How Hong Kong can tackle its silent elderly mental health epidemic

With more than one in three Hongkongers estimated to be 65 or older by 2050, the city must decide whether to spend the coming years improving an overburdened healthcare system or to entirely transform the structure to address the silent epidemic of mental health crises among the elderly. Hong Kong is expected to have the world’s oldest population by 2050. While longevity is a remarkable indication of good health and an excellent medical system, it also comes with challenges beyond those of physical health. Many older adults struggle with isolation, confined living conditions and a lack of meaningful social connection, which can affect both mental and physical well-being. Mental health conditions in older adults, such as depression, are a growing concern and an estimated 10 per cent of the elderly in Hong Kong have depressive symptoms. From 2022 to 2024, more than 470 elderly suicides were recorded annually, making up more than 40 per cent of all cases in the city. Forgetfulness, persistent sadness, lack of appetite, unexplained pain in the body, changes in sleep patterns, and social withdrawal are often dismissed, seen as part of grieving for a loved one or shrugged off as part of ageing – reactions which prevent better mental health support and an early diagnosis. The normalisation of emotional and behavioural changes in older adults that ought to attract concern, on top of the stigma of mental health issues, has greatly prevented them from seeking professional help, exacerbating the conditions in later life. The causes of mental health conditions are complex and systemic. On the surface, it is the slow, cumulative grief of losing loved ones, decreasing mobility and independence, and changes in physical health and cognitive abilities. Research shows a correlation between the mind and the body, with patterns of chronic illnesses, like heart and joint diseases, directly tied to higher risks of depression and dementia. A decline in physical health can take a toll on mental well-being. But beneath the visible risk factors, the problems lie in our fast-paced society – with its information overload, heavy reliance on social media and rampant digital innovation – which has left older people behind. We have moved from a vertical society, where knowledge and traditions were transferred from the older to younger generations, to a horizontal, digitalised, tech-heavy society where information is available on our phones. The role our elderly played as knowledge hubs and storytellers is increasingly lost in transition or no longer valued. With rapid digitalisation, elderly adults face an added burden of having to familiarise themselves with technology, including new mobile apps for booking appointments and connecting with others. It is a painful shift for the elderly, moving from being a contributing member of society to being merely dependent. As with young people, older adults also need and seek engagement, recognition and meaningful roles in communities. The government provides a great deal of support for the elderly, including an old age allowance, healthcare vouchers and community care service vouchers. In recent years, Hong Kong’s community mental healthcare support has grown with funding from groups such as the Hong Kong Jockey Club Charities Trust. Community support services are also in operation, mostly by NGOs with government-subsidised facilities, such as the integrated community centres for mental wellness and the district elderly community centres. Despite the huge progress and investment in elderly mental healthcare, early diagnosis and community-based prevention remain a challenge. Services for mental health and elderly care tend to operate in separate systems, which can lead to increased fragmentation and duplication. Additionally, many programmes are funded by donors and end when the money runs out. Another challenge is inclusive design.Many elderly people have to walk quite a distance and negotiate stairs to get to public transport which makes commuting hard, even impossible, for those who cannot walk or have disabilities. In addition, digital programmes and mobile app use exclude many elderly Hongkongers, specifically those with no access or formal education. Hong Kong’s ethnic minorities also require culturally appropriate programmes. There are gender differences: women facing prolonged widowhood may experience a longer period of isolation while men may resist help due to the stigma around mental health issues. A generic or one-size-fits-all approach will not address diverse needs. A holistic needs assessment and situation analysis is required that addresses questions of diversity. We have to move away from assuming what is needed and how people would benefit from policies. Policies must also move away from treating older adults as passive recipients of care and support, and instead explore their skills and willingness to contribute. Elders can be mentors and sources of knowledge and wisdom, and satisfying the needs of finding purpose and making a meaningful contribution is fundamental to psychological well-being. Policies can work across levels – from the individual level, where pre-retirement planning and support are made mandatory, to the community level in terms of co-designing spaces and hubs with the elders, creating opportunities and integrating services, to the state level, where diverse elderly needs are considered, not just physical health but also social and cultural. Policies must shift from short-term charity funding to sustainable investment, creating formal and informal roles that enable the elderly to contribute, with regular assessments of needs and challenges. The ultimate goal is to support and build holistic well-being through inclusive spaces, reigniting purpose, a sense of belonging and dignity for all.

How Hong Kong can tackle its silent elderly mental health epidemic

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}Too many among the city’s ageing population struggle on their own due to stigmas around mental health and a lack of targeted policies

Too many among the city’s ageing population struggle on their own due to stigmas around mental health and a lack of targeted policies