Supporting the mental health and wellbeing of Hongkongers in London (2025)

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Acknowledgements

Thrive LDN and Basis would like to thank everyone involved in the development of the project:

The seven Hong Kong-led community organisations who collected insights and supported the development and delivery of the unconference event:

1. East South East Asian Community Centre (ESEACC)
Formerly Hackney Chinese Community Services (HCCS), the ESEACC is a charity dedicated to serving the ESEA community, including enhancing the social and mental wellbeing of the local
ESEA population and supporting Hongkonger’s settlement and integration within the UK.

2. Ednovate
Community interest company (CIC) and network of educators dedicated to supporting the holistic development of young Hong Kong diaspora and their parents.

3. Hearth Talk
An international collective of Hongkongers whose membership includes social workers, psychologists and counsellors. They support Hongkongers
by providing mental health education, talking therapies, referrals and information on mental health systems in the UK and other countries.

4. Hong Kong Well UK
Supports the mental health of children who have migrated from Hong Kong to the UK. They provided counselling to children in their mother tongues and specialist advice to parents.

5. Hongkongers in Britain
Provides UK-wide support services to the Hong Kong community in mental health, community outreach, wellbeing and social welfare.

6. Welcome HongKongers H.O.M.E. Project
Provides a safe space for individuals to share concerns and seek support through developmental activities based on psychological and mindfulness frameworks. Through emotional intelligence, self- awareness, career coaching, stress management and cultural engagement, supporting individuals and families to settle in the UK.

7. UK Welcomes Refugees
A UK charity that supports refugees worldwide, with a mission to shape community-led resettlement and build migration policy consensus. The UK Welcomes Hong Kongers project provides support and integration services for Hong Kong British National (Overseas) (BN(O)) status holders in Greater London and beyond.

The Greater London Authority (GLA) for supporting this project through the London Hong Kong Welcome Home Programme.

All colleagues from across the health, care and local government system who took part in discussions about Hongkongers mental health and wellbeing in London at the unconference event on 23 October or have reached out through separate discussions.

Who we are

Thrive LDN
Thrive LDN is a citywide public mental health partnership, working towards the shared mission of a city where every individual has equal opportunity for good mental health and wellbeing. Thrive LDN strives for equitable, sustainable and long-term change to the public mental health landscape. We are supported by the Mayor of London and accountable to the London Health Board.

Basis
Basis helps public services tackle messy problems, co-delivering effective change. They have specialist experience in delivering and co-facilitating workshops with civil society organisations, local, national government and UN organisations, especially for UNHCR.

Greater London Authority (GLA): London Hong Kong Welcome Programme
Supported by the Ministry of Housing, Communities and Local Government (MHCLG), the GLA London Hong Kong Welcome Programme enables Hong Kong Londoners to feel a part of London’s social and cultural fabric. The programme has been built from a strong evidence base, with the commissioning of research that surveyed Hongkongers and ran focus groups to understand their needs and priorities. This programme also echoes the Mayor’s Social Integration Strategy commitment, which extends to supporting Hong Kong British National Overseas (BN(O)) status holders to be able to live, work and study in the UK and to feel fully part of the British society.

Executive summary

This report is a culmination of our work looking into the challenges many Hongkongers are facing in London in relation to their mental health and wellbeing.

Over the past two years, Thrive LDN has received funding from the Greater London Authority’s Hong Kong Welcome Programme, supported by the Ministry of Housing, Communities and Local Government (previously known as Department for Levelling Up, Housing and Communities), to deliver a programme of work aimed at improving the mental health and wellbeing within the Hong Kong community in London. Over this period, Thrive LDN has worked closely with Hong Kong community organisations to create tailored resources, deliver culturally competent workshops and training, host events, and deliver a grants programme to support the mental health and wellbeing of Hongkongers living in London.

This year, additional short-term funding was made available, which presented an opportunity to build on the learning gained over the last two years, deepen the understanding of the public health needs of the Hong Kong community and develop targeted recommendations for individuals, communities and policymakers across the health and care system.

Between August and November 2024, Thrive LDN partnered with Basis to deliver this project. During the first two months of the project, we collaborated with seven Hong Kong led organisations to gather insights on the challenges Hongkongers face in London which impact their mental health and wellbeing.

In total, more than 1,100 community members participated in surveys (pre-existing and new) and more than 100 participated in interviews, focus groups or workshops.

Following on from this, in October 2024, we worked closely with the community organisations to showcase their findings at an unconference event. The unconference event was an opportunity to enhance engagement and peer networking between Hong Kong communities and policy makers across health and care in London. With 40 attendees, the unconference provided a platform for collective understanding of the mental health and wellbeing challenges faced by Hongkongers in London. Through small discussion groups, they generated ideas and recommendations to address these issues within the community.

This report is a culmination of our work looking into the challenges many Hongkongers are facing in London in relation to their mental health and wellbeing, and – ultimately – how these can be reduced through a series of recommendations and policy ideas for individuals, communities, and the health and care system.

Snapshot of the recommendations

Across the report we highlight six key themes emerging from the community, outline more detail on our methodology and approach to engagement, and present key findings and a total of 19 recommendations.

Our hope is that the recommendations, driven by rich community-led insights and engagement, will help London’s health and care partners consider new approaches or adapt existing practices, ensuring that the Hong Kong community feel supported to thrive in London.

01. Hongkongers reconciling their different identities as individuals

02. Family dynamics changing as different family members navigate their transition(s)

03. Loneliness and isolation as Hongkongers adapt to their new home and local community

04. Navigating health care services and the NHS with different cultural and practical expectations of a health service

05. Navigating the education system with different cultural and practical expectations

06. Challenges around finding fulfilling employment and feeling confident in their professional abilities

Theme 1: Hongkongers reconciling their different identities as individuals

1. Create safe spaces in London where diverse migrant communities can unite to share their personal experiences of identity.

2. Support Hongkongers to build local connections where they live.

3. Utilise practical tools to support young Hongkongers to navigate their identity.

4. Encourage advocacy and representation of Hongkongers at local decision- making processes and platforms.

5. Create opportunities for different generations within the Hong Kong community to share experiences and perspectives.

6. Better capturing of demographic and ethnicity data.

Theme 2: Family dynamics changing as different family members navigate their transition(s)

7. Offer safe spaces for open dialogue between Hong Kong parents and their children.

8. Offer Cantonese-language couple and/or parenting support.

Theme 3: Loneliness and isolation as Hongkongers adapt to their new home and local community.

