香港心理卫生期刊 五十卷第二期二零二四年冬 Hong Kong Journal of Mental Health Volume 50 No. 2 2024 Winter
Message from Issue Editor
The 12th Dr. Gerald Choa Memorial Lecture Professor Gerald Choa & Mental Health Movement
Mental Health for All
Dr. T L Lo
Chairman, Executive Committee
The Mental Health Association of Hong Kong
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Abstract
| The burden of mental disorders globally is substantial, impacting society through heavy number of years lived with disability for individuals with mental disorder. Hong Kong has developed a robust mental health care system focusing on treatment, rehabilitation prevention practices and mental wellbeing promotion. Evolving from custodial care to community-based programs, Hong Kong offers services like community support and early intervention to address mental health needs. Emphasizing mental wellbeing promotion alongside mental disorder prevention underscores the benefits of cultivating the former, which can prevent disorders, aid recovery, and enhance overall functioning. Resilience-building interventions are vital for supporting individuals and caregivers facing challenges. The Mental Health Association of Hong Kong provides a wide network of community care services, emphasizing prevention through mental health literacy programs and early interventions in community. Strengthening mental health services, addressing gaps, and promoting mental health across various sectors are critical for creating a mental health friendly society. The Association’s 70th Anniversary Symposium on Mental Health in Hong Kong will explore mental wellness in fostering a supportive environment for mental health. |
摘要
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精神健康 全民共享 世界衞生組織報告全球精神疾病負擔沉重，患有精神疾病人士因其長期病患而對社會帶來重大影響。香港過去發展全面的精神健康服務系統，著重治療、康復、預防和精神健康推廣。從監護治療轉型至社區為本的期間，香港發展不同的社區支援和早期介入服務，應對精神健康需求。精神健康推廣與精神疾病預防同樣重要，促進前者的好處包括可預防疾病、促進康復，及增強整體功能。另韌性的培育對支持個人和照顧者面對挑戰至為重要。香港心理衞生會現時提供廣泛的社區精神健康網絡服務，並透過精神健康推廣計劃和社區早期介入來加強預防。加強精神健康服務、解決服務空隙，並在各個領域促進精神健康對能打造一個精神健康友善社會至為關鍵。香港心理衞生會 70 周年研討會將探討如何在香港以至海外建構支援性環境以促進精神健康。 |
Keywords
| Mental Health Service, Mental Wellbeing Promotion, Community Mental Health Network |
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Reformation for Psychiatric Rehabilitation in Hong Kong?
Prof. K Y Mak, MD, BBS, JP
Vice-President
The Mental Health Association of Hong Kong
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Abstract
| Psychiatric rehabilitation in Hong Kong has been outstanding and proud among Asian countries for many years. With worldwide rapid advances in psychiatric knowledge and holistic approach towards mental illnesses, there is for Hong Kong a definite risk of losing ground, as illustrated in this article. In order to keep up with effective momentum of past achievements, mental health professionals and service providers must seriously and scientifically inspect the present condition and services, and to find out deficiencies and pitfalls. We must in addition be ambitious and bold enough to transform and even reform, as suggested in this paper. |
摘要
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香港精神康復服務需要改革？ 一直以來，香港精神康復服務在亞洲國家中名列前茅。但隨着世界各國對精神醫學及全人關顧服務的迅速發展，香港要保持領先位置確有失手的風險，正如本文中所提及的。故此，若要保持過去成就的有效動力，精神衞生專業人士及服務提供者必須嚴肅及科學化地審視目前狀況、尋找不足之處，及對有關項目勇於更新與改革，包括文章內提供的一些建議。 |
Keywords
| psychiatric rehabilitation, services, transformation, specialization |
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香港心理卫生会服务发展七十年 －口述历史
陈肖龄女士 , BBS 香港心理卫生会义务顾问 |
Abstract
