Bulletin Spring‧Summer 1981

many people fall ill within a period of time for one or other type of illness. What is the clinical course of the illness? Is there any particular pattern likely to be observed? Is it possible to identify a cause for an illness? I f there are multiple causes, how are these inter-related? Are there any treatment methods that would be effective and why? In psychiatric epidemio logy, we are therefore concerned with the study of the accurate estimation of rates of psychological illness. How could they be modified over the years by socio-cultural factors, new provision of health services, and therapeutic intervention. It is clear that such work are not only essential to clinical services by the medical and para-medical professions, but for the planning and organization of courses in the medical school and, above all, of government health services. For this reason, I very much appreciate the presence and support of two distinguished guests here today: our Honourable Secretary for Social Services and the Chairman of the Hong Kong Mental Health Associa tion. Besides, I am also pleased to let you know that the Unit has gained support from the Director of the Division of Mental Health, the World Health Organi zation, who has offered future assistance. There are other reasons why such a Unit is much needed in Hong Kong. First of all, although there were many published works on psychiatric epidemiology in the Far East, they were either con­ cerned only with occasional survey or based entirely upon hospital statistics, which may not give an up- to-date and comprehensive guide for the on-going planning and delivery of mental health care in Hong Kong. The rapid changes in urbanization and in­ dustrialization in Hong Kong could lead to an in­ crease in social mobility and changes in social values. I believe, therefore, that psychiatric epidemiology should be studied longitudinally over a period of time in addition to cross-sectional surveys. The work from many transcultural studies have also shown that there is a changing pattern of psychiatric illnesses, that is, we are today confronted in the community with an increasing number of psychological or psychosocial illnesses rather than the so-called psychotic illness. Moreover, evidence also suggests that there are probably more people in the community with psy­ chological illness than those having consulted a doctor in the hospital. This means that we must extend our epidemiological survey to the community at large, not just relying on hospital statistics. One other reason is the lack of reliable tools common in epidemiological research, particularly in those conducted outside the Western countries. Most published works either used unsophisticated and unstructured clinical interviews or borrowed ready- made measuring scales designed and validated in another country. It is hoped that the Unit will be able to use its resources not only to validate foreign scales but to develop reliable new scales which are both culture-specific and culture-sensitive for people in Hong Kong. Another reason is the belief that there is a decline in research interest among the clinicians, notably the psychiatrists. You probably would agree with me if I say that the aim of research is not only to get a paper published but more importantly to develop an ability to assess a problem critically. The Unit, with its emphasis on research design and field- work, should be an asset for undergraduate and post­ graduate psychiatric education. Furthermore, as you are all aware, the aim of the medical faculty at this University is to emphasize community service and primary care, the future work of this Unit should bring us a step closer to the people in the community. Nothing could be more stimulating to the medical students if such work proved to be useful in the primary or secondary care of their patients. I must conclude by saying that, after so much talk, we must now sit down and do the job. The first task is a survey of the extent of psychological ill nesses in Shatin, but we have to test and validate our research tools and techniques before the field-work is to be carried out. With the generous help from Sir John and the favourable support from our colleagues in the University, I feel most hopeful about the future of the Unit at its inception. Nevertheless, we will continue to require much cooperation and assistance from the Government and, most important of all, the people of Shatin. Without these the Unit would at best be a mere academic exercise. Thank you all for your support. 17