THEME

Recovery Information

 

Recovery Glossary (Traditional Chinese Only)

Recovery is a new concept on the mental health field. It aims at enhancing PIR’s holistic well-being and overcome all negative influences towards them due to the mental illness. The Association started to develop the recovery-oriented services in 2019 and established Alliance for Recovery and Care (ARC) afterward. The Recovery Glossary is for deepen the understanding of the recovery concept.

Click Here to download the Recovery Glossary

 

Understanding Stigmatization

What is stigmatization?
Stigmatization means the tag marked by the public to the mental illness patients due to heavy misunderstanding and ignorance. News report tends to link violence directly with psychiatric illness. As a result, fear is aroused among public to demand quarantine against mental illness patients. The patients are often considered to be intelligently handicapped or naive so that they would not be able to be responsible for their decisions and require close monitor. In fact, those information regarding mental illness patients is incorrect and biased. There was less than 10% of violence crimes were committed by them (Walsh, Buchanan, & Fahy, 2002). People of different intelligent levels may have the possibility to suffer from mental illness as well. As long as proper medication, treatment and encouragement is implemented, they will be able to reintegrate into the society and make contribution. But the stigmatization does not only limit their chances in finding jobs and places to reside, but also increase their inclination to be blamed for committing violence. The stigmatization towards mental illness patients are much serious than the physical handicapped.

Categories of Stigmatization
We tend to categorize people by general characteristics such as skin colors, races and genders. Such division seems convenient, but is inevitably too simple because personality and individual specialty would be often neglected. Biases and stigmatization would then be generated.
There are three main kinds of stigmatization, including Public Stigmatization, Self Stigmatization and Associated Stigmatization.
  • Public Stigmatization means the negative emotions, cognition and reactions against the stained group. For instance, if the public hold bias against PIR, their opportunity to gain equality in employment would definitely be affected.
  • Self Stigmatization means the stigmatization given to one self due to the external negative emotions, cognition and reactions against him/her. For instance, The public biases imposed on the PIR would definitely lead to their lack of self-confidence and the sense of competence.
  • Associated Stigmatization means the stigmatization given to the related parties of a discriminated person such as patients’ families or friends, due to the negative emotions, cognition and reactions of the public (Mak & Cheung, 2008). For instance, his work would be affected because of his mentally ill family.

Why Stigmatization Exists?
  • Variation in production and tags
  • Connected with negative characteristics
  • "You” and "We”
  • Lower social status
  • Discrimination
  • Hierarchy

The Impact of Stigmatization to PIR
Primarily, Public Stigmatization would stubbornly shape a PIR and consequently limit his/her social interaction. Their self-esteem may also be hurt while simultaneously they have to face inequality in education, employment, career selection and livelihood. The sense of shame brought by Self Stigmatization dose not only prevent them from regular social occasions, but worse, force them to conceal their history of illness which increases their resistance to assistance, the unwillingness to receive treatment and the difficulty of recovery.

Respect and The Fight Against Stigmatization
Through regular contact with the PIR, we can enhance our knowledge of psychiatric illness and eliminate misunderstanding. We may also deepen our comprehension of how stigmatization affects the normal life of a PIR so that our acceptance to them can be broadened. We must show respect to the PIR they deserve in daily contact by communicating with them in positive wordings.

 

Reference:
Mak, W. W. S. & Cheung, R. Y. M. (2008). Affiliate stigma among caregivers of people with mental illness or intellectual disability. Journal of Applied Research in Intellectual Disabilities, 21, 532-545.
Link, B, G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363-385
Walsh, E., Buchanan, A., & Fahy, T. (2002). Violence and schizophrenia: examining the evidence. The britsh journal of psychiatry, 180, 490-495

 

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100 ways to support recovery: A guide for mental health professionals

It is a free practical guide for mental health professionals to work in a recovery-oriented way. Since publication in 2009, the first edition has been downloaded more than 23,000 times. It was also translated different languages and New Life is honored to assist the translation into Chinese language. The booklet covered both theoretical framework and practical method to implement recovery-oriented practice. Translation and production of the traditional Chinese version was completed and disseminated on internet.


