Stakeholders' Views Gathered at Stakeholder Engagement Session on "Supporting Children's Mental Health during COVID-19 Pandemic"

• On Mental Health Issues
  • The social development of children has been affected during COVID-19 pandemic owing to the lack of opportunities to socialise with others. Some children even developed symptoms similar to Autism Spectrum Disorder due to the lack of stimulation, while some others were anxious about face-to-face interaction when not wearing masks.
  • The pandemic has caused the mental health problems (e.g. anxiety disorders) to children with specific needs.  Negative emotions such as boredom and unhappiness were common among them as they could barely meet their friends/schoolmates due to social distancing measures and closure of play facilities amid COVID-19 pandemic.  There was also an increasing number of suicide, self-harm and drug abuse cases of children.
  • Children spent more time using electronic devices and surfing the internet which increased the chances of exposing to suicidal and cyber-related risks.  Collaboration between parents and schools should be enhanced to raise the children’s awareness of online traps.
  • The Government was suggested to –
    • promote the importance of children’s mental health through different media platforms, and organise talks/training for parents on parenting, emotional support, techniques to assist children in online learning, etc.
    • financially support the distribution of smiley face masks to re-establish interpersonal relationships in the community.
    • pay heed to the mental health needs of parents/carers and teachers.
• On School Arrangement and Support to Students
  • Some participants suggested the Government to resume whole-day schooling to address children’s learning, social, physical and mental needs.  The objectives of whole-day classes which aimed to allow flexibility in timetable setting, enable children to enjoy diversified activities, foster teacher-pupil relationships, etc., should be adhered to if resumed. 
  • Some other participants suggested to maintain half-day schooling so that children and teachers would have more leisure time in the second half of the day.  The schools would also have more time to tackle the mental health issues of children. 
  • The learning progress of children with specific needs was particularly affected under the online learning mode due to their lack of concentration and attention.  Children also found it stressful to catch up on learning under the half-day schooling arrangement while the school curriculum, examination schedules and homework load remained unchanged.  Similarly, teachers were under tremendous amounts of stress.  The Government was suggested to make suitable adjustments to the school curriculum to help relieve children’s academic stress; incorporate guidelines relating to homework/assessments for students and teachers’ mental health into the “Health Protection Measures for Schools” for schools’ reference; and include mental health of children as part of the Quality Assurance for schools.
  • Positive education should be introduced at the stage of kindergarten to cultivate resilience in children in their early childhood.
  • Professional training should be provided to teachers to facilitate their identification of children with emotional distress or potential child abuse cases. 
  • The Education Bureau (EDB) should consider inviting schools to share their good practices in support of children’s learning and mental health development under COVID-19 pandemic.
• Child Assessment Service
  • The waiting time for Child Assessment Service was lengthened amid COVID-19 pandemic because some parents did not bring their children to assessment to avoid being infected.  It was suggested to allocate more resources to support the services so as to shorten the waiting time for assessments, such as increasing the number of speech therapists, psychologists and paediatricians.  It was also suggested to provide financial aid to parents for seeking professional assessment in the private market.  Community partnerships could be explored to work in tandem with non-government organisations (NGOs) and the social welfare sector to bridge the service gap.
• Residential Care for Children
  • There was an increasing number of referrals of abused, neglected and abandoned children for residential child care services.   Frequent transfer of these children between residential child care facilities should be avoided. 
  • There were some occasions where residential placement were not offered to day students of special schools with urgent needs.  The Government was suggested to review the arrangement to better support the residential care needs of these children.
• Other Support to Children
  • Hospitalised children felt left out as family visits and hospital play therapy services were suspended when anti-pandemic measures were implemented.  It was suggested that the provision of hospital play services for children should be resumed as far as practicable; and that follow-up consultations for children in recovery should be centralised to minimise unnecessary travelling between different service departments/ units.
  • Some participants suggested the Government to resume whole-day centre-based training/therapy services to children with specific needs.
  • Enhanced support, such as online emotional support platforms, should be made available for children to enable early identification of potential suicide or self-harm cases.
  • Some children living in sub-divided flats or from grass-root families experienced tense parent-child relationships due to the crowded living environment and the lack of diversified activities.  It was suggested that schools or NGOs be financially supported to organise more parent-child activities to enhance their parent-child interaction and relationships.
• Others
  • The Government was suggested to conduct research to examine the needs of children with specific needs having mental health problems (i.e. children with co-morbid conditions), and how fathers could be supported to take a more proactive role in taking care of them.  Research on the impacts of the pandemic with analyses of the habits of children (e.g. number of hours spent on sleeping and homework/studying), and the causes contributing to the mental health issues of children was also suggested to facilitate the provision of support.
  • The Government should consider relaxing the “Vaccine Pass” requirement by allowing children unfit for vaccination to provide the rapid antigen test results as documentary proof to facilitate their daily activities.  In addition, the execution of the Vaccine Pass requirements should be aligned across the government bureaux/departments (e.g. on the arrangements for those who have obtained a Medical Exemption Certificate).
  • The Government and the community should develop the capacity to protect all children, with or without disabilities, from any emergency health crisis such as COVID-19 pandemic.  Major stakeholders including children, parents and caregivers should be engaged at all stages of emergency responses (i.e. from planning to post-emergency follow-up).  The Government should ensure information and services were accessible, and strengthen the community-based support networks when a health crisis arises.  Proper guidelines of practice and training should also be provided to health professionals.