| Oral history: 70 Years of Service Development of The Mental Health Association of Hong Kong Since the early 1950s, the care model for psychiatric patients in Hong Kong has gradually shifted from custodial care to treatment based on modern psychiatric concepts. Professor Yip Po-ming, as the first psychiatrist in Hong Kong, played a crucial role in this transformation. In 1954, he co-founded The Mental Health Association of Hong Kong (MHAHK) with Dr. Irene Cheng, promoting mental health education and services. MHAHK joined the World Federation for Mental Health, aligning local efforts with international standards. Activities such as Mental Health Week aimed to reduce stigma and increase public understanding of mental illnesses. As comprehensive psychiatric treatment facilities were gradually established, MHAHK’s f irst service unit, Irene House, was opened in the 1960s to assist psychiatric patients in reintegrating into the community. Over the decades, MHAHK has focused on education and service development to respond to societal changes and needs. Key figures throughout the years have made significant contributions to the development and innovation of services, ensuring their relevance and effectiveness. |
摘要
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自五十年代初，香港精神病患者的照顾模式逐渐由监管式护理转变为以现代精神病概念为基础的治疗。叶宝明教授作为香港首位精神科医生，对这一转变起到了关键 作用。 1954 年，他与郑何艾龄博士共同创立了香港心理卫生会，推广精神健康教育和服务，并加入世界心理卫生联盟，将本地工作与国际标准接轨，而心理卫生周等活动旨在减少污名，提高公众对精神疾病的理解。随全面的精神治疗设施逐步建立，而本会第一间服务单位艾龄楼亦于六十年代开办，协助精神病患者重返社区。数十年来，本会以教育及服务发展为核心，回应社会变化和需求。历年的关键人物对服务的发展和创新亦作出了不少贡献，确保服务之相关性和有效性。 |
Keywords
精精神病护理、精神健康教育、减少污名、
康复服务、政府与非政府组织协作、社区精神健康支援
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Promotion of Mental Health Literacy and Help-Seeking Behaviour of Adolescents with Mental Health Problems - The Local Perspective
Dr. Benjamin Lai, MH
Co-Chairman, T.N. Foo Centre for Positive Mental Health Subcommittee
The Mental Health Association of Hong Kong
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Abstract
| Mental health problems of adolescents are increasing in recent years especially with the COVID-19 pandemic. Promotion of mental health literacy intends to enhance knowledge about mental disorders, reduction of stigma and facilitation of help-seeking behaviour. Studies on the effectiveness of education programmes for adolescents seem to show the effectiveness on improvement in knowledge about mental disorders but differing results on the reduction of stigma and help seeking behaviour. Barriers and facilitators to help seeking behaviour of the adolescents have been reported. Teen mental health first aid is being adapted and attuned to the local context and it forms part of a quality mental health campus project to be launched by MHAHK. Appropriate design of an evaluation study of the education programme could help to inform future development and improvement of the program. |
摘要
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提升青少年心理健康素質及對心理健康問題的求助行為 －本地情況 最近數年，尤其在新冠疫情下，青少年的精神健康問題有上升的趨勢。提升心理健康素養，是意圖通過增加對精神病患的知識、減低歧視、及增進求助行為。對青少年心理健康教育計劃的調研，顯示可以增加對精神病患的知識，但對減低歧視及求助行為，調研結果並不一致。對青少年人求助行為，研究報告了不同的障礙及輔助因素。由澳洲引入的青少年心理健康急救課程，已被翻譯及改編成為本地的中文版本；也被採納在香港心理衞生會推行的優質精神健康校園計劃中。適切的調研，可以改進及輔助這個課程的未來發展。 |
Keywords
adolescents, help seeking, mental health literacy
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Modified Boxing Exercise for Improving the Balance and Gait Performance of Ageing Adults with Mental Disorders in Sheltered Workshop
Cyrus S H Lee Physiotherapy Service The Mental Health Association of Hong Kong |
Abstract
