Resources

The mental health effects of COVID-19

This booklet discusses how teachers can support students and their own well-being during a crisis. It also touches on the role of E-learning and the important role it plays in maintaining communication between students and teachers. In addition, full interviews conducted with teachers in Hong Kong are included to get a first-hand perspective on the teachers’ role and perspective in the current situation.

Download the booklet here:

Resources

Signs of Depression

We would like to acknowledge the Charlie Waller Memorial Trust (CWMT) UK for these resources and for allowing us to adapt this. For the original version of this resource, please refer to the CWMT website: www.cwmt.org.uk

Resources

Perfectionism: when striving for excellence becomes unhealthy

By Professor Roz Shafran

This leaflet is based on work conducted by Prof. Roz Shafran in collaboration with Prof. Tracey Wade and Dr Sarah Egan.

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

We would like to acknowledge the Charlie Waller Memorial Trust (CWMT) UK for these resources and for allowing us to adapt this. For the original version of this resource, please refer to the CWMT website: www.cwmt.org.uk

Some years ago Jessica Lahey wrote in the New York Times: “We all know perfection is an unreasonable burden to place on our children but we also reward them when they strive for that perfection.” Her article was an attempt to understand the complex nature of perfectionism in today’s world where achievement is valued at almost any price.

So what does unhealthy perfectionism look like and what is the distinction between such perfectionism and ‘healthy striving for excellence’? People with a healthy striving for excellence have very high standards but the standards are potentially achievable; when they do not reach their goals, people with healthy striving for excellence are able to stand back and reflect objectively on their mistakes so that they can learn from them. They are able to tolerate uncertainty and don’t react to their failure with intense self-criticism.

“People with unhealthy perfectionism react to mistakes in an extreme and highly self-critical manner and are very uncomfortable with uncertainty.”

“People with a healthy striving for excellence have very high standards but the standards are potentially achievable”.

‘Tyranny of the Shoulds’

People with unhealthy perfectionism often have the same very high standards but the standards are not realistic or only attainable with significant negative consequences; such people react to mistakes in an extreme and highly self- critical manner and are very uncomfortable with uncertainty. The self-esteem of such perfectionists is almost exclusively dependent on striving and achievement but they constantly perceive themselves to have failed and live in fear of such failure and what it means for them. Such perfectionism was described almost seventy years ago as the “Tyranny of the Shoulds” (Horney, 1950). A few years later, Hollender (1965) painted the following clinical picture of perfectionism:

“The perfectionist finds it difficult to sort out items in order of their importance or to maintain a sense of proportion. A small detail that has been missed may deprive him of gratification from a job otherwise well done. He is constantly on the alert for what is wrong and seldom focuses on what is right. He looks so intently for defects or flaws that he lives his life as though he were an inspector at the end of a production line.” (p. 95)

Spotting unhealthy perfectionism

It is not always easy to detect this unhealthy perfectionism and very often people themselves do not consider it to be a problem. Instead, it can cause difficulties for those around them. The area in which the perfectionism is expressed is also very important.

Unhealthy perfectionism applied in the domain of work may lead to someone being labelled as a ‘workaholic’ but the same type of perfectionism applied in the domain of dieting and weight loss may lead to an eating disorder. Typically such perfectionism is applied across many areas of life and can cause multiple difficulties. We know that perfectionism of this sort is associated with depression as well as other difficulties such as eating disorders, anxiety, chronic fatigue syndrome, obsessive compulsive disorder and low self-esteem. Unlike depression, ‘perfectionism’ is not a diagnosis and it can sometimes be difficult for an outsider to spot. Some questions to help spot when perfectionism is a problem are:

“Unhealthy perfectionism applied in the domain of work may lead to someone being labelled as a ‘workaholic’.”

  • How hard are you pushing yourself to meet your goals?
  • Do you tend to focus on what you have not achieved rather than what you have achieved?
  • Do other people tell you that your standards are too high?
  • Do you feel a failure as a person because you have not succeeded in meeting your goals?
  • Are you afraid that you might not reach your standards?
  • Do you raise your standards after meeting them?
  • Do you judge yourself on your ability to meet your standards?
  • Do you repeatedly check how well you are doing at meeting your standards (for example, by comparing yourself to others?)
  • Do you keep on trying to meet your standards even if you miss out on other things?
  • Do you react to small mistakes with intense self- criticism?
  • Do you avoid tests of your performance in case you fail?

These questions can help detect when perfectionism is interfering with functioning and is likely to be associated with low mood and anxiety.

Other types of perfectionism

There are other types of perfectionism that might also be posing a problem such has having high standards for other people and constantly feeling let down. Similarly, some people erroneously believe that other people have high standards for them and that they feel they are constantly letting other people down. In some cases, people are focused on the need to appear perfect and in others their perfectionism may predominantly be focused in an area such as sport or religion.

Treating perfectionism

Until relatively recently, no treatment for perfectionism had been developed, partly due to the suggestion that perfectionism was an unchangeable personality characteristic. However, in 2002 the Oxford Centre for Eating Disorders (where I was fortunate to be working) proposed a cognitive-behavioural approach to perfectionism (Shafran, Cooper & Fairburn, 2002). Although it was controversial, it paved the way for research and multiple studies have now shown that the treatment based on this approach is effective both in terms of reducing perfectionism but also with respect to the impact that the treatment has on other difficulties such as depression and anxiety.

The treatment can be delivered individually, in groups, using a self-help book or over the internet. Some of the key treatment strategies are:

  • Understanding what maintains the perfectionism. It is helpful to understand the causes of the perfectionism but, like other cognitive behavioural approaches, the focus is on the factors that keep the perfectionism going.
  • Dispelling myths. For example, many people believe ‘the harder I work, the better I will do’ but there comes a point at which over-working may backfire and cause a deterioration in performance due to tiredness (for example).
  • Conducting surveys to be able to get information about others’ standards to enable benchmarking.
  • Testing out beliefs using ‘behavioural experiments’. For example, if a person thinks that they will fail an assignment if they do less than eight hours work, he/she would be encouraged to do seven hours work and to use that extra hour to do something enjoyable instead; gradually the amount of work would be reduced and the person would learn that three to four hours is sufficient for that type of assignment.
  • Addressing ‘all-or-nothing’ thinking by helping the person realise the shades of grey between ‘success’ and ‘failure’.
  • Trying to rebalance attention so that it isn’t always focused on the negative.
  • Helping with self-criticism by increasing compassion towards oneself and having the same expectations for themselves and others.
  • Dealing with avoidance, procrastination and other related problems such as poor time management; problem-solving strategies such as the ones described by Christine and Arthur Nezu can be particularly helpful (and problem-solving is also an effective intervention for depression!)