9. Offer culturally specific peer support activities for young Hongkongers in London.

10. Understand and amplify good practices in London Boroughs and schools.

Theme 4: Navigating health care services and the NHS with different cultural and practical expectations of a health service.

11. Promotion of NHS services to be offered in a clear, centralised way within the community.

12. Deliver training packages focused on the cultural background of Hongkongers in boroughs with a high population of Hongkongers.

13. Provision of training for Hong Kong community organisations focussed on support available to Hongkongers in the UK.

14. Work in partnership with community organisations to offer community- led Talking Therapies Services for the Hong Kong community.

Theme 5: Navigating the education system with different cultural and practical expectations.

15. Promote mental health literacy among parents, schools and communities.

16. Utilise learnings from Hongkonger’s Affairs Officers in schools outside of London and understand how this could be applied to schools with a high population of Hongkongers.

17. Develop a school-based mental health hub utilising Hongkongers experience and expertise.

Theme 6: Challenges around finding fulfilling employment and feeling confident in their professional abilities.

18. In partnership with local authorities and community organisations, help streamline the pathway to convert and recognise Hong Kong social work and mental health qualifications in the UK.

19. Develop and promote guidance for those employing BN(O) Hongkongers in London.

Context

In recent years, Hongkongers have immigrated in large numbers to the UK. A study by Hongkongers in Britain (June 2023) identified political and social factors as the primary reasons behind individuals’ decisions to leave Hong Kong after the unrest of 2019. These factors have driven many to seek greater safety, freedom, and new opportunities.2

In January 2021, a new immigration route opened in the UK, providing Hong Kong British National (Overseas) (BN(O)) status holders and their eligible family with an opportunity to come to the UK to live, study and work, on a pathway to citizenship. With over 160,000 applications in the first two years, the arrival of Hong Kong migrants is considered one of the largest in recent UK history. From the nationwide online survey by Hongkongers in Britain (November – December 2022), most respondents (23.4%) resided in the South East region of the UK, with London (22.2%) following closely behind.3

Hongkongers mostly reside in North West and South West boroughs across London. Figure 1 is a map of London showing the distribution of BN(O) school children across the 32 boroughs and City of London, which include statistics on School Placements for Children from Outside of UK (UK government, published 13 October 2022) and data provided to the London Strategic Migration Partnership (LSMP) on the numbers of Hong Kong pupils attending Independent Schools in London in the same school year. The map provides an estimate on the distribution of school children across London boroughs, with the assumption that boroughs with higher numbers of BN(O) school children suggest higher popularity among BN(O) families with children.

Whether you are a newly arrived Hongkonger or you have been in London for some time, the community are still facing security concerns and hate threats within the UK. Large-scale mental health surveys
of Hongkongers indicate that levels of anxiety, depression, and post-traumatic stress are at an all-time high4. As such, the mental health and wellbeing of Hongkongers coming into London, remains a concern.

Figure 1: Estimation on the distribution of Hong Kong pupils across boroughs in the Greater London Authority region

Methodology

Goals and project design
Our overarching goal in this project was to develop tangible recommendations and ideas which would support the mental health and wellbeing of Hongkongers in London. To achieve this, we designed the project around two key phases:

1. Support for Hong Kong community organisations in London to gather insights on the mental health and wellbeing challenges experienced within their community.

2. Deliver an unconference event where the community groups could share and discuss their insights with representatives from across the health and care system in London.

Alongside this, the project also aimed to create opportunities for the participating partners to develop new skills and strengthen networks, both among Hong Kong community organisations and between them and organisations in the wider health and care system.

Participatory-led approach
Through the delivery of our project, we took a participatory approach, which meant we were guided and directed by the Hong Kong community organisations. This started with a series of conversations to understand their capacity for the duration of the project and an opportunity to share their thoughts on our initial proposal. Following on from the conversations, we adapted the original proposal and shared an invitation to community organisations to take part. Each organisation received a financial contribution for their time on the project.

For example, one key recommendation from the community organisation was for the community organisations to share the insights on behalf of Hongkongers in London, rather than invite individuals from the wider Hongkonger community to take part in the unconference event. This reflected both cultural concerns around speaking publicly about mental health issues and security concerns in the Hong Kong community. While this focused approach limited our broader outreach, it enabled insights to be collected directly by the Hong Kong community, and in Cantonese, where this was preferred, building trust, and encouraging engagement in safe community-led spaces.

Phase 1: Community insights
The community organisations collected insights and summarised existing findings independently over a period of four weeks during September 2024. This meant they could provide up-to-date insights into relevant and ‘live’ challenges faced by the community. In total, more than 1,100 community members participated in surveys5 (pre-existing and new) and more than 100 participated in interviews, focus groups or workshops. Despite the short four-week window for delivery, the quality of the reports was very high.

To support the delivery of phase 1, Basis facilitated a series of workshops to coordinate themes, focus areas and target groups, as well as drop-in clinics focused on user research methods and presentation formats to support the community organisations.

Phase 2: Unconference – a co-created space for reflection
The research phase concluded with an unconference where the Hong Kong organisations shared and reflected on their insights with representatives from across the health and care system in London. The unconference was attended by representatives of the Greater London Authority, local authorities, NHS bodies, and voluntary sector organisations.

An unconference is an informal participant- driven event where participants decide on the topics and lead discussions, rather than following a conventionally structured programme of events. Instead of a fixed schedule (as you might in a traditional conference), participants choose what they want to talk about.

This structure created spaces for open and inclusive discussions on challenges and solutions. Representatives of the community organisations played a leading role in the conference. They led the agenda setting process, proposed topics for discussion and facilitated group sessions.

Challenges and key considerations
The project faced several challenges that required us to take a pragmatic and adaptive approach.

Timescales
This was a short-term funded project to provide a set of recommendations. The participating Hong Kong community organisations all developed pragmatic solutions to the timescales, for example, by working with existing data or reaching out to their existing networks or/ clients. This may have limited the extent to which we captured the wider needs and experiences of the Hong Kong community, particularly of underserved or more isolated individuals, who typically require additional effort and time to establish contact and build rapport.

Wider commitments and high workloads The representatives of the Hong Kong organisations were a mix of full-time staff and volunteers, and all had high workloads and other commitments, which required us to jointly define a realistic scope for the project, and flexibility in implementation.