| Objective: To explore the feasibility of using modified boxing exercise for training to improve balance and gait performance in ageing adults receiving service in sheltered workshop with mild to moderate intellectual disability (ID) or mental illness. Participants and Methods: Ten adults diagnosed with mild to moderate intellectual disability or mental illness, aged 40 or above and attending workshop were recruited to receive 36 sessions of 60-minute balance training through a set of modified boxing exercise which was designed by physiotherapist for 9 months. Outcome measures were Brief-BESTest total score and Timed “Up & Go” time. Paired Samples t-Test and Wilcoxon signed-rank Test of SPSS were adopted to analyze the data of pre- and post-test to compare the within-group differences. Results: After training, significant within-group differences were found in both the pre- and post-intervention data for the total score of Brief-BESTest and Timed “Up & Go” time. Conclusions: The results reveal that modified boxing exercise can have benefits on balance ability and improve gait performance in adults with mild to moderate intellectual disability (ID) or mental illness. More in-depth research is needed. |
摘要
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運用改良版拳擊運動改善於庇護工場接受服務的老齡精神障礙人士的平衡能力和步姿表現 目的：探討採用改良版拳擊運動訓練改善在庇護工場接受服務的輕 / 中度智障或精神病老齡人士平衡能力和步姿表現的可行性。 受試者與方法：10 名被診斷為輕度至中度智障或精神病的 40 歲或以上的成年人，接受一套由物理治療師設計的改良版拳擊練習，為期 9 個月，共進行 36 節，每節做 60分鐘。使用了「Brief-BESTest」的總分和「起立 – 行走計時」測試，作為成效評估工具。採用 SPSS 的配對樣本 t 檢驗和威爾科克森符號秩檢驗為前後測的資料進行分析，比較組內差異。 結果：訓練後，介入前和介入後資料中的「Brief-BESTest」的總分和「起立 – 行走計時」測試的時間均有顯著組內差異和進步。 結論：結果顯示，改良版拳擊練習有助提高參與者的平衡力和步態表現。 |
Keyword
Boxing exercise, Balance & Gait, Ageing, Intellectual disability, Mental Illness
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Early Intervention Project for Men with Mental Health Problems: A Stepped-Care Model
Catherine K Y Lee Jockey Club Men's Space The Mental Health Association of Hong Kong Benson K K Chan Jockey Club Men's Space The Mental Health Association of Hong Kong |
Abstract
| The Jockey Club Men’s Space is a 3-year mental health project that aims to provide prevention, early intervention, and advocacy for men with mental health issues in Hong Kong. The project’s main two focuses are monthly programs and mental health services. The mental health services follow a stepped-care model, which sorts the target population into corresponding services based on the risk levels and needs and are categorized into online self-learning, Acceptance and Commitment Therapy treatment groups, and Cognitive-Behavioral Therapy individual counseling. Data is collected throughout the 3-year project to provide more insights and understanding of mental health issues among men in Hong Kong as well as an evaluative tool for the project’s effectiveness. This paper reports an analysis of the initial data collected. Over 1,800 PHQ-4 responses were collected and analyzed during the initial data collection phase. Qualitative data regarding men’s presenting problems, stressors, and help-seeking behaviors is also collected. Results showed that close to 60% of the respondents were middle-aged men ranging from 35-54, and about one-third of the respondents were categorized as experiencing moderate to severe levels of depression and anxiety features. Regarding help-seeking behaviors, 63% of the respondents said they would not seek professional help when needed. Some common stressors among men include work-related stress, family and marital issues, and interpersonal problems. Based on the findings, the project found that middle-aged men are more vulnerable to emotional disturbances than other age ranges. The reasons behind the low help-seeking behaviors include inaccessibility to resources, lack of knowledge, and the societal stigma of mental illness and gender role expectations. JC Men’s Space strives to be a pioneer project to promote public mental health awareness and literacy, improve overall mental wellness for our target population, and provide psychoeducation, protocols, and guidelines to fellow mental health professionals as a reference framework for men in future clinical applications. |
摘要