The future

We have come a long way in our understanding of perfectionism and in developing interventions that work. However, there remains a great deal of work to do so that we can help people with a wide variety of forms of perfectionism and to see whether the interventions work for children and young people. We also need to make sure that people can access the treatments that they need in a timely way. I am hopeful that such ambition reflects healthy striving for excellence and an achievable goal, but only time will tell….

Further reading

Nezu, A. M., Nezu, C. M., D’Zurilla, T. J. (2007) Solving Life’s Problems: A 5-step Guide to Enhanced Well- being.

Shafran, R., Egan, S., & Wade, T. (2018). Overcoming Perfectionism 2nd Edition: A self-help guide using scientifically supported cognitive behavioural techniques. Robinson.

Shafran, R., Egan, S. & Wade, T. (2012) Changing Perfectionism: This booklet describes ‘clinical perfectionism’ and its link with how people evaluate themselves.

References

Hollender, M. H. (1965). Perfectionism. Comprehensive psychiatry, 6(2), 94-103.

Horney, K. (1950). The Collected Works of Karen Horney: Self analysis. Neurosis and human growth (Vol. 2). WW Norton.

Shafran, R., Cooper, Z., & Fairburn, C.G. (2002). Clinical perfectionism: A cognitive–behavioural analysis. Behaviour research and therapy, 40(7), 773-791.

About the author

Roz Shafran is a Professor of Translational Psychology at University College London and a Chartered Clinical Psychologist. She is a Trustee of the Charlie Waller Memorial Trust and founded the Charlie Waller Institute of Evidenced Based Psychological Treatment at the University of Reading.

She is also co-author of ‘Overcoming Perfectionism: a self-help guide using scientifically supported cognitive behavioural techniques’.

Resources

No Harm Done: Recognising and responding to self-harm

Next steps for staff working with young people

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

We would like to acknowledge the Charlie Waller Memorial Trust (CWMT) UK for these resources and for allowing us to adapt this. For the original version of this resource, please refer to the CWMT website: www.cwmt.org.uk

INTRODUCTION

Self-harm describes any way in which a young person might harm themselves or put themselves at risk in order to cope with difficult thoughts, feelings or experiences. It affects up to 1 in 5 young people and spans the divides of gender, class, age and ethnicity. As such, many people find themselves in the position of wanting to support a young person who is self-harming. This can be difficult due to lack of confidence or uncertainty about what to say or do. Here we’ve provided simple guidance for taking those first steps – your support can be life-changing.

“I was so alone and lost and desperate. I thought no one cared until my [social worker] encouraged me to open up. I remember that day so vividly – it was the first day of the rest of my life.”

SELF-HARM WARNING SIGNS

There are many signs you can look out for which indicate a young person is in distress and may be harming themselves, or at risk of self-harm, the most obvious being physical injuries which:

  • you observe on more than one occasion
  • appear too neat or ordered to be accidental
  • do not appear consistent with how the young person says they were sustained

Other warning signs include:

  • secrecy or disappearing at times of high emotion
  • long or baggy clothing covering arms or legs even in warm weather
  • increasing isolation or unwillingness to engage
  • avoiding changing in front of others (may avoid PE, shopping, sleepovers)
  • absence or lateness
  • general low mood or irritability
  • negative self-talk – feeling worthless, hopeless or aimless

“At first we thought he was just accident prone, it was easy to miss, he always had an explanation as to how he’d got hurt.”

THE FIRST CONVERSATION

The sooner we encourage a young person to disclose their self-harm, the sooner we are able to provide or seek appropriate support to help them break the cycle. We can do so by passing our concerns on to a [trusted adult/teacher] or by providing a safe space for the young person to talk to us.

“It was the hardest conversation of my life, but every word I spoke made the load feel a little lighter and for the first time in a long time, I felt hope.”

The most supportive first conversation is one where:

  • the young person is the sole focus of your attention
  • you spend most of your time listening, not talking
  • the young person tells their story, you never guess or assume
  • there is a feeling of acceptance and support, not judgement
  • self-harm is not dismissed as attention seeking
  • unrealistic promises are not made about confidentiality
  • this is recognised as the first step of a difficult journey
  • clear next steps are identified and followed up promptly
  • you recognise how hard this conversation must be for the young person
  • you respond calmly – even if you don’t feel calm

“I’m not looking for attention, it’s just the only thing that helps me control the wayI feel.”

WHEN A YOUNG PERSON ISN’T READY TO TALK

When a young person is more reluctant to disclose or discuss their self-harm, three important questions to consider are:

  1. Who is the best person to have this conversation? You can use your knowledge of the young person, or ask them who they feel comfortable talking to.
  2. How can you help the conversation flow? An informal environment or talking whilst carrying out another activity such as walking or drawing can really help.
  3. Would another medium work better? Some young people feel happier talking via instant messenger, text or email – be creative and use your knowledge of the child.

“I tried several times to talk to him to no avail; it was only when I texted him that the conversation finally started.”

If a young person still isn’t ready to open up, provide them with details of anonymous sources of support and regularly revisit the situation.

“The [phone] counsellor helped me get more comfortable talking about things and next time my teacher tried to talk to me, I felt ready.”

NEXT STEPS

If you have any concerns about a young person’s immediate safety, this is an absolute priority and should be treated as an urgent safeguarding issue in line with your policies. If you think a young person is at risk, they should not be left alone.

All discussions should be recorded and shared with a trusted adult/teacher who will keep these details on file and can provide support and direction on appropriate next steps. These might include:

  • Informing adults who need to know in order to keep the young person safe. This will usually include parents or carers.
  • Visiting the GP to seek further support and guidance.
  • Providing access to a school counsellor.
  • Setting up regular meetings with a trusted adult such as a class teacher who can provide practical support and guidance.

It is important that all wounds are appropriately dressed and cared for as infection is common. Provide the young person with information about wound care or access to a trained first aider or medical professional who can assess and dress any wounds.

“He didn’t want to show me his wounds but he was happy to have the school nurse assess and dress them as long as I told her not to ask any questions.”

