FIGHTING FOR ADHD AWARENESS IN HONG KONG IS AN UPHILL BATTLE FOR SOCIAL ENTERPRISE FOUNDER

Amanda Fok is the founder of Let's Talk ADHD and ADHD Awareness Week, at which adults can get free ADHD assessments on October 25 and 26

After Amanda Fok Choi-ling was told, at the age of 35, she had ADHD, the first doctor she saw about her condition was a child psychiatrist.

"When I was diagnosed in 2008, there were no support systems for adults with ADHD," the Hongkonger recalls.

A professional emcee, Fok founded Let's Talk ADHD, a social enterprise that raises awareness of the disorder and starts conversations to spread the word that it affects children and adults alike. She launched Hong Kong's first ADHD Awareness Week in 2020.

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ADHD, or attention-deficit/hyperactivity disorder, is a neurodevelopmental disorder that results from an imbalance of neurotransmitters, or brain chemicals, like dopamine.

This can affect executive functions, a set of mental skills that enable a person to plan, follow and achieve a task to completion. Someone with ADHD may find it hard to focus, follow directions and manage emotions.

Other symptoms include persistent inattention, hyperactivity that manifests as restlessness or fidgeting, and impulsivity. It is not a behavioural flaw but a chronic condition.

While often diagnosed in childhood, ADHD frequently continues into adulthood, influencing daily life, work and relationships, but can be managed effectively with strategies and treatment.

To make it easy to understand, Fok says to compare having ADHD to having a nearsighted brain that needs glasses.

Fok illustrates her point: "Without [their] glasses, you can't tell someone who has myopia to just focus and see something; likewise, you can't just tell someone with ADHD to just focus and achieve a task."

Raised by a single mother, Fok feels that her background has benefited her.

"My mother was always busy with work, and I did not attend a high-pressure school," Fok says. "In retrospect, I was satisfying my dopamine deficiency with extracurricular activities. My grades weren't good enough [for] university, so I started working.

"It was my job in insurance where my problems began. Seeing clients was great, but the administration side of it was a disaster."

It was at this point in her life that Fok encountered the most common comorbidity of ADHD: depression.

"People with ADHD are very hard on themselves because their executive functions are often affected when taking on tasks, so there is usually a gap between what they want to do and what they end up doing," she explains.

"I was crying when I first saw my therapist, and she told me we have to treat the ADHD, but first I had to treat the depression."

Therapy was expensive, prompting Fok to find out as much as she could about her condition "so that I could quit therapy as soon as possible".

Armed with knowledge and experience, Fok started speaking about it in interviews and started Let's Talk ADHD.

Fok's mission to bring ADHD to Hong Kong's public consciousness is an uphill battle. The medical name of the condition in Cantonese only addresses hyperactivity, not the attention deficit aspect.

"We use the term 'attention dysregulation and hyperactivity' in our materials. I've spoken to other activists, and this is going to take a while as I am trying to get medical associations to change the name," Fok says.

For similar reasons, Fok has also spoken to activists about changing the Cantonese name for blindness to visual impairment. Changing the medical term could reduce stigma around the condition and enable the inclusion of patients with low or residual vision for treatment.

Overlooking the attention deficit part of ADHD can have disastrous consequences.

A child with ADHD gets reprimanded more than an average child, "a lot of the time because parents believe that they can discipline their way to getting the child to focus", Fok says.

In a 2006 study in the UK, 11 per cent of children with ADHD were permanently excluded from their school. Another study in 2009 found the rate of exclusion to be 0.1 per cent for the general population. This means children with ADHD were at a more than 100 times greater risk of being permanently excluded from school than others.

"If you throw in the pressure of school, ADHD children are more likely to attempt suicide," Fok says.

An Australian study published in the journal Psychiatry Research in July 2024 found that children diagnosed with ADHD by the age of 10 are 11 times more likely to have had suicidal thoughts by the age of 14, and 25 times more likely to have engaged in self-harm.

Another challenge in Hong Kong is to get adults to acknowledge ADHD, whether they fall into the category of parents of children with ADHD or that of adults who have ADHD.

"I find parents and spouses the hardest to convince," Fok says. "My solution is to bring more attention to the cause by making ADHD Awareness Week as big as possible."

This year's ADHD Awareness Week event, taking place at the Fortune Metropolis mall in Hong Kong's Hung Hom neighbourhood on October 25 and 26, features free adult ADHD assessments using infrared brain scanning - a first in Hong Kong. Children can take free attention tests.

An Emotional Relief Zone will offer mindfulness workshops for parents and therapeutic board games for everyone. Entertainment includes a mechanical spider race, magic shows, stand-up comedy by artists with ADHD and other performances.

On October 29, expert-led seminars at the mall will cover topics such as medication, diagnosis, metacognitive therapy - which aims to help people regulate their thinking patterns to stop overworrying and rumination - and relationship strategies.

"I have to make all the information very interesting and colourful to attract a bunch of people with ADHD," Fok says. "They won't pay attention if they're bored."

Fok is working hard to get insurance companies to cover ADHD in their workplace policies, making it easier for adults with the condition to get diagnosed.

"The cost of diagnosis and therapy is a turn-off for many people with ADHD. I have an insurance background, so I can see how that can help," she says.

Companies should care about ADHD. In a 2019 study by Deloitte Access Economics on the cost of ADHD on Australian society, it was estimated that productivity losses associated with being absent from work, being at work but impaired because of illness or stress, reduced workforce participation, and premature mortality because of ADHD added up to nearly A$10 billion (US$6.5 billion) in 2019.

Getting the government and society to care about ADHD is a challenge, as the consequences are multifaceted.

"People with ADHD don't end up on the news because they have harmed people. Depression did not get attention in Hong Kong until [singer and actor] Leslie Cheung died because of it," Fok says.

"When I was applying for grants, I was asked how many ADHD people my social enterprise can help find employment. But finding a job isn't a problem for the people with the condition; it's keeping it that's hard for them. They are also three to four times more likely to start a business."

Returning to her reference to poor eyesight and spectacles, Fok says to remember what life was like for people with myopia before glasses were invented.

They were often classed as slow and clumsy, and their job options were mostly limited to manual trades with close-up work like tailoring or shoemaking.

Now, wearing glasses opens up options and is considered normal, not a disability.

Fok gives the last word to Dr Russell Barkley, a retired neuropsychologist and authority on ADHD.

"He says, among the [mental health disorders], ADHD is the most treatable, yet it is the most easily overlooked," she says.

For more details of ADHD Awareness Week, visit letstalkadhd.hk/en/2025-adhd-week.

If you have suicidal thoughts or know someone who is experiencing them, help is available. In Hong Kong, you can dial 18111 for the government-run Mental Health Support Hotline. You can also call +852 2896 0000 for The Samaritans or +852 2382 0000 for Suicide Prevention Services. In the US, call or text 988 or chat at 988lifeline.org for the 988 Suicide & Crisis Lifeline. For a list of other nations' helplines, see this page.

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This article originally appeared on the South China Morning Post (www.scmp.com), the leading news media reporting on China and Asia.

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2025-10-22T23:33:37Z