Adaptations included, for example, occasionally scheduling meetings outside of typical business hours and sharing inputs via short videos to give participants the chance to participate at a time that suited them.

Privacy, safety and trust
Privacy, safety and trust were top priorities in our engagement with the Hong Kong community organisations. Ensuring that all participating organisations felt comfortable about their involvement was essential to our delivery, but also created practical challenges. For example, a clear priority on data security and privacy made it more challenging to coordinate among the project partners. We avoided sharing contact details among the group, or using online meeting platforms that were flagged as being less secure by the Hongkonger community partners. This may have limited how well people could connect and share ideas openly.

Security
Security concerns also influenced the design of the unconference, which was an invite only event. We consulted the Hong Kong community organisations on all invitees to ensure they felt comfortable, and the event was a safe space. We acknowledge that this approach may have excluded organisations and individuals from outside these networks. We invited participation outside of the unconference and followed up with colleagues who were unable to attend, but we know there were more voices that could have been heard.

2. A study report on Hong Kong migrants recently arrived in the UK (2023), Hongkongers in Britain
3. A study report on Hong Kong migrants recently arrived in the UK (2023), Hongkongers in Britain
4. Exploring the Needs of Community Safety and Security amongst UK Hongkongers: A Community Survey. Hongkongers in Britain (HKB). August 2023.
5. This includes in-take forms for new service users who approached the participating organisations. The period of data collection ranges from 2022 to 2024.

Themes and recommendations

Six key themes and findings have been distilled from a comprehensive analysis of the insights gathered from the community organisations and the discussions held during the unconference:

01. Hongkongers reconciling their different identities as individuals

02. Family dynamics changing as different family members navigate their transition(s)

03. Loneliness and isolation as Hongkongers adapt to their new home and local community

04. Navigating health care services and the NHS with different cultural and practical expectations of a health service

05. Navigating the education system with different cultural and practical expectations

06. Challenges around finding fulfilling employment and feeling confident in their professional abilities

Through an iterative process of reflection and synthesis from the shared experiences of Hongkongers in London, this section provides actionable recommendations and examples of best practice that can be readily implemented to improve the mental health and wellbeing of Hongkongers in London.

We have combined and anonymised all the community insights to ensure the information is not identifiable. For further information on the insights gathered, please contact the Thrive LDN team who will liaise with the community organisations directly.

Theme 01

01. Hongkongers reconciling their different identities as individuals

Many Hongkongers find themselves navigating a significant culture shift, grappling with feelings of dislocation and the need to redefine their identity in a new context. The transition often brings about a sense of loss for their home culture, while simultaneously confronting the realities of building a new life in British society.

Hongkongers experience challenges such as language barriers, being misidentified as Chinese, and the pressure to integrate while maintaining connections to their heritage. The political climate and social dynamics surrounding their move, and not knowing if they will return to Hong Kong, can deepen their sense of displacement. These factors can lead to the struggle between embracing their Hongkonger identity and adapting to life in London.

“A Hongkonger moved to London to escape the political tensions in Hong Kong. Their social circle is limited, they struggle to communicate their identity and feel frustrated when locals mislabel them as Chinese, which they believe undermines their unique heritage and values. They feel culturally isolated, challenging to navigate their identity in a multicultural city where connections are often blurred. Their feelings of alienation and misrecognition contribute to their anxiety, questioning their sense of belonging.” – Community Insights

Hong Kong British National (Overseas) route
Under the BN(O) visa scheme which provides a pathway to citizenship, after five years in the UK, BN(O) and their family members will be able to apply for settlement, also known as indefinite leave to remain, followed by citizenship after a further twelve months. Given the scheme started in January 2021, the first cohort of applicants may be eligible to apply for British citizenship as early as 2026.6 For many, British citizenship doesn’t necessarily replace their Hong Kong or Chinese identity but adds a layer of complexity to their identity.

Young people
Children and teenagers may face their own unique struggles as they navigate their dual identities. They may feel pressure to conform to local norms while also wanting to honour their Hongkonger background. The community research among 100 young people (13–21-year-olds) showed that 49% of respondents felt that they do not fit into British culture or cannot be their authentic selves.

Speaking Cantonese is a vital aspect of identity for many Hongkongers. However, the option of Cantonese as an A-level subject in school varies and has led to significant frustration for students
who wish to preserve this linguistic connection. The lack of Cantonese language education can create a sense of disconnection and loss, making it more challenging for young people to fully express their cultural identity in an educational setting.

Figure 2: Comparison of Wellbeing between Hong Kong Youth and UK Average. Survey of 13-21 year olds, sample size 101.

Older people
Older people in the family may have a sense of identity closely tied to their life in Hong Kong, making it challenging for them to adapt to a new culture where they feel less familiar. Those who have lived through the political and economic transitions of Hong Kong over decades, were seen to find it more difficult to relate to younger generations who are more comfortable with English and Western culture. On the other hand, younger Hongkongers may feel caught between two worlds, unable to fully integrate into British society but also feeling disconnected from their parents’ more traditional values. The generational divide plays a significant role in the social dynamics of the Hong Kong diaspora.

Overall, the impact of identity can foster both connection and tension within the family, as members negotiate their individual and collective identities in the context of their new life in London.

Working professionals
Having moved to London to escape political tensions in Hong Kong, many working adults express concerns about their identity. They feel frustrated when mislabelled as Chinese, undermining their unique heritage. Raised under British core values, Hongkongers identify strongly as Hongkongers and some struggle with cultural isolation and navigating their identity in a multicultural city. For many working professionals, some identified mental health challenges, like isolation and anxiety, arise from feelings of misrecognition. Many also find services inadequate to their needs or not flexible in relation to their working arrangements, leaving them to cope without professional support, further reinforcing their sense of invisibility and isolation.

Language
For many in the community, language plays a crucial role in Hongkonger’s ability to engage with public and other services in London. In Welcome HongKongers HOME Project’s in-person survey of 40 Hongkongers, fluency and confidence in English was a challenge and causing concern, particularly in more complex subjects or conversations such as legal terminology, housing property contracts, court cases, medical vocabulary, and cultural nuances. Highlighted by participants, language barriers and difficulties in accessing translation services presented a significant challenge in adapting to their new environment and settling into life in London.

