Early Psychosis Intervention: A Culturally Adaptive Clinical Guide

22. Working with Non-Governmental Organizations in Early Psychosis

22 Working with Non-Governmental Organizations in Early Psychosis Steve Tso and Simon Sai-yu Lui The Early Assessment Service for Young People with Psychosis (EASY) in Hong Kong emphasizes close links with non-governmental organizations (NGOs) involved in providing mental healthcare to the community. In Hong Kong, NGOs provide a wide range of services. Many youth and community centres are run by NGOs where people in the local community meet and join activities. Staff members of NGOs are usually trained social workers. NGOs are key suppliers of mental healthcare for people with early psychosis , as they: 1. refer many suspected cases of psychosis; 2. facilitate detection and identification of people with untreated psychosis in the community; 3. enhance the mental health literacy in the community; 4. assist case managers of EASY; 5. provide community support to patients with early psychosis; 6. enhance community reintegration of clients; 7. deliver rehabilitation programmes through their community and youth centres which offer easy access, less stigmatization, and can approximate real-life situations; and 8. organize group activities in a community setting that is preferable to any clinical settings. NGO-Provided Mental Healthcare Services in Hong Kong NGOs in Hong Kong have a long history of providing care and support to people with mental disorders. In the past, many NGOs, such as New Life Psychiatric Rehabilitation Association and the Hong Kong Mental Health 256 Steve Tso and Simon Sai-yu Lui Association were more heavily involved in caring for psychosis patients discharged from psychiatric hospitals or halfway houses, by providing rehabilitation to “chronic and institutionalized” patients. Obviously, these traditional rehabilitation services are not suitable for early psychosis clients, who are young and managed mainly in outpatient clinics. In recent years, the EASY teams have worked collaboratively with different NGO youth and community centres to provide a wide range of new programmes tailor-made to the needs of early psychosis clients and their caregivers. Community Partnership between the EASY Service and NGOs The EASY teams collaborate actively with NGOs to deliver community programmes for EASY clients and their caregivers, and promote positive messages about mental illnesses to the general public. Since 2001, a range of therapeutic, educational, social and leisure activities have been organized. Enhancing mental health literacy Frequently, NGOs invite the EASY team staff to deliver talks in youth and community centres. The EASY staff members also train NGO frontline workers to deal with people with psychosis and how to engage people who are suspected to have psychosis into psychiatric services. Some of these talks are open to the general public to educate local folk to differentiate early or “prodromal” signs of psychosis from normal adolescent behaviours. These educational activities aim to enhance mental health literacy, to reduce stigma associated with the illness, and to promote early treatment of psychosis. Early detection of untreated psychosis NGOs are encouraged to refer suspected first-episode psychosis cases early to EASY. As some young people who are suspected to have psychosis tend to decline psychiatric assessments conducted in hospitals or clinics, the EASY team has been providing frequent nurse-led assessment sessions in a NGO centre. Those screened by the nurses to suffer from psychosis are eventually followed up at the EASY clinic. Working with Non-Governmental Organizations in Early Psychosis 257 Managing caregivers’ stress Family and caregivers play a significant role in the patient’s rehabilitation and recovery process; supporting family and caregivers is therefore an important part of EASY. Family group work is a way to enhance a client’s support network, and in turn minimize negative impact of the disease on the clients’ families. For EASY clients, round-the-year family groups are regularly conducted collaboratively with NGO community partners. The family groups invite early psychosis clients who are at the similar stages of the illness, to join in with their caregivers . The first few sessions are usually conducted jointly by a senior psychiatrist and a medical social worker and focus on information delivery and support. The NGO workers gradually become more involved by building up support networks, and identifying other areas of need. Community and youth centres are preferred venues for these family groups in place of hospitals and clinics due to easier access, wider acceptance by caregivers, less stigmatization, betterequipped facilities, and greater availability of volunteer helpers. Moreover, clients and caregivers can benefit from other services available in those centres. Reintegrating clients into the community through normalization EASY clients’ linkage...