PROVIDING PRACTICAL SUPPORT

If you find yourself in the position of providing regular support to a young person, here are some helpful things you can do:

Listen – provide a safe space for non-judgmental, supportive listening. Even a few minutes of high quality listening can make a huge difference to how supported a young person feels.

Address stressors – work with the young person to understand their triggers and stressors. Working

through a typical day and highlighting the tough bits can be a great way to start and then think creatively of ways you might address these.

Make a self-soothe box – work with the young person to collect a range of different things they can use to distract or soothe themselves when they feel the urge to self-harm. This might include music, colouring, books, bubbles, photographs or inspirational quotes.

Provide safe sources of further information – highlight sources of further information such as those listed at the end of this resource.

Safeguarding your own wellbeing – It can be emotionally challenging to support a young person who is self-harming so it’s important that you too receive regular support and confidential listening. Keep in regular contact with a trusted adult/teacher and if, for any reason, you feel you are unable to continue to support the young person, discuss this at the earliest opportunity.

“Things changed for me at home and I felt unable to provide the level of support she deserved. I was honest with her and we identified a different adult she could regularly speak to.”

WHOLE SCHOOL APPROACH

Whilst there is much that proactive, supportive individuals can do to help a young person within their school or organisation, this support is best provided within the context of a whole school approach in order to keep both ourselves, and the young person as safe as possible. Simple steps that your school could take include:

1. Developing and implementing a mental health policy

Clear guidance can give staff the knowledge and confidence they need to respond to issues appropriately. It is important to develop a policy that feels relevant and achievable within your setting and to ensure that all staff know who to refer to with concerns.

2. Providing training for all staff

Providing basic training for all staff on how to recognise and respond to self-harm will increase the confidence of both staff and students in making and responding to disclosures.

3. Addressing self-harm as part of the curriculum

Your school curriculum can provide a great opportunity to tackle myths and misunderstandings surrounding self-harm and to provide students with an understanding of how to keep themselves and each other supported and safe.

4. Looking after staff wellbeing

Before we can look after others, we must first look after ourselves. Supporting young people who are in emotional distress can be physically and mentally draining for staff; this needs to be recognised and appropriate support put in place, both in terms of training and supportive listening.

“Most importantly, the [professional training] day got us talking about self-harm. It was uncomfortable at first but we all grew in confidence throughout the day. It was really empowering – we’re no longer scared of disclosures, we feel confident we can help.”

FURTHER INFORMATION (UK-only)

YoungMinds: youngminds.org.uk Parents Helpline 0808 802 5544 (Monday to Friday 9.30am – 4pm)

YoungMinds provides information and free resources to help implement a whole school approach and self-harm, mental health and resilience training for professionals.

Charlie Waller Memorial Trust provides free self-harm training to staff working with young people.

Factsheet from The Royal College of Psychiatrists Childline: childline.org.uk 0800 1111 (24hr)

Helpline (24 hr): 08457 90 90 90 UK & NI

Email: jo@samaritans.org The Site: thesite.org

Self-Harm Alternatives: over 130 ideas for use in recovery suggested by young people, collated by Dr Pooky Knightsmith

Self-Harm and Eating Disorders in Schools: A Guide to Whole-School Strategies and Practical Support by Pooky Knightsmith. Available as a paperback or Kindle

A Short Introduction to Understanding and Supporting Children and Young People Who Self-Harm by Professor Carol Fitzpatrick. Available as a paperback or Kindle

No Harm Done:    film &     resource pack for parents

No Harm Done:    film &     resource pack for young people

“There’s no denying that it’s a gruelling journey and there are downs as well as ups; but once you’re out the other side and you see a happy, healthy young person ready to head out into the world it is the best feeling ever.”

Resources

Bipolar disorder symptoms

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • What is bipolar disorder
  • Sub-types of bipolar disorder
  • Symptoms of bipolar disorder
  • When to seek help for bipolar disorder
  • Key points to remember
  • Where to get more information

What is bipolar disorder?

  • Bipolar disorder is the name used to describe a set of ‘mood swing’ conditions, the most severe form of which used to be called ‘manic depression’.
  • The term describes the exaggerated swings of mood, cognition and energy from one extreme to the other that are characteristic of the illness.
  • People with this illness suffer:
  • Recurrent episodes of high, or elevated moods (mania or hypomania) and depression.
  • Most experience both the highs and the lows.
  • Occasionally people can experience a mixture of both highs and lows at the same time, or switch during the day, giving a ‘mixed’ picture of symptoms.
  •  A very small percentage of sufferers of bipolar disorder only experience the ‘highs’.

People with bipolar disorder experience normal moods in between their mood swings.

  • The mood swings pattern for each individual is generally quite unique, with some people only having episodes of mania once a decade, while others may have daily mood swings.
  • Bipolar disorder can commence in childhood, but onset is more common in theteens or early 20’s.
  • Some people develop ‘late onset’ bipolar disorder, experiencing their first episode in mid-to-late adulthood.

Distinguishing between bipolar I and bipolar II

  • Bipolar I disorder is the more severe disorder, in the sense that individuals are more likely to experience ‘mania’, have longer ‘highs’ and to have psychotic episodes and be more likely to be hospitalised.
  • Mania refers to a severely high mood where the individual often experiences delusions and/ or hallucinations. The severe highs which are referred to as ‘mania’ tend to last days or weeks.
  • Bipolar II disorder is defined as being less severe, in that there are no psychotic features and episodes tend to last only hours to a few days; a person experiences less severe highs which are referred to as ‘hypomania’ and depression but no manic episodes and the severity of the highs does not usually lead to hospitalisation.
  • Hypomania literally translates into ‘less than mania’. It describes a high that is less severe than a manic episode and without any delusions and/or hallucinations.
  • These highs don’t last as long. While they are officially diagnosed after a four-day duration, research has shown that they may only last a few hours to a few days.
  • Both women and men develop bipolar I disorder at equal rates, while the rate of bipolar II disorder is somewhat higher in females.

Symptoms of bipolar disorder

  • Diagnosing bipolar disorder is often not a straightforward matter.
  • Many people go for 10 years or more before their illness is accurately diagnosed.
  • It is important to note that everyone has mood swings from time to time. It is only when these moods becomeextreme and interfere with a person’s personal and professional life that bipolar disorder may be indicated and medical assessment sought.
  • There are two starting points for considering whether you might have bipolar disorder.
    • Firstly, you must have had episodes of clinical depression.
    • Secondly, you must have had ‘highs’, where your mood was more ‘up’ than usual, or where you felt more ‘wired’ and ‘hyper’.
  • If both depression and ‘highs’ have been experienced, then the next thing to consider is whether you also experienced any of the six key features of mania and hypomania outlined below.