Recommendations

1. Create safe spaces in London where diverse migrant communities can unite to share their personal experiences of identity

Audience
This recommendation is aimed at the health and care system to consider when commissioning services to support migrant communities.

Description
The discussions at the unconference highlighted that many challenges related to the intersection of multiple identities across families and generations are shared by other communities in London.

Offering safe, accessible (and free) spaces for migrant communities can help navigate the complexities of identity and recognise shared experiences.

Example: Welcome Hongkongers H.O.M.E Project is known for its inclusive approach, offering support not only to Hongkongers relocating to the UK, but also with other communities. The project aims to foster community support, share experiences, and create a welcoming environment for all individuals in need, regardless of their background and experience.

2. Support Hongkongers to build local connections where they live

Audience
This recommendation is aimed at Hongkongers and Local Authorities. Local Authorities can play a key role in fostering local connections for Hongkongers. Working alongside Hong Kong residents, they can act as conveners and connectors, facilitating ties to local networks.

Description
While some Hongkongers may not yet feel very connected to the UK, it may be easier for them to feel a sense of belonging within their local community and in London as a whole. Local connections can be crucial in fostering this sense of inclusion. Facilitating these connections could be achieved through initiatives such as a local unconference or ‘social hackathons,’ where people come together for a day to tackle a specific challenge.

3. Utilise practical tools to support young Hongkongers to navigate their identity

Audience
This recommendation is aimed at community organisations and social care practitioners supporting young Hongkongers in London. It is also relevant for the health and care system when commissioning services supporting young migrant communities.

Description
Utilise concepts and practical tools such as ‘Darlington Trust; Understanding,
exploring and supporting children’s identity development’7 to help children and young people navigate their identity.

Examples include the use of photographs, videos and music as well as playing games such as identity ‘Jenga’ to express themselves and their beliefs.

4. Encourage advocacy and representation of Hongkongers at local decision-making processes and platforms

Audience
This recommendation is aimed at Local Authorities and Hong Kong residents in the borough. It aims to encourage Hongkongers to participate in local decision-making
and to share experiences of their identity. Local Authorities, particularly in boroughs with a high population of Hongkongers are encouraged to support this process by learning about the complexity of identity.

Description
Promote advocacy for the representation of Hongkongers in local decision-making processes and platforms, ensuring their voices and concerns are heard and considered within the city’s cultural landscape. Active participation can help build confidence and a sense of agency when navigating a new environment. Translation and/ or language support should be considered as part of this process and engagement with local community organisations can support this.

Influencing local policy and services, ensures the needs of Hongkongers are considered
in areas like education, healthcare, housing and employment. This is crucial for ensuring equitable access to resources and opportunities.

For example, NHS England’s first anti-racism framework, the Patient and Carer Race Equality Framework (PCREF) helps NHS mental health trusts and service providers to improve services for people from diverse ethnic, racial and cultural backgrounds. Advocacy and representation of Hongkongers should be included in PCREF at all levels.

NB: It is important to provide options for anonymity in this process to safeguard Hongkongers from potential security risks.

5. Create opportunities for different generations within the Hong Kong community to share experiences and perspectives

Audience
This recommendation is aimed at Hong Kong-led community organisations as part of their service delivery. This is also for the health and care system when considering commissioning services to support migrant communities.

Description
Create opportunities for different generations within the Hongkonger community to share their experiences and perspectives. This can help bridge the gap between older and younger members of the family, fostering mutual understanding and support. Providing spaces for traditional activities, such as playing Mahjong in family settings, can strengthen intergenerational bonds and promote cultural continuity. Delegates at the unconference suggested it as a particularly promising way of facilitating bonding between different generations, due to its popularity and status as a cultural touchpoint.

From another perspective, relationships can be built through practical support. Young people who are proficient in English could volunteer to assist older people who may find it difficult to navigate services such as the NHS. Older people could volunteer and help younger members by improving their written Cantonese.

Research has shown that intergenerational support initiatives yield positive outcomes, foster stronger connections and mutual assistance between generations.8

6. Better capturing of demographic and ethnicity data

Audience
This recommendation is aimed at those collecting such data as part of projects, work and/ or national initiatives.

Description
When collecting demographic data, include ‘Hongkonger’ as an option, rather than Chinese, or Other Asian. This will help service development and resource allocation in a long run.

Recognising Hongkongers as an identity in surveys, registrations, or on official forms will help foster belonging, reduce isolation, and improve integration and well-being among Hongkongers in the UK.

It will also give providers (from community organisations to local authorities) a better and more accurate understanding of the communities they’re support.

Case study: London Borough of Haringey

In response to the Local Hong Kong Welcome Fund, established by the Greater London Authority in March 2022, Haringey Council ran a programme to build capacity and provide services that welcome and facilitate the integration of Hongkongers into their local community.

The Resettlement Team at Haringey Council built a relationship with St James’ Church, a key community organisation, and established a programme led by peer volunteers to ensure the programme was culturally informed and responsive to the needs of the community. The progamme created:

• Celebrations of traditional festivals. In mid-autumn and Lunar New Year, to support Hongkongers to gather together and with members of their local community, attracting over 100 people to each event.
• Creative morning sessions. Twelve in-person Art and Movement workshops to support wellbeing, reduce isolation, and connect with other migrants, who share experiences of resettling in Haringey.
• Monthly three-hour meet ups. Regular shared space for newly arrived Hongkongers to gather, to increase language skills, create a sense of community and belonging, whilst also developing understanding and awareness of council services, to support meet the needs of the Hong Kong BN(O) community in Haringey.
• Employment support: The programme linked with Haringey Learns and Haringey Work to support Hongkongers through the complicated process of adapting their skills and capabilities into employment in London.

The programme benefited enormously from being community-led. This peer-led approach helped the team adapt the programme to be culturally informed and supported other Hongkongers to get involved.

“It’s not easy to get back to work without any local experience. It’s really good to be able to volunteering with the council … That helps me building up confidence.” – Peer volunteer

8. What is the effect of intergenerational activities on the wellbeing and mental health of older people?: A systematic review. Campbell Syst Rev. 2023 Oct 3;19(4):e1355. doi: 10.1002/cl2.1355. PMID: 37795424; PMCID: PMC10546258.

Theme 02

02. Family dynamics changing as different family members navigate their transition(s)

Upon moving to the UK, many families are encountering cultural adjustments, unemployment, and the practicalities of relocation, which put additional strain on their relationships.