Click Here to download PDF version (Traditional Chinese version)

Click Here to download PDF version (Simplified Chinese version)

 

15 Recovery Stories

Throughout the years in embracing the recovery transformation journeys, the Association had gained much knowledge and experience in delivering recovery-oriented practice. A recovery story booklet was produced to recognize staff’s effort and the good practice in promoting PIRs’ recovery as well as to transfer the knowledge and wisdom on recovery-oriented practice. Stories of recovery-oriented practice at both case-work and program levels from all service units were gathered to demonstrate PIRs’ recovery journey, shifts in staff’s mindset and perspectives, challenges overcame during the system transformation process, as well as the reflection on the understanding of recovery.


Click Here to download PDF version (Traditional Chinese version)

 

Recovery Journey Information Kit


Click Here to download PDF version (Traditional Chinese version)

 

PIR’s Rights

Understanding your rights to control your treatment and recovery journey is very important. Just like understanding the traffic rules, you can be more confident to support yourself and flight for anything you need. As a PIR, you have the same rights with others. In Hong Kong, you can refer to "Patients' Rights and Responsibilities” published by Department of Health and the terms about PIR’s rights and related legal matters stated at the "Mental Health Ordinance”. You may feel interest to learn more about your rights on mental health or recovery including:
  • right to be respected and have dignity
  • right to have privacy and confidentiality
  • right to get your own personal profile
  • right to participate in planning your recovery plan
  • right to know about your medication, psychotherapy and steps of clinical treatment
  • right to express your opinions on the medication or psychotherapy
  • right to complaint when you feel that your rights are infringed
The above is for reference only which cannot represent the legal advice. In some of the cases, these statements of rights do not apply or are exercised in another way. For example, your rights in an inpatient ward may differ from the outpatient treatment. Please contact your caseworker if you feel that your rights are infringed.

 

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PIR Responsibilities

As a PIR, I learn to …

Individualized
  • express my needs and preferences to make the service more suitable for myself;
  • understand my ambitions and hopes for setting my own recovery goals;
  • make flexible choices for my recovery journey and life;
  • control my own recovery plan e.g. time and place of the recovery meeting and the people involved in the meeting.
Self-direction and Choice
  • learn to build a sense of self-dominance, dominate my recovery journey and become my own expert;
  • communicate with the rehabilitation team to determine my own treatment and recovery goals;
  • use autonomy in the process of recovery, express my own preferences and choose different services and resources suited for myself;
  • be brave enough to take risks, make new attempts and learn from the failure so as to control my own life.
Responsibility
  • recognize different ways and skills to enhance the recovery process and establish my own crisis and recovery plan;
  • understand more about the Association and the society, and follow the rules reasonably such as complying with the law;
  • recognize my own responsibilities in the recovery process and bear the consequences of my actions.
Participation
  • participate in the matters relating to recovery and affecting my own life;
  • express my opinions, needs, desires and ambitions;
  • share my experience with other PIR;
  • participate in community activities and shoulder my share of civil responsibilities.
Peer Support
  • establish mutual trust with peers;
  • contribute myself and participate in activities that help others, such as self-help group;
  • build my own value by helping others such as participating in volunteer services.
Family Participation
  • nurture myself as independent and responsible person in the family;
  • learn to resolve conflicts and try to understand different perspectives of family members;
  • contact family members proactively and let them know your current situation and condition so as to enhance mutual understanding and support.
Strength-based
  • Understand the resources I can offer and appreciate my own strengths;
  • Participate in different types of activities such as volunteer services and sports and discover my own strengths;
  • accept the failure not entirely due to my own reason but also due to other factors;
  • do not let the negative labeling from public, disease diagnosis and self-stigma content my life.
Respect and Anti-stigma
  • be confident and not feeling shameful because of my own status;
  • not blindly believe in the stereotypical role of mental patients;
  • understand and treat myself as a whole person with both strengths and weaknesses;
  • take actions against stigmatization and negative labelling through advocacy, public education and social activities;
  • find different ways counter the negative attitudes from others such as building mutual respect with other.
Non-linearity
  • understand the importance of continuous attempt;
  • review and revise my own recovery plan with an open mind;
  • Learn different skills to manage stress and my own affairs and share experiences with other PIR.
Holistic
  • discover and cultivate different hobbies and participates in different types of activities;
  • recognize what are meaningful to myself and develop a diversified life such as family, friendship, community activities, career, etc.
Hope
  • face and solve problems, control my own life and achieve meaningful goals;
  • discover and make use of my abilities to enhance my life;
  • find different ways to encourage myself to make practical and positive actions.

