Mental health｜"Total Student Guidance Service" that cannot accommodate "counselors"

The Social Services Department of The Salvation Army recently (March 1) released a youth survey, and found that more than 70% of the respondents suffered from mental health problems to varying degrees, and 30% of them did not seek external assistance.

The supply of mental health services in Hong Kong has always been in short supply, and there are very few that focus on the psychology of children and young people. There have long been voices suggesting that the SAR government promote the development of the counseling profession and make good use of counseling professionals. However, the authorities currently have no relevant plans.

This is really puzzling. Is the "Total Student Guidance Service" implemented by the Education Bureau since 2002 unable to accommodate a formal counselor?

The Legislative Council earlier passed a non-binding motion on “Improving Citizens’ Mental Health and Promoting the Development of Hong Kong’s Counseling Profession”, urging the government to improve Hong Kong’s psychological counseling system, formulate professional accreditation qualifications, and allocate resources to set up counseling posts for primary and secondary schools. "One school, one social worker" was changed to "one school, one social worker, one counseling", so that social workers and counseling could cooperate with each other.

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Poor mental health

Existing services are insufficient

Affected by multiple events such as the COVID-19 epidemic, social movements and immigration waves in recent years, the mental health problems of Hong Kong citizens are very serious.

The Hong Kong Jockey Club Suicide Prevention Research Center estimates that the suicide rate per 100,000 people in Hong Kong will be 12.3 in 2021, and the suicide rate per 100,000 people under the age of 15 will rise to a record high of 1.7.

However, there are only 427 psychiatrists in Hong Kong, and more than 200 of them are in private practice. Due to the huge difference in charges between public and private medical institutions, most patients will choose public services.

According to statistics from the psychiatric clinic of the Hospital Authority, there will be a total of 47,879 appointments for new cases in 2022. Among them, the waiting time for semi-urgent new cases is about 3 to 4 weeks, but the longest waiting time for stable new cases can reach 94 Week.

Given the severe shortage of psychiatrists, many voices believe that the SAR government should pay attention to the professional development of psychological counseling.

On February 8, the Legislative Council passed the non-binding motion "Improving Citizens' Mental Health and Promoting the Development of Hong Kong's Counseling Profession" sponsored by Guo Lingli, an election committee member of the Democratic Alliance for the Betterment of Hong Kong. Resources set up counseling positions for primary and secondary schools, changing the current "one school, one social worker" to "one school, one social worker, one counseling", so that social workers and counseling can cooperate with each other.

However, Lu Chongmao, Director of the Medical and Health Bureau, said in his concluding speech that the government has no plans to make statutory requirements for the professional certification of counseling, and relevant institutions can freely decide whether to hire them.

At first glance, it seems that the government does not take seriously the need for "counseling", and even confuses it with the role of "social workers".

In fact, both "counseling" and "social worker" have the nature of providing psychological counseling, but their working modes and functions are different.

Social workers focus on finding external resources to help students who encounter problems, while counselors focus on students' psychological problems.

For example, if a student encounters domestic violence, the social worker may assist the student to report to the police, and the counselor may devote himself to helping him get out of the psychological trauma.

New Democratic Party Member Ip Lau Sook-yee agrees that the role of school counselors is very important, just as a person with mental distress does not necessarily need to take medicine because of illness.

She cited the incident of two middle school girls who were suspected of being in a relationship in May last year as an example. They were not sick, but might encounter discrimination or emotional problems and needed the help of a counselor.

There are only 427 psychiatrists in Hong Kong, of which more than 200 are private practitioners. Due to the huge difference in charges between public and private medical institutions, most patients will choose public hospitals, resulting in short supply of public services and long waiting times.

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Counseling is not taken seriously,

the work situation is embarrassing

To improve the mental health of students, both "counseling" and "social work" are indispensable professional services; however, the gap in their career development and remuneration is obvious, which puts professional counselors in a rather embarrassing situation.

"Counselors" and "social workers" both require professional training, but the former has not established a statutory registration system.

Practitioners can only rely on their work experience to accumulate word-of-mouth and customers, or join the "Hong Kong Professional Counseling Association (HKPCA)" or "Asian Professional Counseling and Psychology Association (APCPA)" to accumulate a certain number of hours of counseling work (commonly known as "Chu Zhong" in the industry) ) to obtain accreditation from the Society.

In fact, most mental health-related jobs in Hong Kong do not have a statutory certification mechanism. For example, psychologists can only join professional organizations voluntarily established by the industry and receive training and supervision from the association.

However, in the absence of official "blessing", many industry regulations are ineffective, and there are many doubts in the market.

During the debate on the above-mentioned "promoting the development of the counseling profession in Hong Kong", Lin Zhexuan from the medical and health industry questioned that the binding force of the association is limited.

For example, if a person who claims to be a clinical psychologist provides patients with ineffective interventional therapy, the patient will have nowhere to complain. Even if someone registers voluntarily, he will quit the association after being complained and can continue to practice.

