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Published: 03:02, October 18, 2023 | Updated: 10:54, October 19, 2023
Prevention is better than cure when it comes to mental health
By Ho Lok-sang
Published:03:02, October 18, 2023 Updated:10:54, October 19, 2023 By Ho Lok-sang

Wofoo Social Enterprises conducted a survey from July 18-23 — with 1,283 online questionnaires collected — and found that the Happiness Index is the lowest since 2018. 

At 5.88, this is actually the lowest score in memory since I began my annual Hong Kong Happiness Survey in 2005. We used to conduct randomized telephone surveys each year. But in 2011, with sponsorship from ING, a global financial institution of Dutch origin, we also conducted a large scale online survey (attracting over 8,500 respondents) in addition to the telephone survey. In that survey, the happiness score was 71.1 out of 100, or 7.11 in the zero-to-10 scale.

There is little doubt that Hong Kong residents are under tremendous stress nowadays. Quite a number of tragedies have been reported. The Hong Kong Police Force reported an 18.6 percent increase in domestic violence in the first half of this year over last year, a 16.5 percent increase in violent crime, and a 36.5 percent increase in overall crime. The Hong Kong Special Administrative Region government understands the gravity of the matter and will boost professional manpower in the Integrated Community Centre for Mental Wellness under the Social Welfare Department. According to the Social Welfare Department, about 33,000 Hong Kong residents are registered as members of the Integrated Community Centre for Mental Wellness in 2022-23, up from 28,000 in 2018-19.

In parallel with this effort, the Education Bureau implemented the Comprehensive Student Guidance Service in all primary schools starting from the 2002-03 school year. Schools may choose to appoint a student guidance teacher or use the funds to purchase services from nongovernmental organizations to provide guidance service to schools. Starting from the 2018-19 school year, the program was upgraded in order that each publicly funded primary school will be able to appoint one school social worker. Despite all this effort, the overall mental health of students and that of the general population showed little sign of improvement.

The problem is that the nature of the interventions is mainly remedial. Even worse, the existence of a professional social worker in a school may lead to a stigma effect on the one hand, and a referral effect on the other hand. The “stigma effect” is that students referred to a school social worker may think that they may be regarded as “problem students” or having family problems. The “referral effect” refers to the mentality among teachers that “since there is a social worker in the school and he or she is a professional, I do not have any role in counseling the student or offering him/her or his/her family guidance”. There is a crucial difference between help from a social worker who does not really know the student or the family well, and help from a teacher who interacts with the students on a day-to-day basis and who may have earned their trust. Teachers may then lose the role as a friend to troubled students.

Clinical psychologists of course are helpful and needed, and I applaud the effort of the HKSAR government to fund any effort to help with the cause of mental health issues. However, to me, prevention is always better than treatment. Immunizing people from mental illness is far better than treating mentally sick people and assisting them to recover. The latter is of course also necessary. However, “vaccinating” people against mental illnesses is just as important as vaccinating people against the flu or COVID-19.

The “vaccine” in this case, of course is not a drug. It is LIFE Education (“LIFE” is summarized from the acronyms of love, insight, fortitude, and engagement). LIFE Education was supposed to have been covered in Module One in the Liberal Studies course. Unfortunately, the course was mishandled. The type of examination questions used in the Diploma of Secondary Education examination so far shows that the previous “Module 1: Personal Development and Interpersonal Relationships” was largely ignored. LIFE Education is what students and teachers need, so that they will be better prepared to face the challenges of life, and feel connected rather than alienated against other people.

The Lingnan University 2022-23 School Children and Life Education Survey is a collaborative effort by four parties: the STEAM Education and Research Center, the Hong Kong Pediatric Society, the Department of Pediatrics and Adolescent Medicine of the University of Hong Kong, and the Department of Pediatrics of the Chinese University of Hong Kong. We found evidence that LIFE Education reduces bullying, helps students to handle pressures from studies, and generally boosts student happiness. We also found that the LIFE Education Index has been rising slowly in the past three years, which is good news. However, for senior classes, Form 4 and Form 5, the index has fallen noticeably. To our dismay, we also found that 60 percent of the surveyed teachers have never studied LIFE Education.

LIFE Education should help nurture love (respect for one’s life and that of others and a desire to realize the potential that life offers; insight (wisdom or a sense of proportion and the ability to tell means from ends); fortitude (resilience and courage), and engagement (purposive living). It should also include parenting and sex education. Only when people have learned to see the big picture and to realize how precious life is will they become less obsessed with “instrumental goals” and objects that provide immediate gratification but have little lasting value.


The author is director of the Pan Sutong Shanghai-Hong Kong Economic Policy Research Institute, Lingnan University.

The views do not necessarily reflect those of China Daily.

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