Most New Hong Kong Immigrants to UK Doing Well Mentally, but 1 in 4 Have PTSD Symptoms: Survey

Protesters attend a rally for democracy in Hong Kong on June 12, 2021 in London, England. Laurel Chor/Getty Images

Most Hongkongers who immigrated to the U.K. after Beijing imposed a sweeping security law on the city in June 2020 say their mental health has subsequently improved, while smaller numbers say they have experienced symptoms of post-traumatic stress, a survey has found.

The survey report (pdf) by Cambridge University researcher Mark Liang in collaboration with the U.K.-based advocacy group “Hongkongers in Britain,” found that 62 percent of Hong Kong arrivals surveyed said their mental health has improved overall since moving to Britain.

However, the survey found that 18.9 percent and 25.8 percent of survey respondents reported symptoms of depressive and anxiety disorders, respectively.

One in four reported symptoms of post-traumatic stress linked to the trauma they experienced in Hong Kong.

“[Some] 23.8 percent of respondents reported clinically significant symptoms of post-traumatic stress disorder (PTSD) as related to the 2019 Hong Kong Protests and implementation of HK’s National Security Law,” the report said.

In early 2019, the Hong Kong government introduced what’s commonly known as the new extradition bill, which triggered an intense backlash from Hong Kong residents. In June 2019, the Hong Kong Civil Human Rights Front organized a large demonstration against the proposed bill, marking the beginning of the “anti-extradition” protests.

Protests grew in scale over concerns that the city’s freedoms were being eroded and violent clashes between police and some pro-democracy activists followed.

Beijing forced a new National Security Law in Hong Kong in June 2020. The controversial law allowed local police to arrest Hongkongers who participated in the protests, resulting in large numbers of Hongkongers fleeing the city.

Pro-democracy protesters gather during a rally at Victoria Park in Hong Kong on Aug. 18, 2019. The protesters were rallying against a controversial extradition bill. Billy H.C. Kwok/Getty Images

The online questionnaire was the first U.K.-wide survey conducted on newly arrived Hong Kong immigrants in Britain. Some 658 people answered the survey, with 90 percent identified as British National (Overseas) passport holders, and the rest were Hongkongers seeking asylum and naturalized British citizens.

Most respondents were between the ages of 25 and 54, and more than half had lived in the U.K. for four to 11 months.

‘Fear of Retribution’

Cambridge University’s Liang said that in addition to typical immigration issues such as language, employment, family and child relations, the mental health issues specific to the Hong Kong arrival population included “perceived fear of retribution for discussing politics and worry for people still back in Hong Kong.”

Several survey respondents cited wanting to visit parents or family members who continue to live in Hong Kong and so felt they were unable to give any political opinion that might run afoul of authorities. More than one mentioned “survivor’s guilt,” the report stated.

“I hate to think [I] cannot travel back to [my] homeland freely. No one wants to be exiled or named fugitive,” said a respondent.

Riot police guard detained pro-democracy protesters in the Causeway Bay district of Hong Kong on May 27, 2020. AP Photo/Vincent Yu

Mistrust 

Over 90 percent of respondents said they are enrolled in U.K.’s National Health Service (NHS), but only 6 percent of respondents have reportedly discussed mental health issues with a general practitioner. Meanwhile, nearly 75 percent of Hong Kong immigrants said they were unlikely to pursue mental health treatments in the next six months.

Most respondents expressed low willingness to talk to Hong Kong community groups and NHS therapists but rather discuss mental health issues privately with friends and family members.

There appears to be a lack of trust in non-white ethnic support groups or communities, most likely related to political factors, Liang said in a video conference. Many respondents worry that their words will be misunderstood or negatively impact them in the future.

Liang said that the British government had previously allocated funds to provide new Hong Kong arrivals with support services such as education and mental health. However, some Chinese groups that won the bid were suspected of being infiltrated by the Chinese Communist Party, further exacerbating Hongkongers’ mistrust of these services.

PTSD

Liang added that 10 percent of respondents exited the survey upon seeing the PTSD question, which may indicate some form of distress and factors impacting their ability to speak freely.

“[The] worst-case scenario would be a mental health crisis that goes unresolved for years, maybe even decades, because something like PTSD does not go away over time,” he said.

Liang said it is important for the Hongkongers to gain confidence in the British social support system.

The U.K. should have psychotherapy services for Hongkongers, such as counselors who can speak Cantonese or have lived in Hong Kong and are aware of the psychological impact of the political environment, he said.

Protesters attend a rally for Hong Kong democracy at the Marble Arch on June 12, 2021 in London, England. Laurel Chor/Getty Images

Immigration Increase 

By the end of last year, more than 100,000 Hongkongers had applied for the British National (Overseas) visa or BN(O) visa. The U.K. Home Office estimates that between 258,000 and 322,400 Hong Kong people will immigrate to the U.K. over the next five years.

As the National Security Law continues to violate the freedom and rights of Hong Kong residents, the U.K. began to accept BN(O) visa applications on Jan. 31, 2021, providing those with BN(O) status or Hong Kong passport holders a path to immigration.

The latest Hong Kong emigration wave marks the fourth since the beginning of the Sino–British negotiations in the 1980s. The other two emigration waves were the Tiananmen Square crackdown, June 4,  1989, and the transfer of sovereignty over Hong Kong in 1997.