Suicide rates among adolescents and young adults have been on the rise between 2007 and 2024.¹ At the Hong Kong International Mental Health Conference 2025, Professor Hung, Se Fong, presented epidemiological data on the high prevalence and risk factors of child and adolescent psychiatric disorders in Hong Kong, while Professor Leung, Wing Leung Patrick discussed longitudinal findings on early behavioral predictors among Chinese populations. In a panel discussion moderated by Dr. Candice Powell, they emphasized that interventions must be holistic, targeting not just the affected child but also parental distress, adverse school environments, and the need for a balanced, accessible stepped-care model.

Epidemiological data from Hong Kong revealed a crisis of psychiatric disorders among students, coupled with rising youth suicide rates.^1,2 In a study of over 6,000 local students, a high prevalence of psychiatric disorders was observed at 24.4%, with 11.0% having more than one diagnosis.² Anxiety and attention-deficit/hyperactivity disorder (ADHD) rates were notable.²  Sleep problems were also clearly linked, reinforcing that children who lack sufficient sleep have increased psychiatric disorders.² Prof. Hong noted that emphasis on academic achievement creates intense stress, contributing to sleep deprivation and school failure, which in turn increases psychiatric risk.²

Beyond these sources of stress, the data highlighted the importance of the parents’ role.² Parental mental distress was strongly associated with a child’s psychiatric disorder.² Prof. Hong highlighted a significant problem of under-recognition. Even among parents who recognized an issue, half did not seek help, indicating high reluctance and stigma. This hurdle is especially pronounced among the ethnic minority population, where only 8% of parents who recognized a problem sought mental health assistance, necessitating a major effort to reach out to this group. These parental factors compound to form barriers to care.

The role of parental influence in this mental health crisis extends beyond the call for diagnosis. Psychiatric disorders may be deeply rooted in a profound, multi-generational influence of family dynamics. Prof. Leung highlighted factors such as grandparental conflict and maternal mood as early predictors of behavioral issues in mainland Chinese populations, offering a developmental perspective to this issue.

The Jintan Cohort longitudinal study traced the developmental origins of behavioral problems following children from preschool into early adolescence.³ The data confirmed an intergenerational cycle where parental bonding and grandparental bonding affect the child’s psychosocial outcomes.⁴ Conflict between the mother and the maternal grandmother was found to correlate with behavioral problems in the adolescent. These indicate the unfortunate tendency of problems to run across generations, yet Prof. Lung stressed that the model shows multiple points where intervention can break the chain.

Maternal mood states—specifically depressive symptoms during prenatal and postnatal periods—were identified as significant predictors of sleep problems in children at age 4.5.⁵ The transmission of this risk appears to occur through both biological routes, where parental emotional problems are transmitted to the children, and psychosocial interactions, where maternal mood affects interaction with the infant. Crucially, the study also identified strong protective factors. Active bonding behaviors during the first year of life were found to protect against later internalizing problems.⁶ Children who experienced this active engagement had significantly lower levels of internalizing problems, including anxiety, depression, and withdrawal.⁶ This active engagement can offset the detrimental effects of maternal distress on a child’s mental health.⁶

Despite the sobering figures, both professors stressed that the future is not predetermined. Prof. Lung emphasized that interventions can successfully break the cycle. Parents can be educated to manage family conflict without using violence. Prof. Hong advocated for a comprehensive, stepped-care service model, while ensuring prompt specialist psychiatric care for more severe conditions like psychosis or severe depression. Ultimately, addressing the crisis requires not just treating the child, but supporting and educating parents to foster a more caring and nurturing family environment.