 

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Tips for family members

Both the families’ and carers’ participation and support are essential in the recovery journey for people with lived experiences of mental illness. Sponsored by the Community Chest since 2011, the Association has established the Family Support Service to build up a holistic support network among the carers to support them to face the challenges with a positive mindset and to maintain family functions.

Click to learn more

 

Application of Recovery-oriented concept

Apart from the recovery-oriented group or case work, the recovery-oriented concept can apply to the service including daily operation and different activities so as to penetrate the recovery concept towards PIR’s daily life. Below are some examples:

Participation
  • Example:Set up the members’ meeting or residents’ meeting and let the PIR to express their opinions and participate in the development of operational arrangement e.g. content of day-training program, duty arrangement, etc. Also let them serve in different roles at the meeting e.g Chairperson, secretary, etc.

  • Result:After setting up the member’s meeting, PIR are more proactive to express their opinions and participate in the discussion. They have more understanding on the day-training content and the goals. PIR’s cooperation and responsibility have been improved. The conflict with staff has been reduced as well.
Strength-based
  • Example:In order to discover PIR’s ability, PIR are invited to teach other PIR or take responsibilities in different tasks , e.g. production of the daily news for day-training program, attendance checking, hostel affairs management or being the instructor at interest class.

  • Result:PIR’s strengths are valued and their confidence are enhanced. PIR are more willing to lead the day-training program and learn the new skills. As the PIR participated in the design of the service environment, they cherished more on the facilities.
Peer Support
  • Example:Set up the mutual-help group by recruiting PIR with similar experience e.g. work injury. Organize regular PIR gathering and establish mutual support network. Develop peer support service and train up the Peer Support Workers to connect with other members by telephone.

  • Result:PIR can co-produce different activities and they can feel the concerns from each others. The Peer Support Workers are happy for caring other members.
Respect and Anti-sigma
  • Example:General public could understand more PIR by participating in different social inclusive activities e.g Mental Health Month, recovery sharing by PIR, volunteer activities, etc. Also, we promote the ecotour330 at schools and districts including mental health talk, eco-tourism led by PIR and sharing on PIR’s recovery stories.

  • Result:Through the social inclusive activities, the general public not only increase their knowledge of mental illness, but foster a more positive attitude towards mental illness. Volunteers expressed that the activities allowed them to deepen the understand of PIR. Also, PIR’s confidence are enhanced through the activities. Feedback from other organizations or volunteer groups who have participated in the social inclusive activities were very positive.

 

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Common misconceptions about recovery

  • 1. Currently, we are delivering "people-oriented” service and is it necessary to implement the recovery model?
  • "People-oriented” is the core element of recovery model. The recovery concept does not only mean empathy, listening and non-judging attitude. PIR is the key person of the recovery process and they are valued as a "holistic person” but not "psychotic patient” and they deserve to have their dignity. The concept of "people-oriented” is also applied to the planning of the recovery process. PIR should participate more on the decision making of their recovery plan and control their own life.

    Apart from "people-oriented”, recovery model also values other elements e.g individual’s responsibility, peer support, respect, anti-stigma, strength-based, hope, non-linearity and holistic development. Further, the involvement of PIR at the development of recovery model can fully represent the "people-oriented” concept.


  • 2. The implementation of the recovery model will lead the increase of resources and workload of colleagues.
  • Applying the recovery model at the service is not an extra work. Recovery is a process which help the PIR to understand themselves more and learn to manage their life affected by the mental illness. We aim at facilitating this process at our service.