Couples relocating from Hong Kong to London, who previously had professional careers, now find themselves relying on a single income and adjusting to the responsibilities of managing childcare and household tasks. During the unconference event, the concept of ‘astronaut’ couples was explored, referring to situations where one partner lives in London while the other resides in Hong Kong. The transition and long-distance relationship can be daunting and contribute to overall stress.

For some couples, the absence of a local support network, such as local friends and family who are going through similar experiences intensifies marital/couple conflict, followed by caring responsibilities and isolation. Research from community partners highlights how this dynamic has led to communication breakdowns, growing resentment, anxiety, and a significant decline in mental wellbeing for many. This is having an impact on their ability to deal with daily challenges.

“One feels unappreciated for domestic contributions, while another is being overwhelmed by being a sole breadwinner. There is a communication breakdown with misunderstanding and resentment, argument, and frustration on both sides.” – Community Insights

Many Hongkongers feel compelled to ‘tough it out’ rather than seek external help as mental health issues can be seen as a source of shame or weakness. There is a strong cultural emphasis on avoiding public embarrassment. Talking about mental health, seeking therapy, or admitting to emotional struggles can be viewed as something shameful or a failure to cope with life’s challenges.

Some young people may ‘suffer in silence’, hiding their emotions from their family, for fear of disappointing their parents. This creates a communications gap, where both sides struggle to understand the other’s perspectives or emotional needs.

Many parents did not grow up in a culture where therapy was accessible or normalised. The idea of seeing a therapist might, therefore, be unfamiliar or intimidating. The social taboo around help seeking behaviour, has also led some parents to ask, “Will a mental health record affect my child’s promotion to a higher set or a better school?” Those who seek help often become frustrated by the unfamiliar local support systems in England, which differ significantly from Hong Kong.

Recommendations

7. Offer safe spaces for open dialogue between Hong Kong parents and their children

Audience
This recommendation is aimed at community organisations as part of delivery, but also for the health and care system when considering commissioning services for migrant families.

Description
Hongkongers encounter distinct challenges within the family structure. To combat stigma, it is essential to offer programmes that bridge the cultural gap between Hong Kong parents and their children. Workshops or support groups could create a space for open dialogue about the difficulties of adapting to UK society, while also addressing differences in value systems. This approach may help alleviate family conflicts and improve communication.

8. Offer Cantonese-language couple and/or parenting support

Audience
This recommendation is aimed at community organisations as part of delivery, but also for the health and care system when considering commissioning services.

Description
Many Hongkongers relocating to London are facing additional strain on their relationships, particularly marital/couple or family orientated stresses. The introduction of family dynamic workshops for those in the community would offer a preventative approach to addressing communication issues, exploring conflict resolution, and supporting emotional wellbeing of the whole family. In turn, this approach would strengthen relationships in the home. It would be important to ensure such projects or workshops were delivered by Cantonese speakers. Such initiatives may also consider play or arts-based therapy to assist families in expressing themselves and navigating the challenges of raising children in a new cultural environment.

Theme 03

03. Loneliness and isolation as Hongkongers adapt to their new home and local community

The isolation and loneliness faced by Hongkongers in London is a multifaceted issue that stems from a combination of cultural, social and practical challenges.

Leaving behind familiar surroundings, friends and family can lead to feelings of sadness and nostalgia for their previous life in Hong Kong. The lack of close friends or connections in London heightens the feelings of boredom, disconnection and loneliness.

Figure 3: Taken from a community insights survey with 13–21-year-olds (n=101) when asked to use three adjectives to describe life in the UK.

The physical distance from family members and friends in Hong Kong can contribute to feelings of isolation, and for some, the time zone difference makes it harder to stay in regular contact. The stress of adapting to a new environment, combined with the uncertainty of the political situation in Hong Kong, can exacerbate feelings of anxiety, depression, or trauma. Loneliness is often linked with mental health challenges, and without adequate support, it can become more pronounced.

Whilst there are some areas of London with a concentration of Chinese-speaking populations, these communities often reflect broader Chinese identities, which may not align with the specific cultural experience of Hongkongers. Despite living in London and the physical distance, many young people were said to turn to their friends in Hong Kong for support.

For some younger or more tech-savvy Hongkongers, the internet and digital tools can provide a way of bypassing the feelings of loneliness within their new community or environment. For example, they can find comfort and familiarity playing online games and speaking Cantonese with friends in Hong Kong, but this can displace bonding with Londoners.

An individual or family’s concerns about safety and culture in London can trigger anxiety. Some parents are worried that children leaving the house unaccompanied are at high risk of suffering physical crime or, in an effort to fit in, may become engaged in antisocial activity. Delegates felt that these fears were usually allayed once families had had a few positive experiences, but getting over this initial barrier took time. During this period, young people would be more reliant on internet friends in Hong Kong as they would be less able to leave the house.

It is helpful to note that young Hongkongers reported a lower sense of isolation in certain areas of London, particularly in the London Borough of Sutton. This may be due to Sutton having a higher population of Hongkongers than other boroughs, but it appears that the local authority and its schools play a positive and active role in fostering a sense of connection.

Recommendations

9. Offer culturally specific peer support activities for young Hongkongers in London

Audience
This recommendation is aimed at community organisations as part of their delivery,
but also for the health and care system when considering commissioning services supporting young migrant communities.

Description
Create activities specifically tailored to the cultural needs of Hongkongers. Offering programmes that reflect their interests and heritage can help alleviate feelings of boredom and isolation, while also fostering stronger connections within the community. Examples:

• Establish stronger local, youth-led peer support networks for Hongkongers in London to reduce their dependence on friends back in Hong Kong for emotional support.
• Create Cantonese hotlines and safe spaces for young people to connect and share experiences can help them feel more supported and less anxious.

10. Understand and amplify good practices in London Boroughs and schools

Audience
This recommendation is aimed at Local Authorities and community organisations to initiate a ‘positive deviance’ approach9.

Description
There are indications that certain schools and boroughs, such as Sutton, foster an environment where the Hong Kong community can thrive more effectively. Through the established approach of positive deviance, the community can themselves identify the specific good practices and enable this to spread to other parts in London. Positive deviance is a strengths- based approach that is rooted in the belief that solutions to challenges already exist within communities, and that identifying, understanding and sharing these solutions, enables improvements at scale.