In addition to establishing a statutory registration system and qualification certification mechanism for mental health workers, many members of the Legislative Council also hope that the SAR government will set an example and increase the recognition and importance of counselors.

Take the current "one school, one social worker" policy as an example. Although the authorities require each school to hire at least one social worker with a degree, and are free to use subsidies to hire additional counselors, the objective result of "free hiring" is crowding out. The employment space of counselors is under pressure, and it is impossible to guarantee that schools will have sufficient subsidies and whether they can make good use of the subsidies to hire counselors.

They therefore proposed "one school, one social worker, one counseling".

The Hong Kong Federation of School Guidance Professionals suggested that school counselors should be established as permanent posts, and the policy of "one school, one counselor" be implemented, so that school counselors and social workers can perform their respective duties, so as to make up for the huge demand for student guidance services.

(Photo by Zhang Meihua)

All-round student counseling

becomes all-round panacea

In fact, after the February 2018 "Budget" proposed to allocate additional resources to promote the "one school, one social worker" plan, it caused controversy.

Not long ago, the death of a 5-year-old girl was tortured to death, which shocked the whole of Hong Kong. It also aroused the attention of the outside world on the lack of social workers in primary schools, which triggered the SAR government to agree to implement "one school, one social worker" in all primary schools in Hong Kong, following the practice of secondary schools.

However, although the original intention of the plan is good, it obviously ignores the importance of the role of counseling, and even thinks that "social workers" can play the role of "counseling".

In May of that year, the Asian Professional Counseling and Psychology Association wrote a proposal based on industry opinions and questionnaire analysis, pointing out that the policy "has the potential to put senior counselors at risk of resignation, and the relationship they have established in the school will be destroyed. at once".

The Hong Kong Federation of Social Workers criticized the move of the "Student Guidance Officer" to the "New Funding Model" through a three-year transition period as "unrealistic" because there are less than 60 part-time bachelor's degrees in social work in Hong Kong. Respond to the needs of current associate degree or advanced diploma social workers; moreover, the plan will make some counselors who have worked hard for many years but have no social work qualifications lose their jobs.

In August 2020, the Hong Kong Federation of School Counseling Professionals and the Asian Association of Professional Counseling and Psychology launched a statement jointly signed by more than 200 practitioners, accusing the Education Bureau of heavily tilting resources towards the social work profession, and worrying about "one social worker for one school" in primary schools and "one social worker in one school" in secondary schools. After the introduction of the "one school, two social workers" policy, many school counselors faced unemployment problems. They strongly urged the government to implement "one school, one counselor" and make school counselors permanent positions in schools.

However, the industry has called for it for many years, and the Education Bureau has only prevaricated with the "Comprehensive Student Guidance Service" project launched in 2002. It seems that the name of the project contains "all-round" to solve the problem in an all-round way.

For example, the deputy director of the Education Bureau, Sze Chun-fai, responded to the debate on the motion of the above-mentioned councilors. It is not the responsibility of teachers, school social workers or other student guidance personnel, but all teachers cooperate to provide comprehensive guidance services.

However, the original intention of "All-round Student Guidance Service" is to build a multi-faceted and effective support network through cross-professional collaboration of people from different sectors to take care of students suffering from mental health problems.

Looking at the Hong Kong service, it just throws all the problems to teachers and social workers. If there are parts that cannot be solved by the two, it will be left to the discretion of the school to use the subsidy.

The supply of mental health services in Hong Kong has always been in short supply, and there are very few that focus on the psychology of children and young people.

(File photo/Photo by Ou Jiale)

Improve guidance regulations

to pave the way for development

Furthermore, teachers, social workers, and counselors receive different professional training and work in different ways. Even if teachers want to help students with counseling work, they are limited by limited time and energy, and have no professional training in counseling.

On the one hand, the SAR government emphasizes that the counseling work needs to be completed through multi-faceted collaboration, but on the other hand, it refuses to add counseling posts to permanent roles.

Di Zhiyuan from the social welfare sector believes that social work services and counseling services are complementary rather than antagonistic.

In addition, counselors have also received professional training from universities, but there is no professional position for them to play a role, which is undoubtedly a waste of talents.

Taiwan also faced the problems of lack of counseling talents and confusion of professional roles, but it has been improved since 2000. The key is that the authorities attach importance to the establishment of laws and regulations for counseling work and the professional development of counseling and counseling.

The Taiwan government promoted the Psychologist Law in 2001, revised the National Education Law in 2011, and announced the Student Counseling Law in 2014. It clarified the establishment of full-time tutors and professional counselors (such as psychologists and social workers), and set up student counselors on campus. Counseling Center.

At present, many universities in Hong Kong offer teaching programs for counseling majors. Hong Kong Shue Yan University even offers a four-year undergraduate course combining psychology and counseling.

Hong Kong's international environment also brings together counseling talents with different backgrounds, and it can provide multilingual and multi-type counseling services. It can be said that there is no shortage of professional resources and the soil for cultivating talents.

The only question is whether the SAR government can improve the relevant laws and regulations to pave the way for the promotion of the professional development of counseling.