SERVICE INTRODUCTION AND

WORKPLACE REQUIREMENT ON

MENTAL HEALTH CARE INDUSTRY

Stephen Wong

Superintendent

Caritas Jockey Club Lai King Rehabilitation

Centre

FACTS ABOUT MENTAL ILLNESS

� According to HA 5 years blueprint, there are

40,000 diagnosed schizophrenic patients in HK

� It is estimated that around 1M -1.7M people have

a mental disorder and between 70,000- 200,000

people have severe mental illness.

FACTS ABOUT MENTAL ILLNESS

� 2% of population suffered from depression i.e.

around 136,000 people in HK

� In statistic report from year 2000, there are

50,500 people suffering from mental illness

receiving rehabilitation service

FACTS ABOUT MENTAL ILLNESS

� 15,887 in patients in HK (2008-9)

� 171,370 outreach attendances from Psychiatric

outreach and psychogeriatric outreach service

(2008-9)

RESIDENTIAL SERVICES IN HK

� Long Stay Care Home

� Half-way Houses

� Supported Hostel

� Self-Finance Supported Hostel

� 2 BPS Long Stay Care Home (Private Hostel)

LONG STAY CARE HOME

� It provides residential care for chronic mental

patients who are in stable or controlled medical

and mental conditions requiring no active

medical treatment but some nursing care.

ELIGIBILITY FOR THE SERVICE

� Chronic mental patients who are: aged 15 or

above; and in stable or controlled medical and

mental condition; requiring no active medical

treatment or nursing care but requiring long-

term residential service;

� free from assessed disposition to violence and

infectious disease, alcohol or drug; and

� recommended by a pre-discharge case

conference of the hospital concerned

FEES AND CHARGES

� $1,605 per month for 50% disabled adults

$1,813 per month for 100% disabled adults /

Disability Allowance recipients

LONG STAY CARE HOME IN HK

1. Caritas Lai Hong Home (425)

2. TWGHs Yeung Sing Memorial Long Stay Care

Home (170)

3. New Life Building Long Stay Care Home (200)

4. New Life Psychiatric Rehabilitation

Association Tuen Mun Long Stay Care Home

(200)

5. SKH - The Providence Garden for Rehab ~

Long Stay Care Home (402)

6. PLK – South Kwai Chung Complex (100)

7. TSW (to be completed in 2013) (75)

MANPOWER

E.g. for Caritas:

� SWO: 1

� NO: 1

� RN/EN: 23

� OT: 3

� PT: 2

� SW: 12

� Program Worker: 20

� Rehab Assistant: 12

� Care Worker: 80

� Clerical Staff: 5

� Artisan: 2

� Supporting Staff: 42

� Cook: 6

� Program Assistant: 2

APPROX. WAITING TIME

� 9 months to 1.5 year

HALF WAY HOUSES

� It provides a transitional period of residential

care to facilitate ex-mentally ill persons to

achieve an optimal level of functioning for the

purpose of community reintegration

� Capacity: 40

ELIGIBILITY FOR THE SERVICE

� Ex-mentally ill persons who are: aged 15 or

above; and physically healthy and free from

infectious disease;

� with reasonable vocational ability and

motivation for open employment;

� capable of self-care; and halfway houses with

special provision to cater for sub-target group

(i.e. ex-mentally ill persons with a history of

criminal violence or assessed disposition to

violence).

FEES AND CHARGES

� $1,171 ($842 plus $329) for rent per month.

HALF-WAY HOUSE IN HK

� 36 service units in HK

� HWH with special provision: for subtarget cases

� Manpower for HWH special provision:

� SWO: 1; SWW: 1; WW:5; RN (Psy):1; EN (Psy): 5;

Cook: 1; WMII: 1

� Manpower for HWH:

� ASWO:1; SWW:1; WW:5; EN (Psy): 2; Cook: 1;

WMII:1

APPROX. WAITING TIME

� 3 months to 9 months

SUPPORTED HOSTEL

� It provides group home living for people with

disabilities who can only live semi-independently

with a fair amount of assistance from hostel staff

in daily activities

� Capacity: 20

ELIGIBILITY FOR THE SERVICE

� People with disabilities who are: aged 15 or

above; capable of semi-independent living i.e.

mastery of self-care skills but may need a fair

amount of guidance/assistance in some domestic

tasks like cooking or washing or in community

living activities like shopping;

� already engaged in various forms of employment

or day training; and

� physically and mentally suitable for group living.