Key features of mania & hypomania

While it can be difficult to identify what separates normal ‘happiness’ from the euphoria or elevation that is seen in mania and hypomania, researchers at the Black Dog Institute, have identified the following distinguishing features:

  • High energy levels – feeling ‘wired’ and ‘hyper’, extremely energetic, talking more and talking over people, making decisions in a flash, constantly on the go and feeling less need for sleep.
  • Positive mood – feeling confident and capable, optimistic that one can succeed in everything, more creative, happier, and feeling ‘high as a kite’.
  • Irritability – irritable mood and impatient and angry behaviours.
  • Inappropriate behaviour – becoming over involved in other peoples’ activities, engaging in increased risk taking (i.e. by over indulging in alcohol and drugs and gambling excessively) saying and doing outrageous things, spending more money, having increased libido; dressing more colourfully and with disinhibition.
  • Heightened creativity – ‘seeing things in a new light’, seeing things vividly and with crystal clarity, senses are heightened and feeling quite capable of writing the ‘next great novel’.
  • Mystical experiences – believing that there are special connections between events, that there is a higher rate of coincidence between things happening, feeling at one with nature and appreciating the beauty and the world around, and believing that things have special significance.
  • More extreme expressions of mania (but not hypomania) may have the added features of delusions and hallucinations.
  • A number of other symptoms can indicate whether there is a likely diagnosis of bipolar disorder, particularly for those under the age of 40. These include:
    • Racing thoughts (for example, feeling like you are watching a number of different TV channels at the same time, but not being able to focus on any)
    • Sleeping a lot more than usual
    • Feeling agitated, restless and/or incredibly frustrated.

When to seek help for bipolar disorder

  • If you have experienced an episode of mania or hypomania, or have taken the Black Dog Institute’s Bipolar Disorder Self-Test, linked under the resources at the end of this fact sheet, and are concerned about your results, it is advisable to seek professional assessment by a mental health practitioner.
  • The first step is to arrange a consultation with your doctor. They will provide an assessment and, where necessary, refer you to a psychiatrist for further treatment.
  • Bipolar disorder is not an illness which goes away of its own accord, but one which often needs long-term treatment. Accurately diagnosing bipolar disorder is a task for the mental health professional.
  • Some people with bipolar disorder can become suicidal. It is very important that talk of suicide be taken seriously and for such people to be treated immediately. In an emergency you can go straight to your local hospital’s emergency department for help, or dial 999.

Key points to remember

  • Bipolar disorder is an illness involving exaggerated swings of mood and energy from one extreme to the other, usually involving alternating periods of depression and mania or hypomania.
  • The pattern of mood swings for each individual is quite unique.
  • The six features of mania and hypomania are:
  1. High energy levels
  2. Positive mood
  3. Irritability
  4. Inappropriate behaviour
  5. Heightened creativity
  6. Mystical experiences
  • For people under the age of 40, other symptoms of bipolar disorder may include sleeping a lot more than usual, feeling agitated, restless and/or incredibly frustrated.
  • Accurately diagnosing bipolar disorder is a task for a skilled mental health practitioner.
  • If symptoms of bipolar disorder are suspected it’s best to first see a doctor, who will likely refer you to a psychiatrist.
  • People with bipolar disorder can become suicidal. Talk of suicide should be taken seriously and immediate help should be sought from a doctor or other mental health professional.

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more information and support

Black Dog Institute – “Bipolar Disorder Self-Test”

Mind Hong Kong – “What Is Bipolar Disorder?”

Bilingual Telephone Hotlines

Hospital Authority Mental Health 24-hour Hotline: 2466 7350

Social Welfare Department Hotline: 2343 2255

Chinese-Only Telephone Hotlines

Youth Outreach 24-hour hotline service: 90881023

The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 27778899

Resources

Seeking help for anxiety

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • Why seek help for anxiety?
  • Who to talk to
  • Treatment available

It’s important to get treatment for anxiety

Anxiety is physically and emotionally exhausting. Getting help early means you can start to get relief and recover sooner. There are many professionals who treat all kinds of anxiety.

There is a wide range of effective treatments for anxiety, e.g.

  • Cognitive behavioural therapy (CBT)
  • E-mental health tools
  • Relaxation techniques
  • Medications

There are also lots of things you can do to help yourself.

Often, it’s a combination of things that help us get better, such as:

  • A well-informed health professional you feel comfortable talking to
  • The right psychological and medical therapies
  • Support from family and friends
  • Exercising and healthy eating
  • Learning ways to manage challenges and stress, such as structured problem solving, meditation and yoga

How do I know it’s anxiety?

Severe anxiety can appear in ways that feel like other health issues, e.g.

  • Chest pain
  • A racing heartbeat
  • Dizziness
  • Rashes

Sometimes, anxious people think they’re having a heart attack.

When we’re anxious, we can also become hyper-aware of:

  • Our body
  • Aches and pains
  • Perceived threats and danger

Sometimes, once we’re aware of a problem, we can become ‘hyper-vigilant’ in checking on all the discomforts and pains we feel. This can spiral into feeling more concern and worry, making the anxiety more severe.

You should always see a doctor, so they can make a thorough check of your symptoms and rule out any other medical condition.

Who can provide help for anxiety?

As well as your doctor, there are other health professionals who can help with anxiety, including:

  • Psychologists
  • Psychiatrists
  • Counsellors
  • School and university counsellors
  • Social workers and occupational therapists trained in mental health
  • Mental health nurses

What type of treatment is available?

There are three broad categories of treatment for anxiety:

  • Psychological treatments (talking therapies)
  • Physical treatments (medications)
  • Self-help and alternative therapies

Psychological therapies are the most effective way to treat and prevent the recurrence of most types of anxiety. Depending on the type of anxiety, self-help and alternative therapies can also be helpful. They can be used alone or combined with physical and psychological treatments.

A thorough assessment by your doctor is needed to decide on the best combination of treatments for you.

Psychological treatments

Psychological treatments can be one-on-one, group-based or online interactions. Psychological treatments are sometimes called ‘talking therapies’ as opposed to ‘chemical therapies’ (i.e. medications).

