Pre-placement Workshop Rehabilitation Services in Hong Kong Stephen Wong Caritas- Hong Kong 1
Rehabilitation Services in Hong Kong Services for people with Mental Health Problems Services for people with disabilities 2
Services for people with Mental health Problems Day Training & Vocational Support Services Residential Services Community Support Services 3
Facts about Mental Illness In statistic report from year 2000, there are 50,500 people suffering from mental illness receiving rehabilitation service 2% of total population suffering from depression (2004). i.e. about 140,000 people It is estimated that about 1 million people in Hong Kong who are suffering from different degree of mental illness (2004) 4
Day Training & Vocational Rehabilitation Services for Ex MI Day Training Training and Activity Centre for Ex-Mentally Ill Persons Sheltered workshop Integrated Vocational Rehabilitation Service Centre Supported Employment On the job training (Sunnyway) Social Enterprise 5
Residential Services Supported Hostel Halfway House Halfway House (with Special Provision) Long Stay Care Home 6
Community Support Services Community Mental Health Intervention Project Community Mental Health Care Services Community Mental Health Link Community Rehabilitation Day Services Community Support Project for Child & Adolescent Mental Health Aftercare Service for dischargees of HWH Parent resource centre Self-help groups 7
Community Mental Health Care Service (Day Service ) Training & Activity Centre for Ex MI (TAC) aims to improve social adjustment capability develop social and vocational skills prevent relapse social support training and social club 8
Community Mental Health Care Service (Day Service ) Sheltered Workshop adjust to normal work environment prepare for potential advancement in employment having incentive payment 9
Community Mental Health Care Service (Day Service ) Supported employment upward mobility for sheltered worker provide support and guidance in open labour market accept both self referral or worker s referral 10
Community Mental Health Care Service (Day Service ) Integrated Vocational Rehabilitation Service Centre (IVRSC) 11 combination of Sheltered workshop and Supported Employment to maintain a continuum of service Calculation of unit Cost = 1:1.5 (SW : SE) include centre base and noncentre base service
Community Mental Health Care Service (Day Service ) Integrated Vocational Training Centre provide comprehensive vocational training and rehabilitation service to equip them for advancement to open job market (Caritas Lok Mo IVTC ) 12
Community Mental Health Care Service (Day Service ) Sunnyway- On the Job Training Program for Young People with Disabilities - For people age 15 to 24-16 NGO running this project - Not less than 311 quota - Service Content include: employment training, on job guidance, job interview, probation, follow up work - Including 180 training hours (vocational, social, etc.) 13
Community Mental Health Care Service (Day Service ) 'Enhancing Employment of People with Disabilities through Small Enterprise' Project 14 market-driven approach and direct creation of more work opportunities for people with disabilities. grant for seed money to set up the business 60 % disable employee, 40 % ordinary employee
Residential Services in HK Long Stay Care Home Half-way Houses Supported Hostel Self-Finance Supported Hostel 15
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. 16
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 predischarge case conference of the hospital concerned 17
Fees and Charges $1,605 per month for 50% disabled adults $1,813 per month for 100% disabled adults / Disability Allowance recipients 18
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 19
Approx. waiting time 5 to 8 years 20
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 21
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). 22
Fees and Charges $1,171 ($842 plus $329) for rent per month. 23
