In a territory-wide school-based epidemiologic survey conducted on children and adolescents ages 6-17 years from September 2019 to June 2023 in HKSAR, a multi-level stratified random sampling process was adopted to yield a representative and inclusive sample constituting of mainstream schools, schools for non-ethnic Chinese, international schools and special education schools. The study has adopted a single-stage diagnostic assessment to cover more than thirty-one DSM-5 child and adolescent psychiatric disorders complemented by a comprehensive battery of questionnaires on autism spectrum disorder screening, sleep disorders, environmental, medical and psychological attributes. Based on the whole study sample (N=6082) that was reconstituted to the sociodemographic structure of the population, 24.4% of the population ages 6-17 years have at least one or more of diagnosable DSM-5 disorder in the past 12 months. The priority clinical issues are: attention deficit/hyperactivity disorder (10.2%), disruptive impulse control and conduct Disorders (8.8%), anxiety disorders (6.1%), depressive disorders (5.4%). 12-month prevalence of suicidal ideation, plan and attempt (not including the non-suicidal self-injury) are respectively 3.9% ,1.9% and 1.1%. The prevalence rates of suicidal ideation/plan/attempt in secondary schools are alarming, respectively 8.4%, 3.8%, and 2.3%. The overall prevalence of ASD is over 2.9% with an even higher gender specific rate for boys (4.6%). These priority issues are shared across ethnic groups, common to both Chinese and non-Chinese in our community, the latter of whom are relatively lacking trust and knowledge of access to help. Parental emotional distress, any sleep disorder and school adjustment issues (such as repeating a grade, school suspension, absenteeism) are consistently significant predictors for all the highly prevalent clinical problems in statistical models that account for multiple personal and environmental adversities together. The common mental health problems present unmet needs in the school community and yet the risk factors are accessible, visible and potentially modifiable.
