Jacqueline Wu - Clinical advisor in the Youth Programme at Mind HK

Good morning.I’m here today to discuss adolescent’s mental health in HK, specifically, some patterns I’ve noticed lately in my own practice working with young people.

Since we’re coming up to the exam periods, it’s understandably a stressful period for many as these exams may be a key determinant factor for how their future may pan out. Indeed, I have noticed an increase in referrals in recent weeks for many different reasons, including anxiety, low mood, eating disorders, obsessive compulsive disorders, suicidal ideations, personality difficulties, self harm, people refusing to go to school, etc. Although I have just listed a plethora of different mental health difficulties. There is a consistent theme that I’ve noticed, that is underlying all of the issues- and that is ‘perfectionism’.

What I mean by ‘perfectionism’ is the tendency to set excessively high expectations for oneself. While this can be seen as a positive trait as it may help increase motivation or achieve goals, it can actually have the opposite effect when it becomes excessive. I’d like to point out the difference between ‘perfectionism’ and ‘striving for excellence’. When we strive for excellence, we’re focused on growth, development and improvement, we set realistic and achievable goals for ourselves, and we perceive setbacks as opportunities for growth. Perfectionism, on the other hand, is often driven by fear, especially fear of failure and the need for external validation. Similar to my observations, a CUHK study that was published in 2022, examining secondary school students in HK found that perfectionism, and social-oriented achievement motivation (i.e. a desire to gain social approval from significant others), were the key dominant drivers of academic stress in students in HK. This demonstrates the tendency for HK students to evaluate their success/ failures against approval received by others.

Why does this happen? If we start from understanding our internal factors (i.e. internal experiences such as thoughts, feelings, personality traits), some individuals may have developed less helpful thinking styles such as ‘all or nothing thinking’. For instance, they may think “I didn’t do well in one test, this means I’ll fail in all future exams”. They may have low self-esteem or have become self-critical, which would increase the chances of experiencing low mood or anxiety. But if we zoom out a little, there are also many external factors that may contribute to the development of perfectionism, such as family pressure/ expectations, having perfectionistic parents who are high achievers, social media, societal pressures or comparisons, leading to adolescents striving for the perfect appearance, life, grades, friends, materialistic possessions, you name it. Just as an example, according to a study done in 2024 by researchers from CUHK that evaluated factors associated with mental health among children in HK. They found that students who had parents with high parental expectations were at high risks of experiencing psychological distress among primary and secondary school students. Additionally, research from HKU (2023) linked excessive social media use to higher rates of anxiety and poor self-esteem in students.

So what can we do to help? From a professional level, early interventions and prevention work is essential to improve adolescent’s mental health. It is important to normalise help seeking behaviours, and to improve access to psychological therapies. For instance, speaking to school counsellors or accessing free of charge, low intensity interventions such as iACT programme provided by Mind HK is a great option for students with mild to moderate mental health difficulties to alleviate any psychological distress using an acceptance commitment therapy framework.

On a societal level, it is important to help students develop resilience and reduce mental health stigma through school or public awareness. For instance, we are currently working in collaboration with Hong Kong Jockey Club on the LevelMind project, which is a three year project that aims to improve students’ mental wellbeing in up to 130 local schools, by supporting students to develop mental wellness activities within schools, and by launching city wide events and campaigns. The idea is to encourage youth to care for themselves and others.

From a parents’ perspective, it would be beneficial to create a safe space for open communication by being validating, encouraging, compassionate and non-judgmental, and to encourage them to strive for more while embracing the imperfections. This can help your children set more realistic expectations for themselves and become more self-compassionate.

On that note, I’d like to dedicate this song called ‘Youth’ by Glass Animals to you. At the end of the day, we want to make sure that our young people thrive and not just survive! Thank you for listening.