FEES AND CHARGES

� $853 per month for 50% disabled adults;

� $932 per month for 100% disabled adults /

Disability Allowance recipients

SUPPORTED HOSTEL IN HK

1. Christian Family Service Centre - On Yee

Hostel

2. Christian Family Service Centre - On Yue

Hostel

3. Baptist Oi Kwan Social Service- Tsun Kwan

Supported Hostel

4. Caritas Lok Wah Hostel

APPROX. WAITING TIME

� 2- 3 years

Manpower :

SW: 1

WW: 2

WA: 1

WMII: 0.5

PA: 1

SELF-FINANCE SUPPORTED HOSTEL

� Self- financing hostels provide alternative

residential services to meet temporary and

permanent housing needs of people with

disabilities. It can help to release the subvented

residential places for the more needy persons

with disabilities through the provision of extra

residential places.

ELIGIBILITY FOR THE SERVICE

� People with disabilities aged 15 or above;

awaiting rehabilitation services in the

community; or dischargees of the mainstream

subvented institutions

SUPPORTED HOSTEL IN HK

1. The Mental Health Association of HK - Clara

House

2. New Life Psychiatric Rehabilitation

Association - Jockey Club New Life Hostel

3. New Life Psychiatric Rehabilitation

Association - Yee Yuet Home

4. New Life Psychiatric Rehabilitation

Association - Yuet Wo Home

5. Richmond Fellowship of Hong Kong – Likang

Court

REFERRAL FOR RESIDENTIAL SERVICE

� Via CRS Rehab (Central Referral System for

Rehabilitation Service) for all subvented

residential services except self-finance hostels

RECENT DEVELOPMENT

� Licensing Ordinance for Residential

Homes for People with Disability

� to monitor service standard of residential care

homes for the disabled (including private homes)

� Officers from the ROPRCHD will inspect all

residential homes in terms of general management,

fire safety, building safety and health care

� All Health workers working in Homes for the

disabled should possess qualification of HW

including working in rehabilitation training

RECENT DEVELOPMENT

� MOT/ MPT scheme

� Blister Program for EN/ EN (Psy)

� Bridging training in working in rehabilitation

setting for Health Workers

� Social Work Training

Integrated Community Centre for Mental Wellness (ICCMW)

1.5 billion spend on community mental health services in HK

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Service Objectives◦ To provide one-stop community support and social rehabilitation services for the residents, discharged mental health clients, persons with suspected mental health problems and their families and carers living in the district;◦ Integrated mental health service which

combines existing services:• Aftercare Service (ACS)• Training Activity Centre (TAC)• Community Rehabilitation Day Service (CRDS)• Com Link• Com Care• CoMHIP

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Service Objectives

◦ To provide early intervention to people with suspected mental health problems and to network them to necessary services and community resources;

◦ To render necessary support to service users, carers and family members in handling the mental health problem and to help them maintain proper social network and link up to relevant community resources with the purpose to sustain better recovery;

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Service Objectives

� To provide outreach counseling, vocational assessment/training, nursing care and other necessary services to people with mental health problems to develop their potentials and personal growth for self-reliance and fuller participation in community living;

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Service Objectives

� To promote the public awareness on the importance of mental health and to increase their social acceptance of people in recovery through educational programmes, workshops and different training programmes.