Keeping health in mind

Talking therapies can help us change habits in the way we think, and cope better with life’s challenges. They can help us address the reasons behind our anxiety, and also prevent anxiety from returning.

There are a wide range of psychological treatments for anxiety, including:

  • Cognitive behaviour therapy (CBT)
  • Exposure therapy (behaviour therapy)
  • Interpersonal therapy (IPT)
  • Mindfulness-based cognitive therapy
  • Positive psychology
  • Psychotherapies
  • Counselling
  • Narrative therapy

Some of the above treatments can be accessed online. Evidence-based online treatments can be as effective as face-to-face treatments. These online treatments are often referred to as e-mental health programs.

Physical treatments

Your doctor should undertake a thorough health check before deciding whether medication is a good option for you. Taking medication for anxiety must be supervised by a doctor. If medication is prescribed as part of your treatment, your doctor should explain the reason for choosing the medication they’ve prescribed.

Your doctor will:

  • Discuss the risks and benefits, side effects, and how regularly you need check-ups.
  • Advise what treatments can work together with the medication, such as psychotherapy, lifestyle changes (e.g. exercise) and other support options.

Anti-anxiety medications are used for very severe anxiety in anxiety types such as:

  • Panic disorder
  • Generalised anxiety disorder (GAD)
  • Social phobia

Anti-anxiety medications, such as benzodiazepines, can:

  • Be addictive
  • Become ineffective over time
  • Have other side effects such as headaches, dizziness and memory loss

Anti-anxiety medications are not recommended for long-term use.

It’s important to know that not all anxiety needs medication. Many people respond well to lifestyle changes and psychological treatments.

Self-help and alternative therapies

There are a wide range of self-help measures and therapies that can be useful for anxiety. It’s good to know that there are things you can do for yourself to feel better.

Self-help and complementary therapies that may be useful for anxiety include:

  • Exercise
  • Good nutrition
  • Omega-3
  • Meditation
  • De-arousal strategies
  • Relaxation and breathing techniques
  • Yoga
  • Alcohol and drug avoidance
  • Acupuncture

Different types of anxiety respond to different kinds of treatments. Severe anxiety may not respond to self-help and alternative therapies alone. These can be valuable adjuncts to psychological and physical treatments.

e-mental health programs

e-mental health programs can be used in conjunction with a mental health professional or as a stand-alone option. e-mental health programs (also called ‘e-therapies’ or ‘online therapies’) are online mental health treatment and support services. You can access them on the internet using your smartphone, tablet or computer. The programs can help people experiencing mild-to- moderate depression or anxiety.

Some e-mental health tools, such as myCompass developed by the Black Dog Institute, have been found to be as effective in treating mild-to- moderate depression as face-to-face therapies.

e-mental health treatments are based on face-to-face therapy, positive psychology and behavioural activation. These therapies mainly focus on reframing thoughts and changing behaviour.

Key points to remember

  • Lots of professionals can help you with anxiety
  • There are many types of treatments for anxiety, and you can get better
  • Many people who have had anxiety have been able to seek help and live active, fulfilling lives

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more Information and Support

Black Dog Institute – “myCompass”

Student Health Services – “Understanding Anxiety Disorders”

OCD & Anxiety Support Hong Kong

Mind Hong Kong – “Anxiety and Panic Attacks”

The Mental Health Association of Hong Kong:

Phone: 2528 0196
Website: www.mhahk.org.hk



Resources

Helping someone who has a mental illness: for family and friends

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • How to tell if someone has a mental illness
  • What to do if you are concerned about a family member or close friend
  • How to behave with someone who is depressed
  • What to do if someone is suicidal
  • Self care for carers
  • Key points to remember
  • Further information and support

Someone with a mood disorder is like anyone with any other illness – they need care and support. Family and friends can provide better care if they are informed about the illness, understand the type of treatment and are aware of the expected recovery time.

How to tell if someone has a mental illness

Even if you know someone well, you will not always notice when they have changed. You are more likely to notice big or sudden changes but gradual changes can be easy to miss. It’s also true that people will not always reveal all their thoughts and feelings to their close friends and family.

For these reasons, family and friends cannot expect to always know when someone has a depressive illness and should not feel guilty that they ‘did not know’.

The best approach is to acknowledge that mental illnesses are common and to learn how to recognise the signs and how to offer help.

What to do if you are concerned about a family member or close friend

If you are worried that a family member or close friend has a mood disorder, try talking to them about it in a supportive manner and either suggest that they consult their doctor or another mental health professional.

Sometimes they may be reluctant to seek help. You might need to explain why you’re concerned and provide specific examples of their actions or behaviour that are worrying you. Providing them some information such as a book, fact sheets or helpful pamphlets might also help.

You could offer to assist them in seeking professional help by:

  • Finding someone that they feel comfortable talking to.
  • Making an appointment for them on their behalf.
  • Taking them to the appointment on the day
  • Accompanying them during the appointment if appropriate.

This level of help may be particularly appropriate if the person has a severe mood disorder such as psychotic depression or mania.

Young people, adolescents in particular, are vulnerable to mental health problems. If you are concerned about someone, try:

  1. Gently let them know you have noticed. changes and explain why you are concerned
  2. Find a good time to talk when there are no pressures or interruptions.
  3. Listen and take things at their pace
  4. Respect their point of view.
  5. Validate what they are experiencing, but don’t offer reassurance or advice too quickly
  6. Let them know that there is help available that will make them feel better.
  7. Encourage them to talk to a doctor or other health professional, and to find a trusted friend or family member that they can confide in.

There are also a range of services (e.g. telephone counselling and online resources) that are specifically designed for young people. You can find out more about what is provided in Hong Kong on the Coolminds website.

How to behave with someone who is depressed

Patience, care and encouragement from others are vital to a person who is experiencing depression. Someone experiencing depression is very good at criticising themselves and needs support from others, not criticism.

Clear and effective communication within the household or family is also important. Partners or families might find it helpful to see a psychologist during this time for their own support.

An episode of depression can provide an opportunity for family members to re-evaluate the important things in life and resolve issues such as grief or relationship difficulties.