Case study: Tackling Loneliness in Bromley

In response to tackling loneliness, as part of Bromley’s Tackling Loneliness Strategy from 2022 – 2026, a multi-agency plan which is being developed where the local authority created the role of Principal Loneliness Champion.

The strategic key three areas of focus include connecting organisations and services, supporting community infrastructure that empowers connections, and building a strong culture that encourages strong social relationships. The Principal Loneliness Champion is the Local Governments Association’s (LGA’S) expert council on Loneliness with a special interest group supporting other local authorities across the UK.

Bromley’s dedicated Loneliness Lead highlighted the Simply Connect service as a tool for Hongkongers to find culturally relevant activities in Bromley. In October 2024, the Bromley site listed 1,513 activities.

The Simple Connect network offers equivalent activities, groups and support for all boroughs but is reliant on funding and input.

Theme 04

04. Navigating health care services and the NHS with different cultural and practical expectations of a health service

Whilst the concept of free healthcare is welcomed by Hongkongers in London, they often may not fully understand the structure or how to access services within the NHS.

In Hong Kong, many people are used to a more straightforward way of accessing health services or accessing specialist support/advice.

Many new arrivals from Hong Kong are unfamiliar with the process of registering with a GP and may not know how to access specialist services or urgent care. Even for those who are familiar with the concept of seeing a GP first, the specific process in the UK can be cumbersome and unclear, with long waiting times or difficulty booking appointments. This creates a sense of confusion and frustration, especially for those who are in urgent need of medical attention.

The community insights further revealed a reluctance to use NHS services by some, with the top concerns being “confusion over how to access services” followed by “fear of data leak” and “uncertainty about which service to use”. In some cases, these obstacles resulted in Hongkongers choosing to not use NHS mental health services and seek alternative options, and even non-professional sources of support.

Some members of the community who were engaged with the NHS service however were frustrated by being rejected for specialised service such as CAMHS or not offering existing medication (carried over from Hong Kong) without any consultation.

Community insights reveal that individuals accessing NHS services face significant barriers, with the primary issue being that clinicians often struggle to empathise with their experiences. Following this, difficulties with interpretation such as poor translation or a lack of comfort in sharing sensitive information with an interpreter, were also highlighted as major concerns.

“Interpretation may not be helpful if the individual does not feel at ease with the interpreter. It is important to consider both culture and familiarity in the interpreter’s role.” – Unconference event

In addition, the transition and continuation of treatment and medication from Hong Kong to the UK can also be challenging, particularly for parents trying access medication for children with special educational needs. A user journey map from the community insights has been outlined below taken from 133 surveys, 5 interviews by Hongkongers in Britain.

Figure 4: A user journey map of Hong Kong community for accessing NHS medication for mental health illness: a descriptive example. [See page 29 of designed report].

When considering access to mental health support for the Hong Kong community in London, participants raised a lack of knowledge as a key barrier to accessing services in the UK. Some Hongkongers are unaware of the support available to them, especially in relation to their BN(O) status and what this means for future visa applications. There was some suggestion that there is fear felt by some in the community that accessing NHS services may hinder future applications.

There was also an acknowledgement by many participants that Hong Kong community organisations are often the first place Hongkongers in the UK go to for support and advice. This also puts an expectation on them to have a full understanding of the different services, escalation routes and support available to Hongkongers. This is not only a practical challenge for these organisations but can
also surface cultural differences. For example, safeguarding was flagged as an area where there is a difference in cultural expectations between Hong Kong and the UK. When safeguarding concerns arise, there can be confusion about escalation and the process that follows. This has put pressure on community organisations with limited resources.

NHS Talking Therapies
Seeking therapy can be uncomfortable and challenging for Hongkongers. The idea of talking about personal problems with a stranger may feel inappropriate or alien to some. It is not widely available or culturally ingrained in Hong Kong, where individuals experiencing mental health difficulties are more likely to seek support through a social worker who plays a central role in the mental health care system in Hong Kong. This reflects a more family-centred and community- based approach to mental health, rather than therapy for an individual.

Furthermore, the community insights revealed that those who did engage with NHS Talking Therapies often felt the approach was too rigid and short-term, with many expecting longer-term support.

There may be a preference here for a more flexible service which offers other interventions. These could include non-traditional approaches and interventions, such as music or art therapy. This may have led to Hongkongers turning to community organisations rather than NHS services, particularly when also considering waiting times.

That said, there are examples of funded services which are culturally specific and appropriate, such as those delivered by Hearth Talk, being oversubscribed. Demonstrating more willingness to engage with bespoke or more flexible services.

Child and Adolescent Mental Health Services (CAMHS)
Parents and children often find it difficult to clearly communicate mental health concerns to medical professionals. As a result, instead of being referred to CAMHS or receiving the appropriate treatment, they are frequently redirected back to schools to address issues related to academic/ learning requirements or adjustment. This challenge goes beyond language barriers or mental health stigma – families from cultures where mental health discussions are not common often lack the necessary vocabulary to accurately describe symptoms. During appointments, they tend to focus on the child’s refusal or lack of motivation to attend school, rather than addressing the underlying emotional issues. Questions with limited cultural awareness from the medical professionals have not been helpful in this regard. Additionally, those with a diagnosis from Hong Kong struggle with waiting times and processes to have their medication prescription continued.

Recommendations

11. Promotion of NHS services to be offered in a clear, centralised way within the community

Audience
This recommendation is aimed at NHS and organisations who support NHS services in London.

Description
Clear, centralised communication on the NHS will help the Hong Kong community navigate the services available to them. This helps reduce confusion and improves overall understanding of healthcare options available to them. This could include a translated website and videos and infographics in Cantonese on what to expect when selfreferring to NHS mental health services. It will also assist the NHS in understanding more of the nuance around language, including traditional and simplified Chinese.

Providing clear, centralised information also helps to challenge the misconception amongst Hongkongers that mental health support is always long-term. It highlights the support available for situational or circumstantial distress.

Note: In 2022, Thrive LDN, in partnership with Hong Kong-led organisations co-developed a resources page on access services and tools for starting life in London. This page could be strengthened to incorporate further information on NHS services in London.

12. Deliver training packages focused on the cultural background of Hongkongers in boroughs with a high population of Hongkongers

Audience
This recommendation is aimed at the NHS workforce, Local Authorities and schools in boroughs with a high population of Hong Kong residents.