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Service Details

� Target Group

◦ The target groups of ICCMW are those living in the district, including –

� Discharged mental patients aged 15 and above

� Persons with suspected mental health problems aged 15 and above

� Family members/ carers of the above persons

� Residents with interest in understanding and improving their mental health

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Service Details

� Scope of Services◦ The ICCMW provides the following services –� Drop-in services� Outreaching services� Casework counseling� Therapeutic and supportive group work services� Networking services, including social and recreational activities

� Day training� Outreaching occupational therapy training services� Public education programs on mental health� Referral to the Community Psychiatric Service of the Hospital Authority for clinical assessment or psychiatric treatment

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Referring Procedure

Referrals can be made to ICCMW through:- Self-application; or- Doctors, social workers, allied health workers or government departments

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How is it working? Example of Caritas Wellness Link –TsuenWan

Case management system� Either Suspected or diagnosed case� Triage system according to risk level

� Category I - IV◦ Any violent acts (self-harm or harm others) ?◦ Any abusive behaviors on dependent family members?◦ Stability of mental status?◦ Social functioning capacity?

� Evident-based assessment◦ Brief Psychiatric Rating Scale (BPRS)◦ Beck’s Depression Inventory ◦ Beck’s Anxiety Inventory

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◦ assessment with each individual to identify the risk level, areas of need, personal resources and supports, strengths, goals and objectives.

◦ This process is person-centered with the result of an individualized plan for maintaining the individual’s well-being and for pursuing their stated goals and objectives.

Caritas’ approach –case management

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◦ Case manager will:

� Coordinates the completed assessments

� Assist users to implement the recovery plan

by home visits, networking them with necessary providers, and maintaining contact with other services (e.g. medical doctors) throughout the

course of treatment

� Assures the maintenance of

case management records with

appropriate reviews and

updating of service plans.

Caritas approach –casework intervention

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Caritas approach – OT intervention� Service to private residential care home� Counseling, cognitive training and staff training to private

homes in Tsuen Wan to promote mental health among members of the private homes

� O.T service for service users� Daily living skills training by outreaching service

- self care training- home management - community living skill

� Vocational rehabilitation - work assessment - work rehabilitation training

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Caritas’ approach –district characteristics

� Strong support from other service units of Caritas in Tsuen Wan� Co-organize therapeutic groups and activities for users with mental health problems

� Co-organize social inclusion programmes to reduce social stigmatization and enhance acceptance and inclusive environment in the community

E.g. Police, Housing Dept., NGOs, Kwai Chung Hospital, private psychiatrists, general practitioners

� Strong joint work with different local parties

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Caritas approach –

Professional Services

� Multi-disciplinary intervention:

◦ Our team is formed by staff from different professions –we have social workers, an occupation therapist and a psychiatric nurse

◦ Professional consultation and

knowledge exchange among

different service units

� Monthly case sharing meeting

with service advisor

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� Closely work with medical professionals and other parties in the district

◦ Joint interview and bi-monthly case consultation with CPS of KCH

◦ Referrals to be made to family doctors or private psychiatrists when necessary

◦ Maintain contacts with responsible doctors/nurses

◦ Regular district meeting to promote collaboration and to

share practice wisdom

Caritas approach –Professional Services

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Staffing

� Social Workers: SWO/ASWO/SWA

� OT

� Program Workers

� Administration/ Clerical Staff

� Peer support workers (Caritas)

�Workman

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Entry Requirement

� Social Workers

◦ 1) ASWO: bachelor degree on social work

◦ 2) SWA: diploma/ Associate Degree on social Work

� Nurses:

◦ 1) RN: bachelor degree on nursing / conversion training for EN

◦ 2) EN: Blister program (SWD) / EN (HA)

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Entry Requirement

� OT/PT: ◦ 1) OTI/ PTI : at least 3 years OTII/ PT II experience ◦ 2) OTII: bachelor degree from OT or PT ◦ 3) MOT/MPT: have a first degree on related field (SWD subvention)

Health Workers: F5 or above, complete health worker training PCW: F3 or above, complete PCW training Rehab Service Assistant: F3 or above, preferably with rehab service training or special skillsProgram Worker: F5 or above, preferably with relevant experience or training

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Selection Criteria � Caring

� Honest

� Hardworking

� Having experience in working with people with mental problems

� Good communication skills

� Sensitive to clients need

� Alert to potential risk

� Patience

� Able to work with different people/ disciplines

� Independent

� Acknowledge teamwork

� Good reporting skills

� Active involvement

� Responsible & accountable

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Q & A

� Thank You