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Mental disorders have been documented to be detrimental to personal and public
           health. A leading contributor to global disability, mental disorders have also been
           shown to strongly affect one’s quality of life while bringing high social and economic
           costs. The COVID-19 pandemic has unleashed a mental health crisis across the
           globe and in June 2022, the World Health Organization (WHO) published the World
           Mental Health Report to address increasing needs for mental health support. This
           report put forward the importance of integrating mental health support into health
           systems and beyond, with particular emphasis on the need for mental health service
           provision in community settings.

           The mental health status of the Hong Kong population has been worsening over
           recent years, as illustrated by the decreasing WHO-5 Well-being Index Score; this is
           underscored by a local study conducted in March 2022, wherein nearly half of the
           1,000 adult respondents reported depressive symptoms (Mind HK, 2022). While
           ongoing efforts are in place to continuously evaluate and improve Hong Kong’s
           mental health service landscape, as aptly demonstrated by the Mental Health Review
           Report (Review Report) published in 2017, the emerging mental health crisis points
           to a pressing demand for ongoing review and enhancements to achieve a reoriented
           mental health system that adheres to a “fit-for-purpose” vision.

           Strengthening the role of primary care to
           enable timely access to mental health

           While Hong Kong’s approach to mental health support has become less
           institutionalised over the last century, reform has been slow and care still largely
           remains at the specialist level. Accordingly, formal cross-sectoral collaboration
           between medical and social care has been inadequate, and the focus of care is
           still generally targeted initiatives for persons with SMI, with less attention given to
           supporting persons with CMD or the general population.

           Although improvements have been shown in past decades, Hong Kong is still
           challenged by mental health stigma which has been identified as a barrier to
           help-seeking (Chung et al., 2019). Even when people seek help, support from
           medical specialists is often preferred, particularly psychiatrists. Such preference
           contributes to the overload of the Hospital Authority (HA) psychiatric specialist
           out-patient clinics (PSY SOPCs), which is reflected in the long waiting times for
           the intake of new cases, ranging from 14 to 64 weeks for stable cases (HA, 2022).
           Also contributing to the heavy bottleneck of service provision is the practice of case
           referral to PSY SOPCs by different medical practitioners in the system, although
           at the time of writing, 77% of all PSY SOPC patients are persons with CMD.
           Among these, stable and less complex cases, after careful assessment, could
           potentially be handled at the primary care level in non-specialist settings and
           provided with more timely mental health support.

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