Description
Although respondents felt that clinicians were culturally sensitive, most did not feel that their culture and beliefs were fully understood. This highlights a significant need for training to enhance the cultural competency of the NHS and wider health and care professionals, particularly in areas with a higher population of Hongkongers.

Offering CPD accreditation (or similar) for this training could boost attendance. If training resources are limited, an information pack could be provided to enhance understanding of the Hong Kong culture.

13. Provision of training for Hong Kong community organisations focussed on support available to Hongkongers in the UK

Audience
This recommendation is aimed at Hong Kong community organisations providing support to Hongkongers in the UK.

Description
It is recognised that Hong Kong community organisations are a trusted source of support and advice for the Hong Kong community in UK and are often the first port of call for information or support.

Hong Kong community organisations could be provided with training and information that would assist in the provision of support to Hongkongers in London, particularly in relation to navigation of the health and education service and other key areas such as safeguarding. Such a training should be developed in consultation with the Hong Kong community organisations.

14. Work in partnership with community organisations to offer community-led Talking Therapies Services for the Hong Kong community

Audience
This recommendation is aimed at community organisations and Talking Therapy Services in boroughs with a high number of Hong Kong residents.

Description
Work with community organisations to deliver a community-led Talking Therapies service for Hongkongers in London boroughs with a high number of Hong Kong residents, using ‘Derman’ for the Kurdish and Turkish community in East London as a model. This could also help Hongkongers to continue their treatment and medication without problems.

Case study: Derman

Derman is a specialised mental health service offering bilingual and culturally sensitive counselling to the Kurdish, Turkish, Turkish Cypriot and Eastern European Turkish immigrants, asylum seekers and refugees.

The service mainly is located in Hackney and is distinguished by its staff who have operated within the context of these cultural backgrounds.

Derman works closely with the NHS to deliver culturally specific psychological therapies to Turkish/ Kurdish speaking communities. They offer one to one counselling and group therapies to clients to help improve their emotional wellbeing, re-validate their skills to recover, live independently, and to manage their mental and physical wellbeing.

Theme 05

05. Navigating the education system with different cultural and practical expectations

Many parents from Hong Kong experience feelings of loneliness, isolation and helplessness, particularly when navigating the UK education system. Cultural differences, especially around academic expectations, often make it difficult for them to connect with local parents.

In Hong Kong, schools play a central role in supporting children’s wellbeing. Each state school is typically staffed with two full-time social workers, a part-time educational psychologist, and a part- time or full-time speech therapist. Teachers, especially class teachers, are actively involved in student mental health care, with regular after-school communication with parents being the norm. In addition, schools play a key role in preparing children for medical assessments, with teachers often accompanying families to help present the child’s situation clearly.

In contrast, UK professionals may not always have the cultural awareness to guide these conversations in a way that Hongkongers expect or have been used to, which can leave families feeling confused by broader, less specific questions, such as, “How is your child doing in school?”

Parents of children with special educational needs and disabilities (SEND) face a significant gap in support compared to what is available in Hong Kong. This highlights the need for more resources, community-building initiatives, and targeted support systems to help these parents feel better integrated, informed, and supported.

An area of particular concern is access to or knowing how to access speech therapy, where language acquisition delay is particularly prevalent for children living in a bilingual environment. The different resources of schools and teachers’ roles in mental health and wellbeing in the UK can leave parents feeling frustrated by the lack of or slow school-based support for their children.

“…Families experience loneliness and helplessness, especially when navigating the UK education system in which information is not centralised. Parents of children with SEND face a severe lack of support compared to what is available in Hong Kong. This sense of helplessness is particularly pronounced among ‘astronaut families’ with stay-at-home parents of children of the opposite gender.” – Community Insights

Recommendations

15. Promote mental health literacy among parents, schools and communities

Audience
This recommendation is aimed at community organisations supporting Hongkongers and schools with a high population of Hongkongers.

Description
Promote mental health awareness among parents, schools and communities. This could include a public health campaign or school programme to showcase the importance of seeking support for your mental health and where to get help. This could include clinical initiatives and non-clinical initiatives such as coffee meet ups in the community.

16. Utilise learnings from Hongkonger’s Affairs Officers in schools outside of London and understand how this could be applied to schools with a high population of Hongkongers

Audience
This recommendation is aimed at schools with a high population of Hongkongers.

Description
A designated officer could be appointed to oversee and enhance communication between schools and Hong Kong families. This role has been successfully implemented in Manchester and Cambridgeshire.
Ideally, the officer should have teaching experience, and resources for these roles should be prioritised in school areas with the greatest need.

17. Develop a school-based mental health hub utilising Hongkongers experience and expertise

Audience
This recommendation is aimed at the NHS, schools and local authorities with a high population of Hongkongers.

Description
The model in Hong Kong shares many similarities with several aspiring UK policies10. The school nurse plays a central role and has a deep understanding of mental health.

A coordinated approach between teachers, parents and other trusted professionals is easier. The expertise of Londoners with Hong Kong expertise can be of use here; they could help to develop such a school- focussed model in London. If this model was prototyped in a school with many children and young people from Hong Kong, this would have an additional benefit for the community.

Case study: Schools Affairs Officers in Manchester and Cambridge

Example from Manchester

Broadoak School is a coeducational secondary school with academy status located in Partington in Greater Manchester, rated ‘Good’ by Ofsted. One- sixth of the current student body is now from Hong Kong.

As the Head of School stated in an interview with Green Bean Media, the first priority is to make the students from Hong Kong feel happy and safe in a potentially challenging new environment where ‘moving thousands of miles and the language barrier’ adds to the difficulty of settling into a new school. Since 2022, it has introduced a programme to support pupils from Hong Kong funded by the school trust.

The school has taken on a Cantonese-speaking science technician and two Teaching Assistants, one of whom takes over liaison roles with Hongkongers. Regular run induction sessions are offered to new pupils to discuss their challenges in adapting to the local education system as well as culture.

The headteacher said that the staff member is very important in liaison so that those language needs can be identified and met but also to be that bridge and that link between school and home.

Example from Cambridgeshire

Cambourne Village College in Cambridgeshire, which was rated ‘Good’ by Ofsted, has roughly 100 students who arrived from Hong Kong since 2020. From 2022 onwards, the college has allocated resources to hire a part-time Hongkonger affairs liaison officer.

