LettersPathway of Hong Kong pupils’ well-being runs through relationships
Readers discuss the sharp rise in the number of students with mental illness, and an experience with an orthopaedic surgeon

I respectfully take issue with two points raised by a school principal quoted in the article. First, the suggestion that teachers’ role is primarily to help pupils seek support, as educators were not mental health professionals. This framing risks reducing teachers to gatekeepers of referral slips.
Teachers are the adults pupils see every day. Research shows that educators who develop their own social and emotional competencies create warmer classroom climates, stronger teacher-student relationships and greater student engagement, outcomes that are inherently preventive. Teachers need not be therapists; their role is to build safe, connected classrooms where every child feels a sense of belonging. Framing their role as merely identifying and referring risks further stigmatising pupils and undermining the very safety and belonging that protect mental health.
Second, the call to “build resilience” deserves scrutiny. A recent Hong Kong study examined a resilience intervention for Chinese parents of autistic children and found that it only benefited those with moderate levels of stress. Parents who were already overwhelmed showed no improvement, a floor effect, while those with low stress showed a ceiling effect. The implication is clear: resilience training is not a universal remedy. For pupils already in crisis, telling them to “bounce back” may be futile without first addressing the relational and environmental conditions around them.
What does work? A longitudinal study of 313 Hong Kong school-age children, conducted in partnership with Just Feel’s Compassionate School Programme, found that social and emotional competencies predicted greater relationship closeness with parents, peers and teachers, which in turn predicted better subjective well-being eight months later. The pathway to well-being runs through relationships.
This is precisely why whole-school, prevention-oriented approaches matter. The Compassionate School Programme invests in every adult and every child in the school community, building relational capacity school-wide rather than waiting for crises to emerge. When all pupils experience emotionally safe classrooms and connected relationships, we address mental health at its root, before the need for a three-tier referral ever arises.