“Therapy may help Hong Kong youth with mental health problems linked to parental fighting”

As suicide rates among young people have risen, experts in Hong Kong say domestic conflict can be a major source of children’s mental health problems and have called for earlier intervention, including family therapy.

It suicide The University of Hong Kong Prevention Center said the city recorded 15 suicides involving young people aged 18 and under or those in higher education between August and October this year, compared with eight in the same period in 2022.

In the same period of the current year, seven people attempted suicide, compared to three in 2022.

City officials, after the recent incidents, said they plan to create a three-tiered system to prioritize professional help and psychiatric services for children at high risk of suicide.

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Lee said the biofeedback tool she developed two decades ago has been useful in understanding how children respond to conflict at home.

“Some children who seem calm or quiet during the therapist show more than 10 physiological responses, with heart rates reaching more than 190 beats per minute,” he said.

“The responses were particularly strong when parents gave each other the silent treatment.”

The tool has been used in more than 500 cases in Hong Kong and mainland China, and Lee said parents were often surprised to see the effect on their children.

“That’s when the penny drops,” he said.

Dr. Cindy Tam, a psychiatrist at the AAFT, said some young patients became anxious and scared or experienced a drop in heart rate when their parents fought. Photo by Jonathan Wong

John’s parents had argued for years, and during therapy, the teenager described how he felt.

“I hate to see them fight … it’s annoying that I have to take care of my mom after, but I can’t lose my temper because it will overwhelm my mom,” the boy told Lee.

“There is no way out. When they fight, I’m in charge.”

John became ill as he struggled to cope with the stress.

Her psychosomatic headaches and stomach pains became severe, and she began seeing a psychiatrist several years ago before being referred to family therapy.

Family therapy helped her parents understand the impact their fight had on her mental health.

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John has since left Hong Kong to continue his education in Britain and his psychiatrist has heard no more problems from him.

Dr. Cindy Tam Woon Chee, a psychiatrist at the AAFT, says physiological fluctuations occur in children as soon as they experience a crisis.

He said some will feel anxious and scared, while others will feel their heart rates start to drop, like animals playing dead as a survival tactic.

Tam added that the responses were completely involuntary and could not be faked.

“That’s why parents accept the fact that their interactions affect children,” she said.

After helping parents understand the impact on their children’s mental well-being, therapists provide counseling to help family members change the way they communicate.

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“Change doesn’t come easy and it doesn’t always happen, especially for parents,” Lee said.

“For younger children, we aim to create a more reasonable environment for them, but older children must learn to develop their own; [emotional] space instead of carrying that worry.”

He said it was unfortunate that most cases were referred to family therapists only after years of efforts by other professionals had failed.

Lee encouraged families who need help to contact AAFT, a non-profit organization created to promote family therapy research, teaching and practice in Asia.

Families don’t need a referral, she said, and those with financial problems may qualify for subsidies.

*Name has been changed to protect the identity of the interviewer.

If you are having suicidal thoughts, or know someone who is, help is available. For Hong Kong, dial +852 2896 0000 for Samaritans or +852 2382 0000 for Suicide Prevention Services.

In the US, call the 988 Suicide and Life Crisis Line at 988 or +1 800 273 8255. For a list of helplines in other nations, see this page.

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