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香港男性心理健康問題的早期介入計劃：階梯介入模式 賽馬會「再闖男天」計劃是一個為期三年的心理健康項目，旨在為香港的男性提供預防、早期介入和倡導心理健康問題的支持。該項目的主要焦點是每月的活動和心理健康服務。心理健康服務遵循階梯介入模式，根據風險程度和需求將目標人群分配到相應的服務，並分為在線自學、接納與承諾治療小組和認知行為治療個別輔導。在整個三年的項目中，將收集數據以提供更多有關香港男性心理健康問題的見解和理解，以及評估項目有效性的工具。本文報告了初步收集數據的分析結果。 |
Keywords
| mental health, ACT, CBT, stepped-care model, PHQ-4 |
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Recovery Self-Assessment in the Integrated Community Centres for Mental Wellness of The Mental Health Association of Hong Kong
Catherine Yang Integrated Community Centre for Mental Wellness The Mental Health Association of Hong Kong Jerry T K Wong Integrated Community Centre for Mental Wellness The Mental Health Association of Hong Kong Jerry H To Integrated Community Centre for Mental Wellness The Mental Health Association of Hong Kong |
Abstract
| This paper examines the outcome of the recovery-oriented practices implemented in the Integrated Community Centre for Mental Wellness (ICCMW) of The Mental Health Association of Hong Kong (MHAHK). The Chinese Service User version of Recovery Self-Assessment (CRSA-SU) and Recovery Self-Assessment (RSA) were employed to collect the observations and experiences of service users, service providers, and service administrators. 503 questionnaires were received. The scores of service users, providers, and administrators were 4.12, 3.91, and 3.90, respectively, which showed a satisfactory level of attainment regarding the implementation of recovery-oriented practices in ICCMWs. The domain of ‘Invite’ was ranked the highest among the 3 types of respondents. There was also a consistency of the lowest rating in the domain of ‘Involvement’ among the 3 groups. The results tended to reflect the consensus of some recovery-related value in ICCMWs among staff in different positions, which demonstrated the significance of the ongoing recovery-oriented practices and training. On the other hand, the participation of service users in the service planning, unit operation, and service evaluation, as well as the role model effect of Peer Support Workers were suggested to be further strengthened. |
摘要
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香港心理衞生會精神健康綜合社區中心復元為本服務自我評量 本研究旨在檢視本會精神健康綜合社區中心推動復元為本工作的成效。透過復元自我評量表了解服務使用者、服務提供者及服務管理人員對復元為本服務的觀察及經驗。從503 份收回的問卷顯示，服務使用者、服務提供者及服務管理人員的整體分數分別為4.12、3.91 及 3.90，反映復元為本的推動工作具有成效。當中「邀請」範疇的分數於服務使用者、服務提供者及服務管理人員中皆為最高 ; 同時，「參與」範疇亦一致地於三種對象中評分最低。調查結果反映了本會精神健康綜合社區中心的職員不論職位皆於復元取得一致的價值觀，同時亦顯示了本會一直推動復元為本工作的重要性。另一方面，服務使用者於服務策劃、單位運作及服務評估方面的參與，與及朋輩支援工作員的模範效果方面可進一步提升。 |
Keywords
| recovery self-assessment, recovery-oriented practice |
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Translating and Applying the Dynamic Loewenstein Occupational Therapy Cognitive Assessment (DLOTCA) for Adults with Intellectual Disabilities in Hong Kong
K M Wong Occupational Therapy Service The Mental Health Association of Hong Kong C S Lam Occupational Therapy Service The Mental Health Association of Hong Kong C Y Yip Occupational Therapy Service The Mental Health Association of Hong Kong S W Jim Occupational Therapy Service The Mental Health Association of Hong Kong C Y Keung Occupational Therapy Service The Mental Health Association of Hong Kong K Yip Occupational Therapy Service The Mental Health Association of Hong Kong |
Abstract