The liaison role is undertaken by a Cantonese-speaking teacher originally from Hong Kong, who migrated to the UK at a young age. She is paid for two additional hours per week to perform the following responsibilities:

• Pastoral Support: Providing guidance to help students integrate into the school community.
• Academic Transition Assistance: Supporting students as they adapt to different subject requirements, particularly in English and Science, where curricula differ significantly from Hong Kong’s. She also offers pastoral support to students studying European modern foreign languages (MFL) for the first time.
• Parent-School Communication: Acting as a Cantonese-speaking intermediary to facilitate communication between the school and parents, especially those who face challenges with English.
• Library Integration: Coordinating with the library to stock Chinese books while encouraging students to explore diverse reading materials.
• Staff Awareness: Raising awareness among teaching staff about the unique situations and potential challenges faced by Hong Kong students.

She meets with Hong Kong students every half term, responds to parents’ inquiries as needed, and participates in teacher-parent meetings on matters such as safeguarding.

In 2024, the CAM Academy Trust, of which Cambourne Village College is a member, approved a budget of £2,000-£3,000 to extend similar support across its other member schools.

Theme 06

06. Challenges around finding fulfilling employment and feeling confident in their professional abilities

Some professionals from Hong Kong experience a lack of confidence in their abilities when transitioning to work in London.

Key factors contributing to this include the limited recognition of their Hong Kong qualifications and work experience. Despite being in professional roles in Hong Kong, the qualifications were
not always understood or accepted in London, particularly in specialised fields.

University
University students often experienced anxiety about their future career prospects. Many are unfamiliar with the UK job market, finding it challenging to secure internships or part-time positions, and feel uncertain about how to develop the skills and experience needed for their careers. Volunteering can be challenging for some as the roles are unpaid, but this was sometimes seen as a short-term solution if it was a means to securing a role.

The NHS and social care
Psychologists, nurses, therapists, and many social care professionals from Hong Kong have expressed frustration that their expertise, though urgently needed, is difficult to utilise within the UK. Converting their qualifications is challenging, and the guidance on how to navigate the process is unclear. Figure 5 provides a user journey map from the community insights, outlining this.

Workforce
There are many Hongkongers who have secured well paid or management-level positions in London. When employment was found, whether it was in line with professional expertise or
not, community insights revealed that they felt excluded and lacked a sense of belonging. ‘Banter’ and casual or more social conversations in the workplace often left them feeling disconnected and struggling with nuances of informal English communication or popular culture. This impacted their self-confidence in their social skills and contributed to their anxiety and stress.

These issues are found across professional groups and career paths – earning more money or working in higher status job does not necessarily protect their mental health. The lack of established social networks and support systems can heighten feelings of isolation for working professionals.

Workplace stress and burnout are common, as high expectations and the absence of familiar colleagues intensify stress and feelings of inadequacy. Family separation, particularly for those in ‘astronaut families’ increases loneliness and a sense of guilt. Moreover, the relocation experience can trigger an identity crisis for some, as individuals struggle to reconcile their heritage with their new environment. Finally, the social stigma surrounding mental health in Hong Kong often prevents many from seeking help, exacerbating feelings of anxiety and depression.

These emotional burdens lead to increased anxiety, depression, social isolation, and burnout, making it difficult for many Hongkongers to thrive both personally and professionally.

Figure 5: A user journey map of Hong Kong social workers: a descriptive example. [See page 41 of designed report].

Recommendations

18. In partnership with local authorities and community organisations, help streamline the pathway to convert and recognise Hong Kong social work and mental health qualifications in the UK

Audience
This recommendation is aimed at local authorities and community organisations.

Description
Collaborate with various organisations to streamline and communicate a clear pathway for qualified professionals from Hong Kong to begin working in the UK, making the process of degree recognition more straightforward. The British Association of Social Workers, in partnership with the community organisation “UK Welcomes Refugees,” has already developed the initial stages of a learning program.

19. Promote guidance for those employing BN(O) Hongkongers in London

Audience
This recommendation is aimed at employers in boroughs with a high population of Hongkongers working in collaboration with community organisations and public services.

Description
Promote guidance for employers, a working example would be The Welcoming Committee for Hong Kongers’ Employing BN(O) Hong Kongers – what you need to know. Such a guide would offer employers an overview of the BN(O) visa, the potential of Hongkongers to meet staffing needs and to recruit BN(O)s. Further iteration or a London regional version could be facilitated between community organisations, in a participatory approach with those working across various sectors in London, and employment groups or local authorities. Furthermore, this could support professional networking opportunities for Hongkongers to combat isolation and build a peer-to-peer support system.

Case study: Internship to help social workers register to practice

The London Borough of Sutton has developed an internship programme to support Hong Kong qualified social workers living locally to register to practice in England.

The scheme which has been developed with Kingston University provides the practitioners with sufficient supervised practice and formal study to enable them to meet Social Work England’s registration requirements for overseas staff. The scheme provides employment for Hongkongers whilst reducing the shortage of social workers in England.

Conclusion

Conclusion and next steps

Thrive LDN and Basis are immensely grateful for the time community partners have committed to undertake the work which has supported the development of this report and for the enthusiasm and speed in which they’ve responded to the delivery of the overall project.

Many individuals involved in this report have their own lived experiences of mental health, discrimination, and/ or face the many challenges identified in this report, alongside being busy supporting and running their own activities through their respective organisations.

We heard how integrating into London was not just about access to services and the workforce, but learning more about the culture, traditions, and ways of life. Alongside practical recommendations to support Hongkongers transition to life in London, there was also a focus on the nuances of English communication.

Whilst there are distinct historical, cultural and contextual differences for the Hong Kong community in London, there are also shared considerations that may apply to other migrant communities in London. For example, addressing historical and ongoing trauma, isolation, transition, identity and the importance of cultural awareness and humility.

Finally, it feels important to end this report by reminding those working within London’s broad range of health and care organisations that there is a clear appetite amongst and from within the numerous Hong Kong-led community organisations to engage further with system partners. London operates across a complex collection of systems and process, more so than any other UK region, but the willingness to offer advice for the ultimate benefit of the community is clear, all in the spirit of collaboration. System colleagues should take up this offer when exploring the range of recommendations and ideas presented in this report.

We hope therefore that this report provides an insight and springboard into future action and funded projects that can be taken by individuals, community organisations and the health and care system in London to support the Hong Kong community.