“Therapy can help Hong Kong youth with mental health problems related to parenting struggles”

As suicides among young people have increased, Hong Kong experts said that domestic conflicts could be a major source of children’s mental health problems and called for early intervention, including family therapy.

Seven people tried to take their own lives during the same period this year, compared to three in 2022.

City authorities, following the recent cases, said they plan to create a three-tier system to give children at high risk of suicide professional help and priority for psychiatric services.

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Lee said the biofeedback tool he developed two decades ago has been helpful in understanding how children respond to conflicts at home.

“Some children who appear calm or remain silent during therapy show more than 10 physiological responses, with their heart rate increasing to more than 190 beats per minute,” he said.

“Responses were especially strong when parents were given the silent treatment.”

The tool has been used in more than 500 cases in Hong Kong and mainland China and Lee said parents are often shocked when they see the effect on their children.

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

John’s parents had been fighting for years, and during therapy the teenager described how he felt about him.

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

“There’s no way out. Whenever they fight, I’m the one who has to deal with it.

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

His psychosomatic headaches and stomach aches became serious and he began seeing a psychiatrist several years ago, before being referred to family therapy.

Family therapy helped his parents understand the impact his fight had on his 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-chi, a psychiatrist at AAFT, said that physiological fluctuations are triggered in children as soon as they feel a crisis.

She said some would become anxious and scared and others would feel their heart rate start to drop, similar to animals playing dead as a survival tactic.

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

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

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

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

“For children, we aim to create a more reasonable environment for them, but older children need to learn to develop their own. [emotional] space, instead of continuing this anxiety.”

She said it was unfortunate that most cases were referred to family therapists only after years of effort by other professionals did not work.

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

She said families do not need a referral and those with financial problems may be eligible for grants.

* Name changed to protect the interviewee’s identity.

If you are having suicidal thoughts, or know someone who is, help is available. For Hong Kong, call +852 2896 0000 for Samaritans or +852 2382 0000 for suicide prevention services.