Prologue Journal

The fatal shooting of a man with mental illness shows Hong Kong police need a better response to such crises

• prologu5
• 10/05/202410/05/2024

Hong Kong Free Press

By Daisy Cheung

The recent incident in North Point involving the death of a man with mental disorder at the hands of police responding to an emergency at his home is tragic, but unfortunately not uncommon worldwide.

In jurisdictions all over the world, police often act as first responders in cases involving mental health crises, even though in most cases they severely lack training on how best to support such individuals. A quick search reveals the names of countless vulnerable individuals who met untimely deaths due to interactions with police over just the past year. 

As the number of such deaths increase, places around the world are beginning to take a long, hard look at the suitability of police involvement in situations involving people with a mental disability.

See also: ‘My son was panicking, not a bad man’ – Family of mentally ill man shot dead by Hong Kong police recall the tragedy

Many countries are calling for police reform, and in some cases, even the police themselves have concluded that they may not always be the most appropriate responders, since their presence may be an “escalating factor” itself.

What lessons can Hong Kong learn from the experiences of these countries? First, the issue of police inadequacy in the face of mental health crises must be recognised and squarely confronted, rather than swept under the rug as merely another incident where the fatality was unfortunate, but the use of force justifiable in the circumstances. 

Concerns about how police in Hong Kong deal with people with mental disability are not new. In 2015, an autistic individual was wrongfully charged with manslaughter. In the face of heavy criticism of how they handled the incident, the police formed a working group to review their procedures for people with mental disability – known to officers as MIPs or “mentally incapacitated persons” under the Mental Health Ordinance.

New measures were subsequently implemented, including the Care Card Scheme, the creation of a Behavioural Indicators Guide, and police training on how to handle people with mental disability. Apart from these measures, which do not seem particularly effective, police guidelines in relation to people with mental disability are mostly non-existent.

Chapter 34 of the Police General Orders, “Family Conflict, Sexual Violence and Vulnerable Persons,” contains an extremely brief section entitled “Handling Mentally Incapacitated Persons.”

This three-paragraph section simply notes that police should locate an appropriate adult to accompany and assist the person in question, irrespective of them being a victim, witness or suspect, and that the appropriate adult should be provided with relevant information to help them understand their roles and responsibilities. 

This complete lack of guidance on the specific issue of how police should respond in the face of mental health crises is troubling. At the very minimum, clear and comprehensive guidelines that require police officers to de-escalate the situation need to be put in place.

A number of specific de-escalation techniques and approaches have already been developed, which generally involve keeping the individual calm and verbally engaging them to build rapport. Whichever approach Hong Kong police force chooses to adopt, it should be very clearly and specifically laid out, step-by-step, so as to minimise any difficult judgment calls that need to be made in an already highly tense situation.

Such guidelines will also need to be supplemented with education and training. While it is commendable that the police force has engaged a wide range of different perspectives – including clinical psychologists and representatives from the Social Welfare Department, Hospital Authority, NGOs, and parents’ groups – in the development of the measures relating to people with mental disability, more targeted and effective training is needed.

An example of this is the Mental Health Crisis Response Training Program, which has also been migrated into a virtual reality format. Participation in this approach, which contains training manuals, problem-based scenarios, simulations and a validated framework for evaluation known as DePICT, has been shown to significantly improve police officers’ abilities to de-escalate and respond to mental health crises.

Beyond training and guidance, Hong Kong should consider the feasibility of alternative models in responding to such situations. The Crisis Intervention Team (CIT) model, for example, trains select members of the police force who volunteer to receive this training. Calls involving mental health crises are then assigned to CIT-trained officers.

Co-responder models, on the other hand, generally involve police officers and mental health service providers, such as psychiatric nurses, jointly responding to mental health crises. The teams can either arrive together or separately, or the mental health service provider can attend via phone or video.

The design of the programme can and should be adapted to Hong Kong’s context, and given resources and other practical considerations, a co-response model involving participation by the mental health service provider online may prove most feasible. 

The costs of fatal police shootings in mental health crises on the individual, their family, and the trust between the community and the police force are unimaginable. Hong Kong needs to pay attention to how the rest of the world deals with this devastatingly common occurrence, and introduce changes before the next vulnerable person falls victim instead of receiving the support and assistance they so desperately need. 

Daisy Cheung is an Assistant Professor at the Faculty of Law at the University of Hong Kong, as well as Deputy Director of the Centre for Medical Ethics and Law. Her research interests are primarily in the areas of mental health and mental capacity law, as well as medical ethics and law more generally.

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