Hong Kong's Adolescent Mental Health

In my article "Counselling in Hong Kong - A Brief Overview", I stated that counselling services were established in the territory over half a century ago in response to fill a gap catering to the needs of students, when at the time, disorders such as depression were considered rare. (Green, 2017) Since that time, the mental health of youth both in Hong Kong and internationally has been a topic of increasing importance for counselling professionals.

The results of studies from the past decade demonstrate a striking upsurge in the incidence of mental health disorders among those between the ages of 12 and 17. This is especially the case for girls from 16 to 18 years old, where data suggests figures for clinical depression and anxiety could be as high as 1 in 4 in the USA. (Halldorsdottir, 2022). Why is this the case?

The glaringly obvious answer, would of course be the COVID-19 pandemic. Although the full extent of the consequences of this are yet to be fully examined, preliminary research shows that, in the case of Hong Kong, figures for mental health problems in youth have doubled in 4 years. Of greater alarm, for university students aged under 24, mental health problems have increased threefold from 250 cases in 2018 to 776 cases up until the end of April 2023. (SCMP, 7/5/23). The COVID pandemic, rightly deserves an article dedicated to it, which will follow in due course.

Other factors identified which contribute to mental health disorders in adolescents, predominantly anxiety and depression, over the past ten years include genetics, differences in the brain and environment (Geng, 2021). I think the most important of these are "differences in the brain". Although "differences" might be misleading. The brain does not reach full maturity until the age of 24, at which time the pre-frontal cortex reaches adult size. Therefore, the term "development" is perhaps better used, as the word "differences" can imply a more fixed state. So, not only are young people experiencing difficulties related to the transition between childhood and adulthood day-to-day, but simultaneously also having to contend with psychological developments as well. This is a topic which warrants much further investigation and discussion in upcoming articles.

The vulnerability this period of brain development for the establishment of mental health disorders is demonstrated by statistics from the American Psychological Association (APA), which show that 50% of mental illness begins by the age of 14 and three quarters start by the age of 24. After conducting a meta-analysis of 192 studies, in 2021 Ocklenburg's study revealed more detailed information. Alarmingly, the youngest age for the onset of a clinically recognized mental health disorder was 5.5 years old for anxiety and phobias. The latest onset of mental health disorders arose at the age of nearly 21 in the case of mood disorders.

Hong Kong is well equipped to recognize and treat the increasing incidence mental health problems in young people, through either the education system, or through independent organizations such as The Samaritans. I think it showed a high degree of understanding and foresight that Hong Kong pioneered mental health services for young people over 50 years ago - long may they continue!

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