• On Health Issues
  • The social distancing measures led to the developmental regression of children with specific needs as exposure to social interaction, language stimulation and play opportunities was significantly reduced.  The Government should consider from the children’s perspective in formulating anti-pandemic measures.  Pro-child measures, such as partial closure of play facilities instead of full closure, segregation of classes (e.g. by grade) or smaller class sizes in schools, etc. should be considered.
  • Emotional distress was commonly noted among parents/carers and children under the pandemic.  Support on their mental health and emotional needs should be strengthened.  In particular, more attention should be paid to children living in residential child care centres, refugee children with disabilities, and children under the guardianship of the Director of Social Welfare.
  • Problematic use of the internet affected children’s health.  More effective measures on online safety should be in place to protect them from unnecessary harm.
• Training and Therapy Services for Children
  • The effectiveness of online training and therapy services for children with specific needs was limited.  On the other hand, some families could not receive the relevant services at home due to space and training tools constraints.  Resumption of whole-day centre-based services with enhanced support was recommended. 
  • Training support for children with special educational needs in primary schools should be strengthened as K3 students who transitioned to P1 were seriously affected over the past three years.  Provision of subsidies for parents to arrange individual training for meeting their children’s specific needs could also be considered.

• Child Assessment Service

  Measures should be stepped up to shorten the waiting time for new registrations and follow-up medical consultations. 

• Schooling Arrangement
  • The Government should not suspend the face-to-face classes for kindergartens and special schools as far as possible, as the size of these classes was usually small and the risk of contracting and spreading COVID-19 could be minimised through precautionary measures.
  • The mask-wearing requirement hindered the language development of children with specific needs and parents’ understanding of their emotions and facial expressions.  While the daily rapid antigen test arrangements for schools were in force, the Government was suggested to relax the compulsory requirements on wearing masks at schools.
  • With the gradual resumption of whole-day schooling, the Government should review the school curriculum to reduce the academic pressure of the children with specific needs.  In addition, it was suggested to allow more time for children to do homework and participate in extra-curricular activities in the second half of the day.
• Support for Parents/Carers
  • With the prevalence of online learning and the occasional suspension of face-to-face classes, parenting stress increased as they had to spend more time taking care of their children.  Some participants shared that some NGOs had formed parent groups and set up a designated page on the social media platform to provide parents with emotional support and facilitate their sharing of parenting experiences.
  • With the anti-pandemic measures in place, parents/carers could maintain a reasonable level of social activities, such as gatherings to relieve their stress.  Psychoeducation should be provided for parents to develop their positive attitudes to face the challenges under the pandemic.
• Others
  • The Government should centralise the dissemination of COVID-19 pandemic information related to young children, and produce simple and comprehensible promotional videos to facilitate children’s understanding of the Government’s anti-pandemic measures.
  • Family visits for children with intellectual disabilities receiving boarding service in special schools were mainly conducted online during the pandemic.  These children could not express their sufferings clearly in case of maltreatment in these facilities.  The Government was suggested to strengthen inspections and monitor measures taken by the special schools to tackle the mental health issues faced by the children.
  • Chronic child patients felt abandoned and isolated in the hospital due to the restricted hospital visit arrangements during the pandemic.  Some children were unable to communicate with their families online due to physical disabilities.  It was suggested to teach parents some useful communication and play techniques to facilitate effective communication with their children within limited visiting time.  Festive decorations in wards was also suggested to let hospitalised children feel the festive atmosphere.
  • The Vaccine Pass arrangements had restricted the activities of unvaccinated children.  Nucleic acid testing instead of vaccination should be considered to facilitate children’s resumption of normal lives.
  • Low-income families faced financial pressure amid COVID-19 pandemic.  It was suggested to increase the subsidies of the Comprehensive Social Security Assistance Scheme and Student Textbook Assistance Scheme to help ease their financial burdens, and to relax the requirements for Disability Allowance to cover various types of children with specific needs.
  • For children requiring different discipline consultations, appointments should be scheduled on the same day as far as practicable for the service users’ convenience.

Children with specific needs shared their feelings and problems faced during the COVID-19 pandemic as follows:

• Most of the children missed their friends/schoolmates when face-to-face classes were suspended.  They enjoyed moments of happiness when seeing each other during online learning, and were excited to have face-to-face contact again when schooling resumed.  Some felt disappointed that they could not attend the graduation ceremony under the pandemic and some felt sad as they did not have the chance to bid a proper farewell to the friends and teachers who had emigrated.
• On the academic front, some children found it difficult to focus during online learning.  Some also expressed worries about the learning progress, homework load, and school adaptation after the resumption of schooling or transition from primary to secondary school.
• Notwithstanding the challenges and problems faced during COVID-19 pandemic, children explored different ways to relieve their negative emotions, such as leisure activities, developing new interests, chatting with friends, sharing their problems with someone they trusted, etc.
• With the continued support from schools, children were given opportunities to attend online interest classes and had fun with schoolmates through different online activities.  In some schools, there were tutorial classes, social-emotional training/courses, positive education and play therapy available to support children’s academic, emotional and mental needs.
• A child shared her experience and stress during hospitalisation, and hoped that the hospital could offer more interest classes that suit the patient’s age, periodic consultations with the clinical psychologist, more opportunities to socialise with other hospitalised patients for experience sharing, etc.
• More support should be provided to the underprivileged children to cope with the problem of digital divide when online learning prevailed.
• A participant shared the personal experience of school bullying as well as the sadness and loneliness of not having much support from the working parent and the school.  Another participant mentioned the personal experience of being rejected by schoolmates at school and considered online learning might have reduced the chance of students being bullied when face-to-face classes were suspended under the pandemic.