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The Centre for Health Education and Health Promotion (CHEHP) in The Jockey Club School of Public Health and Primary Care (JCSPHPC) at The Chinese University of Hong Kong (CUHK)’s Faculty of Medicine (CU Medicine) recently held the Healthy School Forum. The officiating guests at the event were Ms Michelle Li Mei-sheung, Permanent Secretary for Education of the Government of the Hong Kong Special Administrative Region (HKSAR); Dr Ronald Lam Man-kin, Director of Health; Ms Scarlett Pong Oi-lan, Chairman of the Health Promoting School Advisory Committee; Dr Thomas Chung Wai-hung, Consultant Community Medicine (Family and Student Health), Department of Health; and Professor Samuel Wong Yeung-shan, Director of JCSPHPC.

Supportive school and family environment is important in safeguarding students’ mental health

At the forum, Professor Martin Wong Chi-sang, Director of CHEHP and Professor at JCSPHPC, shared the results of his team’s research. The team conducted a survey using the Patient Health Questionnaire-9 in 2024 on the depressive symptoms of students in Secondary 1 to 5. During the first phase of the survey conducted from January to March, the team collected 791 questionnaires and discovered that 16.1% of male students and 26.1% of female students had experienced moderate to severe depressive symptoms, exhibiting a significant gender difference. The research team is now conducting the second phase of the survey and will collect and analyse more data.

For another survey the team conducted in 2017, questionnaires from 4,884 Primary 4 (P4) and Secondary 3 (S3) students in 55 local schools were collected. Using the Kessler Psychological Distress Scale (K6), the team identified that 16.1% of S3 male students and 21.2% of S3 female students had experienced a certain degree of psychological distress. Among  all S3 students who filled out the questionnaires, 6.3% had experienced feelings of sadness and hopelessness almost every day for two weeks or more in the year before the survey, which led to the suspension of some daily activities; 13.8% had considered suicide and 1.9% had attempted suicide.

A follow-up analysis in secondary schools found that risk factors associated with poor mental health include female, poor sleep quality, poor health, being bullied, self-perceived poor academic performance and parental expectations that are too high or too low. Meanwhile, having close friends and being highly satisfied with school and family lives were protective factors. These findings highlighted the need to create a supportive environment in school and family to safeguard children’s mental well-being.

Promoting healthy campus through government, school and community partnerships

The World Health Organization (WHO) and UNESCO have developed global standards to create a supportive environment for the health of every schoolchild, making every campus a health-promoting school (HPS) by enhancing collaboration. These standards are based on eight areas: government policies and resources, school policies and resources, school governance and leadership, school and community partnerships, school curriculum, school social-emotional environment, school physical environment, and school health services. CHEHP has adopted this framework to promote school health in Hong Kong.

At the forum, Ms Michelle Li emphasised, “The Education Bureau (EDB) has been supporting schools in helping students lead a healthy lifestyle, which is one of the seven learning goals of primary and secondary education. In recent years, the EDB has actively worked with schools, teachers and parents on the enhancement of the support on students’ mental health while keeping up the synergy through cross-departmental and cross-sectoral collaboration. In order to promote mental health in schools in a more comprehensive and systematic manner, the EDB has recently launched the 4Rs Mental Health Charter. The 4Rs cover the four elements for promoting mental health, including Rest, Relaxation, Relationship and Resilience. We hope that schools can set practical objectives, and every member of the community can join hands, sharing common goals, so together we can create a campus atmosphere full of love and hope, enabling students to develop a healthy and happy life.”

Dr Ronald Lam thanked CHEHP for their efforts in promoting HPS in Hong Kong and expressed his support for universities to participate in formulating and continuously developing health-promoting school indicators that are suitable for local schools, as well as providing the necessary training, support, evaluation, and accreditation services. Dr Lam remarked that the Department of Health will continue to collaborate with various stakeholders to expand the health-promoting school concept to all schools in Hong Kong. He believed more schools would become a health promoting school, and work together to achieve the target of “whole school, whole health”.

During the panel discussion, Ms Scarlett Pong, Dr Thomas Chung and Professor Samuel Wong expressed concern about schoolchildren’s mental health. An increase in the prevalence of depression, anxiety, social pressure and other health risks were seen among local students. This situation is alarming and requires all sectors’ attention. Evidence from the past decade has confirmed that implementing health-promoting schools improves the social environment of schools, enhancing students’ health literacy and improving their physical, mental and spiritual health.

Professor Martin Wong added, “While COVID-19 caused many school activities to be suspended, campus life has returned to normal. Our forum marked the restart of school health promotion in the post-pandemic era. We will continue to analyse the status and trends of students’ physical health and mental well-being to gain insights into potential risks. We will also liaise with key stakeholders to jointly explore strategies that promote the health of schoolchildren and equip them to face future challenges.”