Some Tips:

  • Avoid suggesting to the person that they “cheer up” or “try to get over it”. This is unhelpful as it is likely to reinforce their feelings of failure or guilt.
  • Another important part of caring is to help the treatment process – if medication has been prescribed, encourage the person to persist with treatment and to discuss any side effects with their prescribing doctor.
  • The person may also need encouragement and help to get to their therapy appointments or complete any online therapy exercises they have been asked to do.
  • During a depressive illness, counselling or psychotherapy often results in the person working through their life events and relationships; while this can be difficult for all concerned, friends and family should not try to steer the person away from these issues.

What to do if someone is suicidal

If someone close to you is suicidal or unsafe, try:

  • Talking to them about it and encourage them to seek help.
  • Remembering that if someone is feeling like their life is not worth living, they are experiencing overwhelming emotional distress.
  • Helping the person to develop a safety plan involving trusted close friends or family members that can keep the person safe in times of emergency.
  • Removing risks (e.g. take away dangerous weapons or items if that person is angry or out of control and threatening to disappear).

Self care for carers

(A carer is someone who provides support to a friend, family member, or neighbor in need of help because of their age, disability, or physical or mental health.)

  • Carers are also likely to experience stress. Depression and hopelessness have a way of affecting the people around them.
  • Therapy can release difficult thoughts and emotions in carers too. So, part of caring is for carers to look after themselves to prevent becoming physically run down and to deal with their internal thoughts and emotions.
  • Treatment has a positive time as well; when the person starts to re-engage with the good things in life and carers can have their needs met as well.

Key points to remember

  • If you are worried that someone is depressed or has bipolar disorder, try talking to them about it in a supportive manner and suggest that they see a mental health professional.
  • If they don’t want to seek help, explain the reasons for concern and perhaps provide them with some relevant information.
  • Young people are particularly vulnerable to depression.
  • Patience, care and encouragement from others are all vital to the person who is depressed.
  • If a loved one talks of suicide, encourage them to seek help immediately from a mental health professional.
  • Depression can take a toll on carers and close family members – it is important for these people to take care of themselves as well.

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more help and support

Bilingual Web Resources

Mind Hong Kong – “Am I A Carer?”

Mind Hong Kong – “What Can Friends and Family Do To Help?”

Student Health Service – “Understanding Depression”

Student Health Service – “Emotional Health”

English-Only Web Resources

Reach Out: a web-based support for adolescents

Headspace online: help for young people

Bilingual Telephone Hotlines

Samaritans Hong Kong 24-hour hotline: 28960000

Samaritan Befrienders Hong Kong 24-hour hotline: 23892222

Suicide Prevention Services 24-hour hotline: 23820000

Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777

Hospital Authority Mental Health 24-hour Hotline: 2466 7350

Social Welfare Department Hotline: 2343 2255

Chinese-Only Telephone Hotlines

Youth Outreach 24-hour hotline service: 90881023

The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 27778899


Resources

Depression in adolescents & young people

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com


Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website:
www.blackdoginstitute.org.au

What this fact sheet covers:

  • Signs of depression in adolescence
  • Where to get help for an adolescent
  • Key points to remember
  • Where to get more information

Introduction

  • A 2017 study by the Hong Kong Federation of Youth Groups found that of the 3,441 secondary school and university students surveyed, 51% displayed symptoms of depression and close to 40% experienced high levels of stress (7 on a scale of 10).
  • According to research done by the University of Hong Kong, more than two-thirds of Hong Kong’s university students experience symptoms of mild to severe depression.
  • The HKJC Centre for Suicide Research and Prevention observed that suicide rates for full-time students increased by 76% between 2012 and 2016.
  • Onset of depression is typically around mid-to-late adolescence, and it is important to recognise the early warning signs and symptoms. Early intervention can often prevent the development of severe depressive illness.

Developmental Impact

  • The teenage years are a time when individuals develop their identity and sense of self.
  • If depression is left to develop, it can lead to isolation from family and friends, risk-taking behaviours such as inappropriate sexual involvements and drug and alcohol abuse.
  • It can also impact on school performance and study, which can have downstream effects on later career or study options.
  • Both biological and developmental factors contribute to depression in adolescence. If bipolar disorder or psychosis is suspected, an assessment by a health professional is recommended. See our Fact Sheet “Symptoms of Bipolar Disorder” for more information.

Signs of depression in an adolescent

  • An adolescent who is depressed may not show obvious signs of depression.
  • It is often hard to distinguish adolescent turmoil from depressive illness, especially when the young person is forging new roles within the family and struggling with independence, and having to make academic and career decisions.
Signs of a depressed mood include:
  • Lowered self-esteem (or self-worth)
  • Changes in sleep patterns, that is, insomnia (inability to sleep), hypersomnia (excessive sleep) or broken sleep
  • Changes in appetite or weight
  • Inability to control emotions such as pessimism, anger, guilt, irritability and anxiety
  • Varying emotions throughout the day. For example, feeling worse in the morning and better as the day progresses.
  • Reduced capacity to experience pleasure: inability to enjoy what’s happening now, not looking forward to anything with pleasure such as hobbies or activities.
  • Reduced pain tolerance: decreased tolerance for minor aches and pains
  • Poor concentration and memory
  • Reduced motivation to carry out usual tasks
  • Lowered energy levels

Where to get help for an adolescent

  • If you think someone you are close to might be depressed, you should encourage them to seek advice from a professional. (At school – school counsellor, social worker. Outside school – doctor, counsellor, psychologist)
  • The first step is to speak to a professional who can conduct an assessment, provide options and discuss the next steps to take.
  • Other initial sources of help are school counsellors and trusted close family members to whom the young person feels comfortable talking.
  • If the young person does not want to seek help, it is best to explain your concerns and to provide them with some information to read about depression.
  • There are also some excellent websites designed for young people, as well as confidential online and telephone counselling services in both English and Chinese. Please see our list of services at the end of this fact sheet.
  • It’s important for young people to know that depression is a common problem and that there are people who can help.
  • If there is any mention of suicide this should be taken seriously, and immediate assistance is available by calling 999 or going directly to the nearest hospital.

Key points to remember

  • A 2017 study by the Hong Kong Federation of Youth Groups found that of the 3,441 secondary school and university students surveyed, 51% displayed symptoms of depression and close to 40% experienced high levels of stress (7 on a scale of 10).
  • Depression in young people is associated with social withdrawal, drops in performance at school, drug or alcohol use and engaging in risky behaviours.
  • It can be hard to distinguish depression from adolescent turmoil; if depression is suspected, an assessment should be sought from a doctor or other mental health professional.
  • Immediate help should be sought if a young person talks of suicide.

