Background and Objectives The prevalence of child and adolescents mental health problems has been increasing in Hong Kong and is comparable to that of the world. It is estimated that the mental health problems of the future generations would account for 15% to 30% of their disability-adjusted life years (DALYs) and become a healthcare burden on societies in the near future. Therefore, it is necessary to address their mental healthcare needs now. The objective of the project is to review how the mental health services for children and adolescents have been changing in Hong Kong throughout the past few decades and to assess whether the local services have improved. While the service advancement in adult and old age (for example dementia) psychiatry has been significant, the children and adolescent mental health services would be reviewed by using the Donabedian framework. Based on some local and western models, the project will also address what the local healthcare providers can do for the children and adolescents with the capacity of developing multi-disciplinary and community-based integrated care as well as primary care and prevention. Service gap and areas of improvement on addressing the healthcare needs would be identified for the consideration of policymakers. Methods This project is a literature review. Archives of the Hong Kong College of Psychiatrists and Paediatricians, PubMed, PsycInfo, World Psychiatry, Lancet, etc have been searched with keywords including “children”, “adolescents”, “mental health services”, “child psychiatry” and “Hong Kong”. Journals from 1991 to 2011 have been retrieved. Publications and official sites of Hospital Authority and government organizations have also been searched. 52 journals, articles and online sources have been searched. 38 papers are identified and 19 are providing relevant materials. Studies with aggregated population level data rather than clinical studies which focus on symptoms and treatment of individuals are much more useful and providing more relevant information to this project. Results Secondary and tertiary care, in terms of screening, detection, in-patient and out-patient setting and rehabilitation services have been developed in Hong Kong since the 1980s whilst there are rooms for further development on primary care and prevention. An integrated approach, which emphasizes early identification and treatment by specialists-led multi-disciplinary professionals, has been more prominent. The stigmatization, which would result in reluctance of treatment, should also be addressed by enhancing the public understanding and awareness on the mental healthcare needs of children and teenagers. Conclusions It is necessary to work on the improvement of child and adolescent mental health in the primary, secondary and tertiary care in Hong Kong at present. Policymakers shall consider strengthening the support for child and adolescent psychiatry services in addition to the adults’. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Social Work / Master / Master of Social Work

Background Persons with severe mental illness (SMI) are vulnerable to mental health (MH) crises in the community. These crises often resulted in costly hospital admissions. Crisis Resolution Team (CRT) was implemented based on limited empirical evidence to address this problem. In 2001, UK implemented a national policy making CRT mandatory nationwide. Since then, more studies were performed on the effectiveness of CRT. It appeared CRT is cost effective in reduction of admissions. There was evidence of positive clinical outcome in comparison with standard care. Hong Kong does not have a specific community crisis program for people with SMI. It is desirable for policy makers to consider alternatives to reduce hospital admissions and to strengthen community support for people with SMI. Aims To evaluate the feasibility on the implementation of CRT Model in Hong Kong as a service to reduce hospital admissions. Method A review of current evidence on the effectiveness of CRT model and assess the feasibility and desirability of such model for implementation in Hong Kong. Results Evidence from observational studies and randomized controlled trials show CRT to be effective in the reduction of hospital admissions and inpatient days in the UK. CRT is also associated with higher acceptance from patients and family members than from standard care. CRT appears to be feasible against other service to address the acute needs of persons with SMI in reducing hospitalization. Conclusion A preliminary assessment ruled out a number of alternatives in dealing with mental health crises in the community. Preliminary results suggested the CRT model might be a feasible and desirable solution. There is evidence on the effectiveness of such teams in the UK. Successful implementation of CRT service in Hong Kong will be a challenge for stakeholders of the mental health system. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Public Administration / Master / Master of Social Sciences

published_or_final_version / Psychology / Master / Master of Philosophy

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

by Yau Mei-siu, Teresa. / Bibliography : leaves 141-147 / Thesis (M.S.W.)-Chinese University of Hong Kong, 1982

published_or_final_version / Politics and Public Administration / Master / Master of Public Administration