Half-way house in HK 36 service units in HK HWH with special provision: for subtarget cases Manpower for HWH special provision: 24 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 25
Supported Hostel It provides group home living for people with disabilities who can only live semiindependently with a fair amount of assistance from hostel staff in daily activities 26
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. 27
Fees and Charges $853 per month for 50% disabled adults; $932 per month for 100% disabled adults / Disability Allowance recipients 28
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 (will commence service in July 2008) 29
Approx. waiting time 2-3 years 30
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. 31
Eligibility for the Service People with disabilities aged 15 or above; awaiting rehabilitation services in the community; or dischargees of the mainstream subvented institutions 32
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 33
Referral for residential service Via CRS Rehab (Central Referral System for Rehabilitation Service) for all subvented residential services except self-finance hostels 34
Introduction to Existing Community Mental Health Service Community Mental Health Intervention Project (CoMHIP) Community Mental Health Care Service (CMHCS) Community Mental Health Link Service (Com Link) Child & Adolescent Mental Health Community Support Project (CAMPcom) Community Rehabilitation Day Service (CRDS) 35
Community Mental Health Intervention Project (CoMHIP) 社 區 精 神 健 康 協 作 計 劃 Commence in October 2007 36
Service Information 11 teams in Hong Kong District Eastern & Wan Chai Central & Island Kwun Tong Wong Tai Sin & Sai Kung Shatin Tuen Mun Shamshuipo Kowloon City & Yau Tsim Mok Yuen Long Tsuen Kwai Tsing 37 Tai Po & North Operators BOKSS TWGHs MHA Richmond Fellowship Steward New Life New Life SRACP SPACP Caritas Caritas
Service Target Age 15 or above who is suspected having mental health problems such as poor interpersonal relationship, social withdrawal, depression, anxiety, suicidal, self-harm etc. Referred by IFSC or CPSU Shared cases if welfare needs identified 38
Main focus provide early intervention network service users/ carers to necessary services and community resources provide support to carers and family members enrich knowledge and skills for carers and family members on mental health related issue stress management enhance/ consolidate the skills and knowledge of professions/ frontline practitioners in handling people suspected to have mental health problems through collaborative training/ sharing of experience 39
Intervention Individual Level Enhance insight, expand social network, social skill & vocational skill training, job attachment Family Level Enhance understanding & knowledge of mental health, foster positive relationship Community Level Enahnce awareness, reduce labeling through mental health promotion activities, organize workshops and seminars for professionals in order to enhance skills in handling people suspected to have mental health problems 40
Services Outreach visits Counseling Referrals to Community Psychiatric Service (CPS)/ General Medical Practitioners/ Private Psychiatrists/ Clinical Psychologists for clinical assessment and treatment Networking to community resources Therapeutic/ Supportive groups Programs for families/ carers Public education programs and training Organizing workshops and seminar for public and professionals 41
Staffing of CoMHIP team 2 ASWO 2 SWA (Lump Sum varied according to district size and population) 42
Output standards of CoMHIP team Example in Caritas Tsuen Kwai Tsing Fanling & Tai Po Capacity per year 152 113 Home visits 4.5 (per case per quarter) 4.5 (per case per quarter) Support/ development groups Educational programs Service Promotion programs 8 (served 48-64 participants per year) 10 (served 800-1000 participants per year) Monthly (served 1200 participants per year) 6 (served 48 participants per year) 8 (served 320 participants per year) Bi-monthly (served 1200 participants per year) 43
