Integrated Community Centre for Mental Wellness in Hong Kong
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Introduce ICCMW Services in Hong Kong
Integrated Services in Hong Kong
Start from 1991, the establishment of first integrated youth services centre, there are more and more integrated services has been developed in Hong Kong. It is believed that integrated services generated a lot of advantages, such as avoiding wastage of resources and duplication of services. For different target group of people, different kind of integrated services has been developed afterwards. Nowadays, there are integrated youth services (ICYSC), integrated family services (IFSC), integrated elderly services (DECC), integrated disable services (DSC), and integrated mental wellness services (ICCMW) in Hong Kong. In this paper, the integrated services of mental wellness in Hong Kong will be focused and discussed. The strengths and limitations of this integrated social service would be analysed, as well as the improvement of implementation.
Background of Integrated Mental Wellness Services
In March 2009, Social Welfare Department set up the first Integrated Community Centre for Mental Wellness (ICCMW) in Tin Shui Wai. The major aims of setting up ICCMW are enhancing the social support and re-integrating the ex-mentally ill persons into the community (Social Welfare Department, 2014). The goals of ICCMW are providing one stop services and accessible community supports for the needy. The targeted service users are discharged mental patients, persons with suspected mental health problems, their families or carers of above persons, and people who are interested in understanding and improving their mental health. ICCMW has been established in all the 18 districts in October 2010. Upon now, there are 24 ICCMW provided by 11 non-governmental organization (Social Welfare Department, 2014).
Integration of Services
Generally, there are three integration levels that integrated services have to address the different needs of clients, includes ICCMW, which are linkage, coordination, and full integration. For the first level, linkage, ICCMW would like to link up the service users and the particular services. For example, it provides information for people who concern about their stress level. For the second level, coordination, ICCMW would serve the function of coordinator between systems and agencies, process to address problem of service users. For example, follow up the case which just has been discharged from hospital by providing day training programs or counseling services in the centre or in other organizations, is a kind of cross-sectional operation between medical and mental wellness sectors. For the third level of integration, full integration, multidisciplinary team cooperation, and community integration would be the targets of ICCMW. There are nurses, occupational therapists, doctors, clinical psychiatrists, social workers as a team to provide mental rehabilitation services for clients, in order to let clients re-integrated to the community.
Using the agency of The Wellness Centre in Tin Shui Wai of New Life Psychiatric Rehabilitation Association (New Life) as an example, it provides prevention services and intervention by using recovery-oriented approach. For the prevention, New Life offers a lot of mental health promotions and public education, letting general people have more understanding about mental health and mental illness. For the group work intervention, New Life provides support groups, carer volunteer training, and psycho-education programs for clients. For the individual level intervention, New Life provides counselling, peer support worker training, vocational planning and development services, wellness programs, and so on (New Life Psychiatric Rehabilitation Association, 2013). These kinds of intervention and therapy are for the goal of making people with mental health problem to reintegrate to community.
Strengths of ICCMW
There are a lot of advantages of setting up integrated services in Hong Kong, so do ICCMW. The first advantage of ICCMW is, convenient to services users. For the service users, ICCMW is multi-functional which provides occupational training, vocational training, care and support, and leisure opportunities. For the public who concern about their mental wellness, they can self approach ICCMW and ask for information and related services. Services are easier accessed nowadays.
The second advantage of ICCMW is better coordination among workers and services. After integration, there are multidisciplinary within a team in ICCMW, such as occupational therapist, nurses, doctors, and social workers. They have regular case meetings for discussing how to manage the case, and it is believed that coordination would be better between each division due to more communication.
The third advantage of ICCMW is reducing stigmatisation. ICCMW provides different kind of services, not only giving therapy and counselling for people with mental illness but also providing public education and volunteer trainings for mentally ill person or the caregivers. Public education serves the function of letting general public know more about mental health, and letting them to understand that it is not only refer to mental illness but also mental wellness related to everyone. Also, the chance of letting mentally ill person doing voluntary work to community helps them integrating back to community. Therefore, multidimensional services provided by ICCMW would let the concept of mental health and also the mentally ill person integrated into community.
Limitations of ICCMW
A coin has two sides, although ICCMW provides lot of advantages to service users and community, it is not faces no limitations.
