Hong Kong Student Mental Health: With Rates Rising, Are Our Public Health Responses Keeping Up?

Rising rates of anxiety and depression among secondary students have become one of the essential health problems in the Greater Bay Area (GBA), which is a mega-region that is progressively integrating and revamping nine major cities in the Pearl River Delta and two other special administrative regions, Hong Kong and Macao. Students have been under immense pressure and stress due to the intensifying academic competition, examination pressure, and rapid social change. This serious issue has been reflected in Hong Kong’s recorded number of fatal suspected student suicide cases, as there were 32 cases in 2023, 28 in 2024, and 31 in 2025 (Choi, 2026). Also, a joint study by the Christian Family Service Centre and the University of Hong Kong’s Centre on Behavioral Health further found that almost 30% of secondary students reported severe or very severe anxiety (HKT, 2026). These findings highlight the need for an immediate government response to improve public health among students.

The Hong Kong government introduced the Three-Tier School-Based Emergency Mechanism in December 2023. It was implemented across all secondary students in Hong Kong through cooperation between the Education Bureau (EDB), Health Bureau, and the Social Welfare Department (SWD). The purpose was to identify students at a higher mental-health risk and provide support like counselling, immediate assistance, and professional support. The schools were able to connect students with off-campus counselling and hospital-authorised psychiatric services (news.gov.hk, 2024). The model was in three levels: universal, selective, and indicated, which was to improve the referral system and standard identification (news.gov.hk, 2024). In 2025/26, the mechanism became a regular system in secondary schools. By early June 2026, more than 95% of public-sector schools joined the 4Rs Mental Health Charter (Choi, 2026). This implies that the government has made several attempts to improve the mental-health support system in schools for students to use and get support from.

Table 1 shows the number of Three-Tier School-‍based Emergency Mechanism referral cases referred by schools/the EDB under the second-tier mechanism to the off-campus support network teams engaged by the SWD. 

It shows that the second-tier referral to off-campus support increased sharply, from 104 in 2023/24 to 330 in 2025/26 (Choi, 2026). This suggests that schools are becoming better at identifying students who need mental health support. On the other hand, third-tier psychiatric referrals decreased from 292 in 2023/24 to 63 in 2025/26, which meant that fewer students were reaching the severe stages of mental health issues (Choi, 2026). However, those statistics did not prove that the system was working better because the decrease in third-tier psychiatric referrals also meant that students were not being referred to specialists when they needed it. 

Figure 1 shows the average anxiety score reported by Hong Kong secondary students 2020–2025. Even tho systems were implemented, the anxiety level still rose. 

In conclusion, the government has now taken great measures to improve the mental health program for students. However, there is still uneven implementation of policies, limited support in primary schools, and stigma around mental health. Overall, the GBA’s student mental health system is still improving but still needs further development. More cooperation and consistent support from the government are needed.

By Elva Lee

Bibliography

HKFYG’s back-to-school survey reveals rising anxiety and steady stress levels among secondary students, alongside low help-seeking intentions. (2025, October 14). 香港青年協會 The Hong Kong Federation of Youth Groups. https://hkfyg.org.hk/en/2025/10/14/%E9%9D%92%E5%8D%94%E5%85%AC%E5%B8%83%E3%80%8C%E4%B8%AD%E5%AD%B8%E7%94%9F%E9%96%8B%E5%AD%B8%E9%81%A9%E6%87%89%E8%AA%BF%E6%9F%A5%E3%80%8D%E7%B5%90%E6%9E%9C-2/

LCQ15: Promoting student mental health. (2026). Info.Gov.Hk. https://www.info.gov.hk/gia/general/202606/24/P2026062400367.htm

Students” mental health supported. (2024, June 5). Hong Kong’s Information Services Department. https://www.news.gov.hk/eng/2024/06/20240605/20240605_154552_859.html

The Standard 英文虎報. (2026, July 14). Nearly 30PC of secondary students report severe anxiety: Survey. The Standard 英文虎報. Thestandard.Com.Hk. https://www.thestandard.com.hk/news/article/337207/Nearly-30pc-of-secondary-students-report-severe-anxiety-survey