Case termination The case will be terminated in the following situations: The case has received psychiatric services. No follow-up services on client s mental health problem is required from CoMHIP after consultation with CPS/HA; or The case has received intervention from CoMHIP team for a period of time and no follow-up services on client s suspected mental health problem is required from CoMHIP; or The case is persistently unmotivated to receive CoMHIP service for at least 8 weeks 44
Case termination For a shared case with IFSC/ISC/FCPSU, The CoMHIP should issue the discharge memo to the concerned parties when the case is closed For a case that is not on shared-basis, The case will be referred to concerned MSSU/IFSC/ISC/FCPSU for follow-up services on the case s welfare needs if necessary 45
Project Evaluation 3 years review Quarterly statistic on FSA Outcome evaluation 46
Community Mental Health Care Services 社 區 精 神 健 康 照 顧 服 務 Commence on Oct 2005 11 Agencies All districts 47
Service Target People with mental illness who are discharged from psychiatric wards within 2 years and aged 15 or above Discharge from Half-way house Newly admited to HWH and waiting for vocational rehab services (idling cases) 48
Objectives Provide additional care and support to people with mental illness in the community Assist them for independent living 49
Referral By doctors, Social workers Allied health workers 50
Services Home visits Outreaching visits Counselling Training on communication skills, work habit, budgeting and home management Job placement Social networking 51
Unique Role of the Services Multi-disciplinary collaboration MSW, CPN, OT, Psychiatrists, in-house workers Social network Volunteering, social support, carer support, job-skills training, community adjustment, peer support 52
Community Mental Health Link 社 區 精 神 健 康 連 網 Commence on 2002 Use of HWH premises to conduct programs 20 ComLink in HWH & 5 ComLink in TAC in Hong Kong with total 25 ComLink 53
Service Target People with mental illness who are living in the community Family members of service users 54
Objectives Establish social network Social recreation programs Referral to community resources Provide psychoeducation for service users and carers 55
Services Outreaching service Vocational consultation Referral to community resources Social recreation programs Carer support programs Community education program Other supportive programs e.g. canteen service, laundry service etc. 56
Referral Psychiatrist, Social Workers Allied health workers Self-referral Membership fee $21 once, may use all ComLink service in all districts 57
CAMPcom 兒 童 及 青 少 年 精 神 健 康 社 區 支 援 計 劃 Commence in Dec 2005 Target for aged 6-18 who are suspected having mild to moderate mental health problems such as depression or anxiety 58
Teams 10 social workers in 5 EASY teams HK & Island Kowloon East Kowloon West NT East NT West 59
Services Community Education in School, Child & Youth centres etc. on early detection of mental health problems among children and adolescent Assessment and consultation for service users Referral to community resources Counselling Groups 60
Community Rehabilitation Day Service (CRDS) 日 間 社 區 康 復 服 務 Commence in Oct 2006 Outreach OT service 61
Service Target People with Mental illness living in Community or private hostel Aged 15 or above HWH dischargees, Clients of TAC, or Social Club OPD patients (No OT day service is received) 62
Training Scope Self-care: personal hygiene, dressing, diet, daily living Home management: laundry, cooking, domestic cleaning, home safety, first aid, risk management Health management: personal health knowledge, relaxation, communication with family members Community living: use of leisure, budgeting, social skills, road safety, use of community resources 63
Referral By psychiatrist, MSW, allied health Not need for registration in CRS Rehab Direct referral to respective service operator 64
