inextricable link between state violence, and sociopolitical oppression, as well as the resulting psychological wounds they cause. Another academic reported that there was little difference in prevalence of mental health issues among those who did or did not attend protests, suggesting a “community-wide spillover effect” akin to a “mental health epidemic”.
Professionals refer to mental health conditions like ASD (Acute Stress Disorders), PTSD (Post Traumatic Stress Disorders), and believe that HK is heading towards a mental health catastrophe. Since October 2019 the HK Council of Social Service has launched a limited referral program for people with mental health problems as identified by outreach social workers. In response to the unmet mental health needs among people from different walks of life, the HK College of Psychiatrists also started a systematic and multilevel mental health intervention strategy known as the Care4ALL program.
According to the Lancet Medical Journal, the prevalence of anxiety and depression [in psychiatric cases] two months after the 2015 Umbrella Movement in HK were 47% and 14%, respectively. In this instance the prevalence of depression was at least eight times higher than population norms. Data that relates directly to the current HK unrest is not yet available, but there is ample anecdotal evidence that protesters involved in violent clashes with Police do suffer flashbacks of the incidents they were involved in. Many others report sleepless nights after watching footage online of protest action, being disturbed by what they see, or feeling anxiety with issues in their mind unresolved.
Teachers report their students being under intense stress, finding it difficult to concentrate on their studies, and some experiencing things like peer pressure, bullying or doxxing. Teachers too, have been the subject of government criticism, though many have tried to maintain a supportive yet neutral position amidst the conflicting tensions. [see our blog about what is happening in the HK education sector] The events each week are a new and challenging experience for all.
HK secondary students are dealing with higher than ever stress levels. A poll by the Wellness Mind Centre under the HK Federation of Youth Groups (HKFYG) revealed that more than half of respondents displayed signs of depression. Their survey of 2,685 students from 14 secondary schools was conducted in September and October 2019 to determine stress levels and identify underlying causes at the start of the academic year. More than 40 per cent of the students rated their stress level as high, and nearly a quarter of them indicated they were worried about the tense social climate.
At the end of December 2019, it was reported that a form six student who was beaten by HK police on 7th September had been diagnosed with PTSD and that he had decided to abandon his upcoming school exams. It's tragic that this boy, Chu, who now has to take 4 different psychiatric medications was not protesting and just happened to be in an MTR station when riot police stormed in.
We should not, however, assume that all youngsters are immediately buckling under the stress, as some are more resilient than others with strong support from friends and family. One group of young protesters took the initiative to organise a study group protest at the New Town Shopping Mall in Sha Tin, well known as a protest hotspot. About 20 young people wearing masks and all dressed in black heeded online calls to "study" at the shopping centre. One of the organisers said he hoped they might get some help from volunteer tutors in the future to help make up for time lost to months of anti-government protests. In HK's high pressure education system exams are always on students' minds, even amidst all the protests.
Many young people have changed their career and study plans in the wake of the protests. Perhaps the most serious challenges protesters face are presented to those arrested and charged by police, to those who experience police pepper spray or tear gas, or perhaps to those who feel helpless amidst events unfolding around them. Even journalists are finding it fairly tough here in HK, with some seeking counselling. The HK Watch organisation keeps a tally of the number of persons arrested by police, and although at last count it had surpassed the 6,000 mark, the number actually charged is much, much lower. It must be disconcerting to have the prospect of charges or a prosecution hanging over you. This is what happened to Jocelyn Chau, newly elected Eastern District District Councillor who was formally charged by HK police on New Year's Eve for assaulting a police officer back in August. Chau had been filming a video at the time of her altercation with police, and reported that she felt helpless over the incident. She described the police’s action as a form of political suppression against the pan-democrat District Councillors.
Not every young person has the language skills, maturity or social nous to remain unscathed. Even adults can fall into difficulty. There have been reports in social media of family feuds breaking out over differences of political opinion, and similar spats have sometimes created tensions between friends and colleagues, or workers and their employers. The latter is a particularly worrying trend as employment insecurity adds a further layer of stress to the adjustment people are having to make in the current crisis in HK. Whether it is healthy or not, some people now choose to keep their political views to themselves. Finding yourself unemployed in HK right now is particularly tough given the economic and political situation.
Adding to life's complexities public television in HK and the media in general serve vital functions as both vehicle for disseminating announcements and sources of information. Social media is especially important in HK which has opted for a leaderless social movement. Unfortunately in 2019 much of the media has been weaponised to spread disinformation, to confuse and undermine, to win influence and favour. Every pro-democracy protester, for example, knows the feelings of frustration and exasperation when Police offer fudged explanations, outright lies, groundless defenses, and thin excuses to account for their excesses, abuses and failings in their daily media briefings. It's even more ironic when the Police Force themselves claim that fake news is undermining the stability of HK. For those who don't understand Cantonese, the sources and flow of protest news in English are limited.
A government sponsored television advertising campaign lambasts those who use violence to reinforce their protest message, urging protesters to "think deeply" and "think rationally". In other advertisements viewers are reminded about the hard-fought efforts to make HK what it is today, and like a religious sermon another advert says "It's better to love than hate." It's not clear whether such soft sell advertising really soothes the soul of viewers, whether it galvanises the hearts and minds of intelligent pro-democracy protesters in the way that the government intended, or whether it actually hardens dissenting views.
Some of the television advertising and messaging by online '50 cent trolls' on social media has been relentless to the point that it is in-your-face annoying. Perhaps that is part of the HK government strategy? There's a tactic well-used by the CCP in their propaganda war of mentally wearing the opponent down, of messing with your mind. Coupled with coercion, threats and intimidation, physical and verbal, real and imagined, the HK protesters have a lot to contend with!
Newspaper columnist Bernard Chan in his assessment of HK's current mental health calls it a ticking time bomb. He wrote: "Mental health has long been one of Hong Kong’s more serious social problems. Our high-pressure work environment and education system add to stress and anxiety, while our culture discourages openness about depression and other personal problems...Our mental health resources are also widely recognised as being inadequate. For example, we have barely a third of the number of psychiatrists per 100,000 people compared with Britain...The events of the past few months have put us all under greater stress."
So, now we have a much more complete picture of mental health in HK during these protests, and it is grim. Going forward, however, we should remind ourselves of how much strength we have individually and as a united force. Take time to rest, to talk and listen, to regain lost vitality. Though we do look after one another, your first responsibility is always to look after yourself. Be positive and focus on the present - live in the now. All is well. Though our battle with the HK government and the CCP is not over, there have been things to celebrate. We have allies. We are organised. We have creative talent and passion. There will be more good things in 2020. Our dream for a better Hong Kong is still alive, and dreams do come true!
Hong Kong Protester Calculates Personal Toll After a Year of Activism, 7 July 2020, VOANEWS