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more Information and Support

Mind Hong Kong – “What Is Depression?” 

Student Health Service – “Understanding Depression”

Student Health Service – “Emotional Health”

Bilingual Telephone Hotlines

Samaritans Hong Kong 24-hour hotline: 28960000

Samaritan Befrienders Hong Kong 24-hour hotline: 23892222

Suicide Prevention Services 24-hour hotline: 23820000

Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777

Hospital Authority Mental Health Direct hotline: 24667350

Chinese-Only Telephone Hotlines

Youth Outreach 24-hour hotline service: 90881023

The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 27778899

Resources

Causes of depression

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • Factors involved in developing depression
  • Key points to remember
  • Where to get more information

Introduction

Unlike other illnesses or disorders, there is no simple explanation as to what causes depression. In general, depression can be due to a number of factors including stresses which can range from mild to severe, combined with vulnerability or predisposition to depression that can result from biological, genetic or psychological factors.

Each type of depression is associated with different mixtures of causes. For psychotic or melancholic depression, physical and biological factors are relevant. In contrast, for non-melancholic depression, the role of personality and stressful life events are important.

Genetic factors

There is strong evidence that genetic factors play a significant role in a person’s predisposition towards developing depression, especially melancholic depression, psychotic depression and bipolar disorder. No single gene is likely to be responsible, but rather a combination of genes.

The predisposition to develop depression can be inherited. The genetic risk of developing clinical depression is about 40% if a biological parent has been diagnosed with the illness, with the remaining 60% being due to factors within the individual’s own environment. Depression is unlikely to occur without stressful life events, but the risk of developing depression as a result of such an event is strongly genetically determined.

Biochemical Factors

Our knowledge of the human brain is still fairly limited, therefore we do not really know what actually happens in the brain to cause depression. It is likely that with most instances of clinical depression, neurotransmitter function is disrupted. Neurotransmitters are chemicals that carry signals from one part of the brain to the next. There are many neurotransmitters serving different purposes. However, three important ones that affect a person’s mood are serotonin, noradrenaline and dopamine.

In normal brain function, neurotransmitters interact with a series of nerve cells, with the signal being as strong in the second and subsequent cells as it was in the first. However, in people who are depressed, mood regulating neurotransmitters fail to function normally, so that the signal is either depleted or disrupted before passing to the next nerve cell.

Physical Illness

In a simple sense, physical illness can lead to depression through the lowered mood that we can all experience when we are unwell, in pain or discomfort, confined and less able to do the things we enjoy.

Illness can also change the body’s functioning in a way that leads to depression. Even if the illness isn’t making us feel down we can still suffer from depression. For example:

  • It is known that certain cancers can produce a depressive illness – in these cases a person might be quite unaware that they are suffering from depression.
  • Compromised immune functioning might play a part in the emergence of depression, although further research is needed to establish this link.
The ageing brain

As we age, our brain’s general functioning can become compromised and this can affect the neurotransmitter pathways which influence mood state. Three reasons for these changes are worth mentioning in relation to depression:

  • Late onset depression: Elderly people who develop dementia may also develop a severe depression for the first time; this type of depression is commonly of a psychotic or melancholic type and reflects the disruption of circuits linking certain basal ganglia and frontal regions of the brain.
  •  These brain changes can reflect an ageing process, particularly in people who are vulnerable to this kind of ‘wear and tear’.
  • In others however, high blood pressure or mini-strokes (often unnoticed by the individual and their family) may contribute. Good blood pressure control can reduce the chance of depression in some people.
Gender

Gender is a partial but incomplete explanation of why people may develop depression. Equal numbers of men and women develop melancholic depression. However, studies have shown that there is a much greater likelihood of women developing non-melancholic depression than men. Some of the explanations for this are:

  • Women are more likely than men to ‘internalise’ stress, thereby putting them at greater risk of developing depression.
  •  Women with unsatisfactory marriages or who are caring for a number of young children are also highly over represented among samples of depressed people.
  • Hormonal factors commencing in puberty may account for the increased chance in women of developing anxiety (a precursor to depression) or depression.
Stress

It is important to recognise that nearly every individual can be stressed and depressed by certain events. Most people get over the stress or depression within days or weeks while others do not. Ways that stress can lead to depression include the following:

  • Past or long-standing stresses can increase the chances of an individual developing depression in later years e.g. growing up in an abusive or uncaring family may increase the risk of developing depression in adult life.
  • Events that affect a person’s self-esteem such as the break-up of a close relationship or marriage
  • Feelings of ‘shame’ for example, thinking they have not lived up to their own or others’ expectations.
Personality

Our research has shown that people with the following personality types are more at risk of developing depression than others. Those who are high on the first four factors are at distinctly greater risk to depression (especially non-melancholic depression):

  1. High levels of anxiety, which can be experienced as an internalised ‘anxious worrying’ style or as a more externalised ‘irritability’.
  2. Shyness expressed as ‘social avoidance’ and/or ‘personal reserve’.
  3. Self-criticism or low self-worth.
  4. High interpersonal sensitivity.
  5. Perfectionism is somewhat protective against the onset of depression but if depression occurs, it can result in longer episodes.
  6. A ‘self-focused’ style is likely to be at greater risk for brief depressive episodes only

Key points to remember

  • There is no single cause for depression; rather it’s a combination of stress and a person’s vulnerability to developing depression.
  • The predisposition to developing depression can be inherited.
  • Other biological causes for depression can include physical illness, the process of ageing and gender.
  • Stress can trigger depression but understanding its particular meaning to the person is important.
  • Certain temperament and personality styles pose risks for developing non-melancholic depression.

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more information and support

Mind Hong Kong – “What Is Depression?”

Student Health Service – “Understanding Depression”

Student Health Service – “Emotional Health”

Cheer Centre: Interpretation services for Ethnic Minorities for use of public services

Bilingual Telephone Hotlines

Samaritans Hong Kong 24-hour hotline: 28960000

Samaritan Befrienders Hong Kong 24-hour hotline: 23892222

Suicide Prevention Services 24-hour hotline: 23820000

Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777

Hospital Authority Mental Health Direct hotline: 24667350

Chinese-Only Telephone Hotlines

Youth Outreach 24-hour hotline service: 90881023

The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 27778899

Resources

Mental health problems in children and young people: guidance for parents and carers

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

We would like to acknowledge the Charlie Waller Memorial Trust (CWMT) UK for these resources and for allowing us to adapt this. For the original version of this resource, please refer to the CWMT website: www.cwmt.org.uk

Looking after a child or young person who has emotional or mental health problems can be very hard. You may feel challenged, isolated, scared and deeply upset and wish you knew where to turn for help.