Firstly, ICCMW is hard to select centre location. Usually, ICCMW have to select a location for services centre which is close to community for residents convenience, however, there are lots of limitation of setting up centre in estates. Many of the ICCMW reflects that they are hard to find a permanent premises which are large enough for group services and training. And the reason may attribute to the approval time of Welfare Department are too long (Cheung, 2011). In addition, there are objective sounds reject if ICCMW is too close to community or located in estate. For example, in 2010, the residents and the district councilor of Tuen Mun Wu King Estate objected one ICCMW established in their estate, and requested the moving out of ICCMW (MingPao Health, 2011). The major reason is due to stigmatization of mentally ill people who are dangerous and would attack public suddenly. Therefore, residents object if ICCMW too close to the residents.
Secondly, there is shortage of man-power. As integrated, ICCMW needs professional staff from different discipline such as nurses, clinical psychiatrists, and doctors. It is all known that, these kinds of professions are now shortage in Hong Kong. Even an ICCMW start in estate, they may face the problem of down man-power for a period of time.
Thirdly, it is time-consuming to have meetings for multidiscipline to discuss and examine the case management. Since services integrated, operation complexity would be increased. Regular meeting is essential to understand the roles and views of other professions, however, caseworks and pressures would relatively increase. That makes the workers may easily burnt out for the increased duties.
Lastly, there is lack of centralized data for different agencies. Although the communication and interaction between agencies, departments, or bureaus increased under integrated services, they do not have share information between each other. For example, a mental illness patient who just discharged from hospital with marriage problem, Medical Social Services Department in Hospital, Integrated Family Service Center (IFSC), and ICCMW would be involved in this case. Since there are no platforms for information sharing between agencies, the social workers in ICCMW may need to contact IFSC social workers and medical social workers particularly for further information. Procedures may be duplicated due to lack of data transparency.
Suggestions for ICCMW
First of all, it is suggested that increase the linkage between agencies and organization by developing a platform to share essential information. For example, the doctors in hospital can provide medical reports, integrated progress notes provided by social workers from related agencies etc. It is believed that can raise the transparency of information and data.
In addition, it is suggested that Social Welfare Department can simplify the application system of centre location, to avoid the situation that appropriate venue has been rented by other private parties during the long and complicated approval process.
Furthermore, it is important to strengthen the public education for public understanding the nature and image of ICCMW. As residents have misunderstanding about people with mental health problem are all dangerous to society, public education is necessary to eliminate their incorrect perception. It is recommended that government should strengthen the advertisement and civil education in community and education institutions, to let people have correct concept about recovered mental ill person that they are also a part of society, and not only harmful to society.
Finally, it is also suggested that more resources should be granted for ICCMW. As ICCMW is the newest service within integrated services since 2009, the resources and experiences are not yet well-developed. Therefore, resources like funding for ICCMW allow them to purchase more useful treatment tools for clients, or hire more professional staff for relieving the pressure of existing staff.
Integration of services in Hong Kong are designed to fulfill different needs of clients, and avoiding wastage of resources. ICCMW generates the advantages of convenience to service users, better cooperation among services workers, and reduce the stigmatization of mentally ill people in society. However, there are still some limitations that ICCMW facing, such as difficulty of selecting centre location, shortage of man-power, time consuming of multidisciplinary meeting, and lack of centralized data. It is believed that ICCMW is still in the developing process, if government provides certain assistances and recourses for them, the integrated services would benefit more and more people in need in the coming future.
Cheung, K. C. (2011), Hong Kong Social Workers General Union. Service Series- Rehabilitation Services, Retrieved on 29 April 2014 from http://www.hkswgu.org.hk/node/70
MingPao Health (2011), “Only 6 out of 24 ICCMW location confirmed” retrieved on 5 May 2014, from http://www.mingpaohealth.com/cfm/news3.cfm?File=20110213/news/gok1.txt
New Life Psychiatric Rehabilitation Association (2013), Annual Report 2012-2013. Retrieved on 2 May 2014, from http://www.nlpra.org.hk/information_n_publications/Annual_report/pdf/049_117_2013.aspx
Social Welfare Department (2014), Integrated Community Centre for Mental Wellness (ICCMW), Services Description, retrieved on 2 May 2014, from http://www.swd.gov.hk/en/index/site_pubsvc/page_rehab/sub_listofserv/id_iccmw/
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