You’re Not Alone: Three Mental Health Experts Shed Light on Stigma in Hong Kong

As stigma continues to plague the topic of mental health in Hong Kong, three experts in the field shed light on how we can further raise awareness and help those suffering. 

Let’s be honest: mental health isn’t something we talk about nearly enough, whether it’s with our family, friends or – perhaps most importantly – ourselves. According to Mind Hong Kong’s research in 2023, a staggering 62 percent of individuals diagnosed with a mental-health condition chose not to disclose it to anyone, including close family members. But can you blame them?

The same survey, the organisation’s CEO Candice Powell tells me, revealed that 46 percent of respondents wouldn’t be willing to live nearby someone with a mental-health problem, and 38 percent would be unwilling to work with one. Worse still, 58 percent said they’d end a friendship with someone if that person developed a mental-health disorder. 

It’s clear from these worrying figures that stigma is very much alive when it comes to mental health. And in a city like this with excessive pressure, that poses a huge problem, especially when you realise approximately one in seven people in Hong Kong suffer from either depression or anxiety.

“Despite more than half of Hong Kongers having poor mental health, shame and secrecy still shroud the topic,” Neurum Health co-founder and CEO Megan Lam tells me. “This is primarily due to a general lack of mental-health literacy, and deeply ingrained cultural beliefs. These perceptions equate mental illness with personal weakness or a lack of self-control, which are negative, false and unfair beliefs that have very real effects on people’s lives.”

“We need to promote the message that most people haven’t felt good enough, that it’s common to have fears, to feel bad when you’re rejected, to feel sad when you lose things and to feel nervous about your performance – and you don’t have to stay with these uncomfortable feelings or cover them up,” CEO of All About You Wellness Centre Sonia Samtani adds. “This isn’t the way we were meant to function, but it’s become common because of years of societal conditioning. It’s important to realise we can work through it, move through the limitations of our conditioning and choose a healthier life.”

While societal stigma is external, it’s easy to internalise these beliefs, but having a conversation with yourself about your mental wellbeing is of the utmost importance. If others aren’t willing to listen or help, at least you should do those things for yourself – you owe yourself that much. But how do you get around to it?

“Firstly, educate yourself on mental-health symptoms to improve your mental-health literacy, much like you’d recognise the signs of a cold or flu,” Powell explains. “Familiarise yourself with common indicators, such as insomnia, low motivation, constant worrying and difficulty concentrating. These could be signs of depression or anxiety and not merely stress. It’s important to understand that such symptoms can significantly impact daily functioning, including relationships and work performance.

“Secondly, it’s essential to normalise seeking help and understand that it’s not a sign of weakness. Sharing your problems and allowing others to support you is a healthy and positive step towards wellbeing. Encouraging open conversations about mental health can pave the way for more people to access the help they need and deserve.”

Sadly, even for those who do realise they need help and have been diagnosed, only 25 percent receive appropriate clinical support. It’s clear we still have a long way to go. But options do exist. “In Hong Kong, there are numerous wellness practices offering a range of services, such as psychotherapy, counselling and hypnotherapy, with options available at various price points, including subsidized options,” Samtani says.

One such option is Powell’s Mind Hong Kong, which offers accessible and affordable psychotherapy for individuals through its Improving Access to Community Therapies scheme. The initiative offers clinically proven short-term interventions aimed at teaching effective emotional management skills, which then help individuals take more proactive steps towards improving their mental wellbeing in a supportive and non-judgmental environment. 

If you find your situation more pressing, Lam also recommends more immediate support. “If you’re in a crisis, please call 999 or go to the closest A&E. Other services such as crisis hotlines are open to the general public, including The Samaritans, which provide an anonymous safe space.” The government also recently opened a new hotline that offers immediate conversations with counsellors – simply dial 18111.

For those who’ve been diagnosed and received treatment, but fall under the 62 percent who decided not to disclose their conditions to those around them, the idea of opening up can be daunting. And while it isn’t necessary for you to disclose this information, if you do decide to do so, there are also ways to approach it that can help ease the tension and stigma.

“Remember that who you decide to share with is your choice,” Lam says. “Some may find it more comfortable to speak with loved ones first, whereas others may find it more comfortable to speak with a professional. Some may find it better to speak in person, while others may prefer to write a letter. There’s no one right way.”

“In the US, a recognised method to guide this process is the HOP approach,” Powell adds. “Honest, Open, Proud. The approach involves considering the potential risks and rewards of discussing your mental wellbeing in different environments whether it’s among family, friends or colleagues. Think carefully about the potential outcomes of disclosing your condition and choose a setting where you feel safe and respected.

“The approach also encourages you to frame your journey with mental health as a narrative of strength and resilience. This reframing can help you and others see your experiences not as a shortcoming but as a testament to your courage and a significant part of your life that’s contributed to personal growth. By adopting this perspective, you can approach the topic with confidence and a sense of pride, which may inspire and facilitate understanding from those around you.”

Much of the information we’ve discussed so far is understandably targeted at helping those going through something themselves, but to really combat stigma in our society – which in turn will significantly help those suffering from mental health conditions – change must also come from family, friends and co-workers.

“The most loving thing you can do for your loved ones who are struggling is to seek to understand them, listen to them without imposing your own agenda, be with them through their journey, sit with them through their discomfort, ask them what they need instead of assuming you know and check in on them regularly,” says Samtani.

“But it’s also important for caregivers to be aware of their own limits; caregiving can be demanding, and it’s essential to maintain one’s own wellbeing in order to be effective in helping others,” Powell adds. “Self-care isn’t selfish – it’s a necessary part of being a supportive friend or family member.”

All this information can be overwhelming at first, but ultimately, if there’s one take-away from this, it’s that you are not alone. As Samtani reminds us: “Remember that support is available, sharing your struggles is your choice, there’s nothing wrong with you, and you can create a powerful context that primes your listener to be receptive and understanding.”