LCQ1: Mental health of primary and secondary school students
5.6.2024

Following is a question by Dr the Hon Tik Chi-yuen and a reply by the Secretary for Education, Dr Choi Yuk-lin, in the Legislative Council today (June 5): Question: Last year, the number of suspected student suicide cases reported to the Education Bureau (EDB) by primary and secondary schools in Hong Kong remained high and even hit a record high in the past five years. In addition, self-administered questionnaires were collected from 330 000 primary and secondary school students attending the Student Health Service Centres of the Department of Health in the 2022-2023 school year, with results indicating that 1.3 per cent of the students had attempted suicide in the past 12 months. In this connection, will the Government inform this Council: (1) as the Government implemented a Three-Tier School-based Emergency Mechanism in all secondary schools in Hong Kong in December last year to address the problem of student suicide, how the EDB assists schools in identifying at an early stage students with mental health needs, and of the number of referral cases received so far by the off-campus support network team and the follow-up situations; whether it has assessed the effectiveness of these two tiers under the mechanism; (2) of the number of students with severe mental health needs who were referred by school principals under the aforesaid mechanism to receive psychiatric specialist services of the Hospital Authority in the past six months, and the follow-up situations of such cases; and (3) given the EDB's call for active participation from primary and secondary schools in the 4Rs Mental Health Charter to be launched in the next school year to enhance students' mental health, of the number and percentage of schools signing up for joining the charter before the deadline last month? Reply: President, Nurturing students with proper values and a positive attitude has all along been the objective of education, and "leading a healthy lifestyle" is one of the goals of school curriculum. The Education Bureau (EDB) attaches great importance to the physical and psychological well-being of students. Through cross-departmental and cross-sectoral collaboration with the Health Bureau (HHB), Department of Health (DH), Social Welfare Department (SWD), Hong Kong Police Force and other non-government organisations (NGOs), we work together to provide support for schools, students and parents. With the efforts of all parties, we can build a more robust safety net for students. In consultation with the HHB and SWD, my consolidated reply to the question raised by Dr the Hon Tik Chi-yuen is as follows: (1) and (2) In view of the upward trend of suspected student suicide cases in 2023, the Government has implemented the Three-Tier School-based Emergency Mechanism (the Three-Tier Mechanism) in all secondary schools in Hong Kong from December 2023 to December 2024 through the cross-departmental collaboration of the EDB, HHB and SWD so as to provide support for students with higher risk as early as possible. Under the Three-Tier Mechanism, schools will give priority to caring for and counselling students with higher risk and will provide timely assistance and seek professional counselling or treatment services for them through the school's interdisciplinary team in the first-tier. The EDB urges school personnel to refer to A Resource Handbook for Schools: Detecting, Supporting and Making Referral for Students with Suicidal Behaviours published by the EDB to preliminarily identify the more vulnerable students and pay attention to whether they have displayed related warning signs. If necessary, schools may arrange students with higher risk to conduct a preliminary mental health screening by using screening tools, such as Self-test Station: Depressive Mood from the DH and Kessler Psychological Distress Scale (K10) from "Shall We Talk". The interdisciplinary team in schools, which consists of guidance masters/mistresses, guidance personnel, school social workers and school-based educational psychologists, will prioritise and launch follow-up services for students with higher risk. School personnel are recommended to refer to the Guidelines on How Schools can Help Students with Mental Health Problems published by the EDB to provide support to students as soon as possible. In order to strengthen school personnel's early identification of and support for students with suicidal tendencies, apart from providing guidelines and a 60-hour thematic course on "gatekeeper" training for teachers every year, the EDB also organised online "gatekeeper" training courses for primary and secondary schools in December 2023. About 1 000 school personnel enrolled for the online training course. In addition, the EDB organised more than 40 additional training courses and workshops early this year, with an enhanced focus on enriching school personnel's knowledge and skills in caring for students with mental health needs. The courses benefited about 2 200 school personnel. In the second-tier of the mechanism, if the schools consider that they need to seek extra support subsequent to the identification and school-based intervention in the first-tier mechanism, they may seek assistance from the off-campus support network (support network) co-ordinated by the SWD. The SWD has engaged five NGOs to form the support network to provide extra support to schools. Upon receiving referrals, the support network team would contact the students concerned as soon as possible and arrange follow-up services, including emergency intervention services covering assessments, support and counselling through individual, group or online format; and would also refer the students to other services such as the Integrated Family Services, the Integrated Community Centre for Mental Wellness and the Integrated Children and Youth Services Centre according to their individual needs. As of March 2024, the support network team has received a total of 69 referral cases. Besides, the EDB has also collaborated with the SWD to arrange the support network team to visit about 150 secondary schools to organise mental health activities since February this year, with a view to enhancing students' awareness of mental health, as well as strengthening their adaptability and awareness of help-seeking. In the third-tier of the mechanism, school principals may refer students with severe mental health needs to the psychiatric specialist services of the Hospital Authority (HA). After triage and screening, the HA will accord priority to students in urgent cases. Furthermore, the HA has set up a telephone consultation hotline specifically to provide professional advice for school principals. As of March 2024, the HA's psychiatric specialist services received a total of 168 referrals and 75 telephone enquiries from school principals through the Three-Tier Mechanism. Among the referred cases, around 3 per cent were Priority 1 (urgent) category, while about 40 per cent were Priority 2 (semi-urgent) category. The remaining cases were either Routine (stable) or were already being followed up by the HA's psychiatric specialist services. Based on our understanding and communication with schools, with the concerted efforts of schools and various stakeholders, school personnel's awareness on students' mental health has enhanced in general, being able to early identify and support students with higher risk. The operations of the second-tier and third-tier of the Mechanism are smooth, providing timely and appropriate counselling and treatment to students in need. The Government will closely monitor the operation of the Three-Tier Mechanism and engage a consultant to evaluate its effectiveness. (3) The EDB launched the 4Rs Mental Health Charter (4Rs Charter) in April this year and invited all public sector and Direct Subsidy Scheme (DSS) schools in Hong Kong to join. The 4Rs cover four important elements in fostering students' mental health, namely Rest, Relaxation, Relationship and Resilience. We hope that the stakeholders' awareness on mental health will be enhanced and they will work together and take actions through the promotion of 4Rs Charter. Schools participating in the 4Rs Charter are required to set practical and feasible goals and take concrete actions to promote students' physical and psychological well-being. Schools joining the 4Rs Charter must also pledge to join the Mental Health Workplace Charter, which is jointly implemented by the DH, the Labour Department and the Occupational Safety and Health Council, as well as the Whole School Health Programme launched by the DH, so as to carry on with their school-based health promotion efforts in a more comprehensive and effective manner. The EDB has also been engaging NGOs as partner organisations of the 4Rs Charter to provide schools with additional services, activities and courses to enhance students' health. As of May 31 2024, a total of 340 primary and secondary schools have applied to join the 4Rs Charter, accounting for 34 per cent of all public sector schools and DSS schools in Hong Kong. We will continue to encourage more schools to join the 4Rs Charter, so as to cultivate a healthy environment that is conducive to students' growth. The EDB will continue to work with various stakeholders to promote mental health in a more comprehensive manner, jointly establish a support network and create a caring culture, so as to promote students' physical and psychological well-being.