What is this leaflet for?

This leaflet offers guidance on how best to support your child and where to find further advice and help with their mental health.

Be assured, things can improve for your child. Mental health, like physical health, is relevant to all of us, including children and young people. Problems are often temporary and, with support, can change for the better.

Seeking help

You are not alone. Many parents and carers have similar concerns and stresses, although they may not feel able to discuss them openly. There is good support and guidance, through national and local organisations. On the back of this leaflet is a list of reliable organisations that offer information based on sound evidence. Do have a look to find out which sources of support might be best for you.

The sooner you seek help, the better. Every local area is different but the three places listed below are a good place to start.

Talk to your GP

Your GP will listen, begin to understand your child’s needs and suggest the most appropriate course of action or support for your child, including referral to mental health specialists, if necessary.

So, make an appointment for your child and explain your concerns when you do so. You might also find it helpful to make a second appointment with the GP, for yourself, to discuss the “ripple effects” of your child’s difficulties on the rest of the family.

“[I spoke] about my hopelessness and sadness to a teacher, who called my Mum, and arranged for us to see my GP. A year later, I have just turned 16 and am in a completely different place to where I was a year ago.”

Help at school

School is an important part of the picture when it comes to children’s mental health. It’s a good idea to stay in communication with the school about the issues your child is experiencing. There may well be sources of help and support within the school, so do encourage your child to talk to a trusted teacher or member of support staff.

“The younger generation will hopefully grow up where mental health is not something that is ignored but something that should have everyone’s attention.” Teacher

Integrated Family Service Centre

Funded by the Social Welfare Department, IFSC’s are located all across Hong Kong. You can approach to receive support for your child, young person of family. Their social workers can provide counselling services or refer you out to a psychologist if necessary. You can call 23432555 to locate the IFSC for your family.

What you can do to help your child

As a parent you can have a crucial role in your child’s recovery. The more you can understand about mental health and your child’s difficulties, the more confident you will be in supporting them. Getting professional help can be important but there is a great deal you can do as a parent too. Every case is individual, but these general tips might help you to help your child:

Encourage them to talk

Try ‘open-ended’ questions like, “How are things for you?” “What’s happening with you?” “What do you think or feel about…?” or “What’s on your mind?”, rather than questions that have “yes/no” answers.

When discussing their problem, don’t try to ‘fix’ it. For the most part, young people simply need to know you are there to support them.

Listen and be understanding

Listen calmly and try not to judge your child. Let them know you are happy to listen while they chat about anything and everything, whenever they want to. Never underestimate the importance of being an attentive, non-judgmental listener.

Remember, you don’t need to know all the answers, listening without responding is often enough.

Give your child reliable self-help information from trusted sources, based on sound evidence

They can read and use this at their own pace, allowing them some privacy, but at the same time you are showing you are there to help and they are not alone. Peer-to-peer support can be really useful. Self-help links include:

Tell them, and show them, how much you care and how important they are in the family

It is not easy when stress levels are high, but a peaceful, loving home life can really help recovery. Keep family routines as normal

as possible and do simple things together – maybe watching a film, or having a meal, going for a walk or playing a game. Just doing simple everyday things together (like grocery shopping or cooking) can provide a really helpful distraction. This can bring everyone in the family closer.

Enjoy the time you spend together but understand that it might be a while before your child starts enjoying activities again. Try not to pressurise them and, if they need a little space, support them with that while not leaving them isolated.

Understand the problems

As with physical health, there are many different ways of experiencing mental health issues. Try to read up on your child’s specific problems. This will help you understand their experiences and what helps recovery, building their confidence for the future.

Encourage social contact with friends and family

Encourage your child to go out (if only for short periods) and to keep in touch with friends.

Simple physical activity

Taking regular exercise, such as going for walks, can help improve mood and reduce anxiety.

Know that recovery will not happen overnight

As a parent or carer, you want to make your child feel better immediately but, like physical health problems, mental health problems can sometimes take time to improve and some, such as eating disorders, may be complex and seem illogical. There will often be ups and downs in recovery.

Don’t be afraid to seek further advice from mental health professionals

Many of them have a great deal of experience and are generally an excellent source of guidance and support.

Don’t blame yourself

Parents or carers often feel guilty, thinking they have caused the problems, perhaps through genetics or the home life they have created. Usually, this is not the case.

Look after yourself

In order to support your child, you need to stay strong and well yourself. Often it helps to talk to someone, so don’t be scared about doing this, with friends, family or a parent helpline. For further resources and support for parents please visit the online helplines and resources on www.coolmindshk.com

Hong Kong organisations which help parents

Mind Hong Kong provides information and advice on a range of mental health topics, as well as a community directory of available resources.

New Life Psychiatric Rehabilitation Association provides a Family Support Service. They aim to build a holistic support network among carers to support them to face challenges with a positive mindset and to maintain family functions.

Caritas Family Crisis Support Center (in Chinese only) aims to manage family crisis at an early stage by providing integrated and easily accessible services to assist individuals or families in crisis or distress. Services provided include 24-hour hotline service (18288) and short-term emergency accommodation.

Youth Outreach (in Chinese only) has a 24-hour hotline for young people from ages 8 to 18. The organisation also provides support through emergency accommodation, individual and family counselling, academic and career advice, among others.

Hong Kong Eating Disorders Association
In addition to patient support groups and members gatherings, they host small group gatherings for caregivers to share and de-stress.

Baptist Oi Kwan Social Service has a family resource and service centre providing support and counselling for families of those recovering from mental illnesses.

Christian Family Service Centre provides education, counselling, groups, shelter and other services to children and families. They aim to help overcome family problems, provide quality learning environment, and build up their mutual support networks.

International organisations which help parents

Young Minds is an excellent source of information about all aspects of child mental health, including a Parent Helpline.

Minded for Families provides free, quality- assured advice which is easy to understand. It is helpful for any adults caring for children or teenagers with mental health problems.

Beat gives clear advice on all aspects of dealing with eating disorders, including helpful guidance to parents, carers and families.

Anna Freud Centre – a leaflet about mental health for parents of young children.