| Background and Purpose: The Chinese Dynamic Loewenstein Occupational Therapy Cognitive Assessment (DLOTCA-CV) was designed to evaluate cognitive skills and visual perception in adults. This study aimed to translate and adapt the DLOTCA-CV for individuals with intellectual disabilities (ID) in Hong Kong, while ensuring cultural and linguistic appropriateness. Methods: A team of seven experienced occupational therapists (OTs) was involved in the translation, adopting an idiomatic approach to preserve the natural meaning. The process included the stages of parallel translations, review and moderation meetings. This pilot version was then tested on a convenience sample of seven service users to evaluate comprehensibility and feasibility. Results: The sample comprised individuals aged 21-40 (43%) and 41-60 (43%), with varying degrees of ID. One participant withdrew, while the remaining six completed the assessment in over 120 minutes, exceeding the expected 45 to 90 minutes. Feedback indicated that certain items posed challenges for individuals with poor upper limb function, contributing to fatigue and anxiety. To enhance the feasibility of the assessment, it is recommended to incorporate more breaks or allow multiple sessions for completion. Additionally, user-friendly instructions should be developed to facilitate understanding and engagement with the assessment. Specific revisions in translation were also suggested, particularly for terms related to cognitive functions. > Conclusion: The process of translating and adapting the DLOTCA-CV has created a version that is culturally and linguistically suitable for adults with ID in Hong Kong. This adapted version demonstrates the feasibility for implementation in Hong Kong, providing a valuable tool for OTs to better understand and address the cognitive and perceptual needs of adults with ID. |
摘要
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香翻譯和應用動態洛文斯頓職業治療認知評估 (DLOTCA) 於香港智力障礙的成人 背景與目的：動態洛文斯頓職業治療認知評 方法：七位職業治療師參與翻譯工作，採用符合本地語言習慣的翻譯方法，過程包括平行翻譯、審查會議及裁定，最終形成測試版本。隨後職業治療師用該版本為七名智力障礙服務使用者進行測試，以評估其易讀程度及可行性。 結果：參與者年齡介乎 21 至 60 歲，具有不同程度的智力障礙。一名參與者未有完成評估，其餘六名參與者需要用超過 120 分鐘完成評估，超出預期的 45 至 90 分鐘。結果顯示，某些項目對上肢功能較弱的參與者的挑戰較大；測試時間過長亦容易使參與者感到疲勞和焦慮，需要進一步調整評估的執行程序和長度。 結論：本研究成功將 DLOTCA 初步翻譯成符合香港文化的版本，並應用於香港有智力障礙的成人身上，為職業治療師提供了一份有效了解智力障礙人士認知能力的評估工具。 。 |
Keywords
| DLOTCA, Intellectual Disabilities, Occupational Therapy, Cognitive Assessment, Hong Kong |
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Medication Management Service for People with Intellectual Disabilities in Hong Kong: A Descriptive Analysis of Prescribing Patterns and Pharmacists’ Interventions
K H Li
Department of Pharmacology and Pharmacy
The University of Hong Kong
S M Leung
Department of Pharmacology and Pharmacy
The University of Hong Kong
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Abstract
| A Pilot Project of Pharmacist Service for People with Intellectual Disabilities which launched by The Mental Health Association of Hong Kong (MHAHK) was initiated in September 2023. The project aimed at providing medication management services (MMS) for people with intellectual disabilities (PWID). This study describes the prescribing patterns among PWID receiving the MMS and summarizes the recommendations provided by pharmacists. Results indicate a high prescription rate of psychotropic medications, particularly antipsychotics (44.8%). The use of these medications poses significant health risks for PWID, including side effects and polypharmacy. Their use should be carefully monitored and reviewed regularly. Additionally, pharmacists made recommendations to address drug-related problems (DRPs), with the most common recommendation being the deprescribing of medications (44.2%). |
摘要
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香港智障人士藥物管理服務：描述性分析處方模式與藥劑師介入 由 2023 年 9 月開始，香港心理衞生會推行的「智障人士藥劑師服務試驗計劃」正式展開。本研究旨在探討服務受眾的用藥模式，並總結藥劑師所提供的用藥建議。研究結果顯示精神藥物的處方十分常見，當中以抗精神病藥（44.8%）為最多，使用這些藥物會為智障人士帶來健康風險，包括副作用和多重用藥的挑戰，因此我們應該定期觀察及評估用藥的需要。藥劑師亦會針對藥物相關問題提出改善意見，最常見的建議是透過精簡處方來減少用藥（44.2%）。 |
Keywords
| Medication management service, intellectual disabilities, psychotropic medications |
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| PDF |
