The COVID-19 crisis and the ensuing lockdown measures have exacerbated levels of anxiety and stress among Hongkongers, who had been reeling from nearly a year of anti-government protests that had already led to a significant increase in post-traumatic stress disorder cases (PTSD). A University of Hong Kong survey showed that more than 30% of adults in the territory reported signs of PTSD, up from 2% in 2015, while 11% suffered from depression compared to 2% in 2014.
Meanwhile, a recent poll by health insurer Cigna showed that Hong Kong had one of the highest stress levels among 11 countries surveyed, with 91% of respondents claiming to be stressed – higher than the global average of 83%.
“Our research concluded that the cost of stress on Hong Kong’s health system is substantial, and 25% of total spending on inpatient care relates to stress-induced illness, equating to some $1.7bn of public sector spend and $586m of spend in the private sector.
“It was estimated that 35% of total GP appointment spend relates to stress-related mental illness, with a spending of $832m and around 12m appointments,” Cigna Southeast Asia CEO and regional health solutions Julian Mengual, told Asia Insurance Review.
“Mental health does not mean the absence of mental illness alone, it also includes all-round wellbeing. Factors such as work-life balance, family wellbeing, social wellbeing, financial wellbeing and the emotional aspect of physical health all have effects on a person’s mental health.”
In particular, the carrier believes there is a strong correlation between mental and physical health. “By supporting customers’ mental wellbeing, we can reduce the risk of physical disease, and by healing physical problems we can reduce mental distress,” said Mr Mengual.
Addressing the stigma
He added that insurers have an important role to play in promoting mental health, by not only providing products and services but also through raising awareness which would hopefully lead to a change in people’s attitudes towards mental health.
“In Hong Kong, as well as in many Asian cities, it is difficult to express freely and open up about mental illness. Many Asian cultures place emphasis on resilience, honour, duty and collectivism. Hong Kong people’s attitude toward mental health is changing, but there is plenty of room for improvement,” he said.
FWD group CEO Huynh Thanh Phong believes more insurers in Hong Kong need to offer solutions to mitigate the risk of mental health. In February 2018, FWD Hong Kong introduced the first ever critical illness insurance plan to incorporate mental health in Hong Kong – while taking into account sensitivities around the subject.
“Some customers told us that they would be reluctant to buy a mental health-only product due to the stigma attached to it. We took their feedback on board, and developed it as a bundled product with other types of insurance,” said Mr Huynh.
He said, “If all insurers can offer a greater depth and breadth of products and services and include mental health option, it will go a long way to help remove the stigma associated with mental illness.”
Closing the gap on mental health coverage
On its part, Cigna offers a range of services for individual and group customers that focuses on prevention as well as treatment of mental health issues.
On the prevention side, the insurer offers an ‘all-round healthcare concierge service’ which includes an employee assistance programme that provides a 24-hour counselling service for employees. It also runs campaigns in Hong Kong that encourages people to ‘check in’ on their stress levels and the people around them, while providing resources and information on stress care.
On the treatment side, it offers several products that provide mental health coverage, which includes psychiatric inpatient treatment fees on mental illness or nervous disorders; and post-hospitalisation auxiliary treatment benefit which covers fees for consultation with psychologists registered in Hong Kong.
But similar to many parts of Asia, mental health coverage is traditionally excluded from health insurance plans in Hong Kong, although some insurers in Hong Kong provide inpatient psychiatric treatment benefit via their medical plans and offer a 24-hour emotional support hotline to assist their customers.
Mr Huynh believes that insurers should begin to view physical and mental health as something that goes hand in hand. “As insurers we should also take responsibility to raise awareness and educate the public to take care of their mental health and that of their loved ones in the same way that they take care of their physical and financial health.
“In view of the pervasiveness of emotional problems and growing concerns for mental health in our society, protection for both physical and mental health has become equally important,” he said.
Carrying on the work
He also revealed that FWD Hong Kong has partnered with The Hong Kong Society of Psychiatrists and The Child Development Centre “to develop a professionally endorsed mental health self-assessment online tool and a digital platform for children’s individual learning progress”.
Meanwhile, Cigna hopes to support its customers through various new programmes and services – whether it be physically or virtually.
“We understand from our group customers that many of them prefer online or telehealth mental health service during COVID-19. Therefore, we are looking at the possibility of expanding the scope of our current telehealth service to allow virtual counselling sessions with psychologist or virtual consultation with psychiatrist at an affordable price,” said Mr Mengual.
He added that Cigna also plans to work with local charities in Hong Kong this year to both promote mental health awareness as well as support them in providing community mental health services for those in need. A