    At the beginning of the service transformation, we really need to allocate more resources and manpower. For example, we need to assess the current service model, develop service plan, provide training and implement the concept to the service. In the long run, more PIR and their family members can involve in the service operations and development which could help share the burden from the colleagues.


  • 3. Will the recovery model replace the traditional mental rehabilitation service?
  • The implementation of the "recovery-oriented” service does not mean stopping the current medical treatment or any other treatments to alleviate the symptoms of mental illness. Also, it does not mean stopping other rehabilitation services. Indeed, the recovery model and the traditional mental rehabilitation services are not mutually exclusive, buy the two complement each other. For example, the "pre-advance directive" and personal symptom management training based on the recovery can be matched with the traditional mental rehabilitation services.


  • 4. Recovery model is only applicable to PIR with good mental condition and good illness awareness.
  • Many people believe that recovery-oriented service is only for PIR with stable condition. In fact, the focus of "recovery” is not to eliminate all symptoms, but it is to help PIR manage their life affected by the mental illness. Even when they face a relapse of mental illness, the process of recovery will not be stopped. Therefore, regardless of the mental condition of PIR, they all need recover-oriented service. From PIR’s perspective, relapse of mental illness only temporarily disturbs their recovery process and the proper care and services can help them to manage their life again. Recovery model emphasizes on respect, respect is a basic human right which should not be exploited because of the mental illness.


  • 5. The recovery model only increases the risk and responsibility of the service provider.
  • The concept of recovery encourages co-production of PIR, family and service provider. Through the open discussions, PIR can set up their own goals and method to achieve these goals. Therefore, PIR, family and the service provide all share the responsibility.

    Moreover, even if the choice of the PIR may lead to adverse consequences, facing failure is a very important learning opportunity which can help them grow up. Although the recovery model emphasizes the participation and self-determination of the PIR, it does not mean that PIR can make any decisions without any norm. Like everyone, PIR’s choice and decision are also limited by the objective environment and laws. Service provider needs to evaluate the immediate crisis level by the decision.

    Foreign studies have shown that the implementation of recovery-oriented service can reduce the overall hospital admission rate and there is no evidence that the PIR risk level is increased.


  • 6. We need to develop more new services so as to implement the recovery model.
  • The recovery model focuses on the attitude change rather than designing new activities or services. We believe that mental illness is only an experience in a life and mental illness should not be the whole life of an individual or degrade personal value. In the recovery model, we value the values of hope, respect and holistic. New service might help practice these values, but the most important is the attitude of the service provider.

    For example, when the PIR refuses to take the medicine, we will focus on the problem under the traditional concept of rehabilitation. In the recovery model, we will try to understand the cause of the behaviour. Also, we will base on their strength and personal goals to encourage them to take the medicine or find another way to achieve their goal. In another words, we can apply the recovery model to our current services.


  • 7. Individualism and self-determination contradict with traditional Chinese culture.
  • Harmonious relations is one of the important value at the traditional Chinese culture, however, individualism is not a contradictory concept and it should be a different level of interaction with society.

    Implementing the recovery model at service properly can lead to a more harmonious relationship. For example, co-production from PIR, family and staff can encourage more communication. One the one hand, it can enhance the self-determination of PIR, one the other hand, it can deepen the mutual understanding among PIR, family and staff. For PIR, the continuous training can help them understand their condition, manage their symptoms and learn how to make appropriate choices for themselves.

    In addition, if the PIR think that letting the family make the decision for them is the best choice at their recovery process, it is not necessary to force them to make the decision themselves. As respecting PIR’s choice has already reflected the spirit of self-determination.


  • 8. The recovery model cannot be implemented if other organizations do not apply it to their services together.
  • Service transformation requires time and resources. Although many local organizations have not applied the recovery model to their services and there will be many challenges in implementing the recovery model in the current environment, the recovery model has been implemented in many foreign countries for more than a decade with many support from PIR and positive results. As a pioneer in the implementation of the recovery model in Hong Kong, New Life Psychiatric Rehabilitation will continue to share the experience and information for facilitating the improvement of mental health environment in Hong Kong.

     

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