Service operators HK Island: BOKSS KLN West: New Life KLN East: MHA NT East: Steward NT West: New Life 65
Self-help group 4 subsidized self-help organization 1.Concord Mutual aid Club ( 康 和 互 助 社 聯 會 ) 2.Christian Oi Heep Fellowship Ltd ( 基 督 教 愛 協 團 契 ) 3.Alliance of Ex Mentally Ill of HK ( 香 港 精 神 康 復 者 聯 盟 ) 4.Amity Mutual Support Society ( 恆 康 互 助 社 ) 66
弱 能 人 士 支 援 服 務 學 前 弱 能 兒 童 服 務 ( 初 生 -6 歲 ) 智 障 成 人 日 間 訓 練 及 就 業 服 務 (15 歲 或 以 上 ) 智 障 成 人 住 宿 照 顧 (15 歲 或 以 上 ) 智 障 人 士 社 區 支 援 服 務 67
學 前 弱 能 兒 童 服 務 學 前 教 育 及 訓 練 中 心 特 殊 幼 兒 中 心 弱 能 幼 兒 暫 托 服 務 自 閉 症 兒 童 綜 合 服 務 計 劃 68
學 前 弱 能 兒 童 服 務 及 早 甄 別 及 介 入 個 別 啟 導 訓 練 及 治 療 69
智 障 成 人 服 務 綜 合 職 業 訓 練 中 心 輔 助 就 業 庇 護 工 場 展 能 中 心 宿 舍 社 區 支 援 70
職 業 訓 練 職 業 技 能 培 訓 準 備 公 開 就 業 就 業 安 置 及 輔 導 餐 飲 服 務 工 業 工 藝 汽 車 清 潔 71 文 字 輸 入 及 電 腦 排 版
輔 助 就 業 實 際 工 作 中 掌 握 工 作 技 能 從 勞 動 中 獲 取 較 好 待 遇 印 刷 流 動 清 潔 隊 72
庇 護 工 作 簡 單 加 工 及 裝 配 手 工 藝 製 作 及 銷 售 培 養 良 好 工 作 習 慣 73
日 間 展 能 訓 練 獨 立 生 活 技 能 訓 練 肌 能 訓 練 及 維 持 74
院 舍 照 顧 75 獨 立 生 活 能 力 訓 練 健 康 護 理 舒 緩 家 長 照 顧 壓 力
個 人 成 長 及 發 展 歷 奇 訓 練 培 育 餘 暇 興 趣 陽 光 大 使 家 長 義 工 76 靈 性 培 育 活 動
社 區 支 援 服 務 家 居 訓 練 兒 童 及 成 人 健 樂 運 動 77
社 區 教 育 活 動 弱 能 人 士 與 藝 術 活 動 學 校 巡 迴 話 劇 表 演 78 公 眾 教 育 講 座
整 體 服 務 強 化 現 有 家 長 教 育 學 院 工 作 延 續 弱 能 人 士 與 藝 術 之 活 動 主 題 重 新 考 慮 成 立 家 長 聯 會 之 可 行 性 協 助 弱 能 青 年 成 立 自 助 組 織 發 展 自 閉 症 成 人 服 務, 推 動 社 區 認 識 亞 氏 保 加 症 人 士 79
香 港 弱 智 人 士 的 生 涯 歷 程 和 康 復 服 務 見 附 件 80
Related Legal issues Mental Health Ordinance Disability Discrimination Ordinance Residential Care Homes (Elderly Persons) Ordinance 81
Mental Health Ordinance To amend and consolidate the law relating to mental incapacity and the care and supervision of mentally incapacitated persons, to provide for the management of the property and affairs of mentally incapacitated persons, to provide for the reception, detention and treatment of mentally incapacitated persons who are mentally disordered persons or patients, to provide for the guardianship of such patients and for mentally incapacitated persons generally, to make provision for the giving of consent for treatment or special treatment in respect of mentally incapacitated persons who have attained 18 years of age, to provide for the removal of objectionable terminology relating to mental incapacity in other statutory provisions and to provide for matters incidental or consequential thereto. 82
Disability Discrimination Ordinance An Ordinance to render unlawful discrimination against persons on the ground of their or their associates' disability in respect of their employment, accommodation, education, access to partnerships, membership of trade unions and clubs, access to premises, educational establishments, sporting activities and the provision of goods, services and facilities; to make provision against harassment and vilification of persons with a disability and their associates; to extend the jurisdiction of the Equal Opportunities Commission to include discrimination against persons on the ground of their or their associates' disability, and for connected purposes 83
Residential Care Homes (Elderly Persons) Ordinance An Ordinance to regulate homes established for the residential care of persons who have attained the age of 60 years. 84
Innovative Projects and Strategies Integration of Community Support Services for ExMI and MH users Enhancement of ComLink Service Development of residential Services for ExMI Youth Mental Health Service 85
How to prepare ourselves? Cooperation with multi-disciplinary professions Understand receptive ability of service users and familiar with their functioning level Familiar with community resources and respective referral procedures Sensitive to users need and expression Effective documentation and reporting Effective communication with carers Knowledge on vocational rehabilitation Aware of modelling effect Empowerment in daily living 86
Q&A Stephen Wong Tel: 31871201 Email: wongstephen@caritassws.org.hk Thank You 87