Replies to LegCo questions
LCQ2:Service provision for ex-mental patients
Following is a question by the Dr Hon Fernando Cheung and an oral reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council meeting today (December 1):
Question:
It has been reported that not long ago an ex-mental patient, who relapsed due to a divorce, died after having jumped from Lei Chak House of Ap Lei Chau Estate, carrying his six-year-old son with him. The incident causes extensive concern in the social work sector regarding family services, as well as treatment and rehabilitation services provided for mental patients. In this connection, will the Government inform this Council:
(a) whether the five Single Parent Centres will be re-opened; if so, of their re-opening time; if not, the reasons for that;
(b) of the total number of mental patients receiving services from public psychiatric specialist out-patient clinics in Hong Kong at present, as well as the number of medical social workers in these clinics; and whether the Social Welfare Department (SWD) still maintains its personnel policy of 'triennial transfer' for medical social workers; and
(c) whether the Hospital Authority and SWD have any plan to provide services to those mental patients who have not taken the initiative to contact medical social workers?
Reply:
Madam President,
(a) The service needs of the socially disadvantaged including the single parents have always been high on the Administration's agenda. Improvement has also been made to the services through regular reviews and service restructuring to achieve better quality and cost effectiveness.
SWD commissioned the University Professionals to conduct a Consultancy Study on the Review of Family Services in August 2000. According to the report which was published in June 2001, the service model under which new services were introduced in response to newly emerged family problems would lead to gaps and overlaps in service boundaries. This arrangement was not cost-effective as well. In this connection, the report recommended that various family services, including services exclusively for single parents, be restructured and merged to form into Integrated Family Services Centres (IFSCs).
IFSCs will be in a position to provide more holistic and user-friendly services to families in need, including the single parent families. All services currently provided by the Single Parent Centres are also available in IFSCs, and the new service model which put a premium on early prevention and intervention can better meet the needs of the clients.
(b) At present, SWD and the Hospital Authority (HA) have a total of 168 medical social workers on its establishment providing welfare services to the psychiatry departments of public hospitals and specialist out-patient clinics in Hong Kong. Until November 2004, they are handling some 13,500 cases (among them, 3,200 are in-patient cases and 10,300 are specialist out-patient cases).
Regarding the posting arrangement for SWD staff, the Department has been following a set of policies underpinned by established principles and a mechanism, with the objectives of enhancing the overall service quality, achieving the vision and mission of SWD, and facilitating career development of the staff. The basic principle is to bring the transfer in alignment with the needs and demands of various SWD services, and service needs would invariably be the prime consideration. Regular transfers also enable the staff to gain wide exposure from different types of services and/or service units, bringing into full play their strengths and potential. Therefore, medical social workers under the social worker grade are subject to posting every three to four years in accordance with the established mechanism as long as the delivery of services remains unaffected.
(c) At present, medical social workers are attached to the psychiatry department of all hospitals and specialist clinics and they work closely with other colleagues including healthcare professionals (such as medical practitioners, nurses and occupational therapists) in assessing the social and psychological condition of discharged mentally ill and devise suitable rehabilitation plan to help them to adjust to normal life, to control their temperament, to establish social relationship with others, on their finance and to provide them with counselling services. In assessing and following up on the service needs of patients and their families, medical social workers will take the initiative to contact or visit them even if the latter show no intention of seeking help. Regular follow-up action will be taken to provide them with the necessary counselling and support services.
A mechanism has also been established in the 14 psychiatric specialist clinics under HA to trace patients who fail to turn up for the scheduled follow-up consultation. As a common practice, staff of the clinics would first call the patients and their families to enquire why the patients failed to turn up for the scheduled follow-up consultation. If need arises, pro-active follow-up actions would also be taken by sending staff to pay home visits to the patients.
In addition, medical social workers have also posted and handed out service leaflets in hospitals and clinics to inform patients of the medical social services available. These services are primarily provided through the HA's community psychiatry outreaching teams, each comprising a multi-disciplinary crew of psychiatric personnel including medical social workers, psychiatrists, community psychiatric nurses, clinical psychologists and rehabilitation therapists. They are mainly engaged in outreach visits to discharged mentally ill and their families living in the community and providing crisis intervention in urgent cases. Medical social workers will also involve themselves actively in publicity, promotion and public education programmes at district level to give individuals and families in the community a better idea about the plight and needs of discharged mentally ill and members of their families, as well as disseminate information on medical social services.
Ends/Wednesday, December 1, 2004
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