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LCQ7: Services of Integrated Community Centres for Mental Wellness
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     Following is a question by the Hon Cheung Kwok-che and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (January 7):

Question:

     During the period from 2010 to 2011, the Social Welfare Department (SWD) extended the services of Integrated Community Centres for Mental Wellness (ICCMWs) to cover all 18 districts in Hong Kong and set up a total of 24 ICCMWs. Also, SWD undertook to strengthen the manpower of various ICCMWs to cater for future service needs, and identify permanent sites suitable for various ICCMWs for the provision of full-fledged service as soon as possible. On the other hand, appropriate services are provided for people with mental illness through the referral of cases between the Personalized Care Programme (PCP) provided by the Hospital Authority (HA) and various ICCMWs. The authorities have established a referral mechanism and formulated the guidelines on the referral procedures, and are drawing up a Service Manual on Mental Health Case Management (the Service Manual). However, some social workers have relayed to me that the positioning of ICCMWs at present is unclear and the staffing establishment is inflexible, thus affecting service implementation. In this connection, will the Government inform this Council:

(1) whether it will conduct a comprehensive review of the operation and service effectiveness of ICCMWs in the past four years with a view to improving their services; if it will, of the details; if not, the reasons for that;

(2) given that the number of people with mental illness has increased continuously in recent years, how the authorities will strengthen the manpower of various ICCMWs to cope with the increasing service demand and alleviate the work pressure on staff members so as to maintain service quality;

(3) how the authorities help find sites meeting SWD standards for those ICCMWs which have yet to identify permanent sites, and when the authorities expect such work to be completed;

(4) of the referral mechanism between PCP and ICCMWs, as well as the guidelines on the referral procedures; and

(5) of the details of the contents and the publication date of the Service Manual; whether the authorities will undertake to consult the stakeholders (including service providers and users) before the Service Manual is finalised?

Reply:

President,  

     My reply to the questions raised by the Hon Cheung Kwok-che is as follows:

(1) Since October 2010, the Integrated Community Centres for Mental Wellness (ICCMWs) have been providing one-stop and district-based community support services ranging from prevention to crisis management for discharged mental patients, persons with suspected mental health problems, their families/carers and residents living in the serving districts in Hong Kong. These services include outreaching visits, casework counselling, therapeutic and supportive groups, social and recreational activities, day training and public education programmes and, where necessary, referral of cases to the Hospital Authority (HA) for clinical assessment and psychiatric treatment. ICCMWs need to work jointly with HA and other service units in service delivery from time to time. In view of this, the Social Welfare Department (SWD) has drawn up guidelines for ICCMWs on the collaboration with other service units for reference by ICCMWs and other stakeholders on the principles in the division of work and referral of cases.

     As at September 2014, ICCMWs provided services for over 40 000 discharged mental patients and persons with suspected mental health problems. More than 9 900 public education programmes with a total of over 500 000 participants were also organised to enhance public awareness of mental health.

     On the other hand, since April 2010, HA has rolled out the Case Management Programme in different districts of Hong Kong in phases for patients with severe mental illness. Under the Programme, case managers work closely with community partners, particularly ICCMWs in different districts, in providing intensive, continuous and personalised support to patients with severe mental illness residing in the community. Given that certain experience in the provision of ICCMW services has been accumulated and that the Case Management Programme has been expanded to cover all 18 districts in Hong Kong in 2014-15, SWD plans to review the services and development directions of the ICCMWs in collaboration with the non-governmental organisations (NGOs) operating the ICCMWs and relevant stakeholders in 2015.

(2) SWD has been monitoring the manpower and service performance of ICCMWs as well as the public demand for ICCMW services. As a matter of fact, the resources allocated by SWD to ICCMWs increased year by year from $135 million in 2010 to $205 million in 2014 (up by more than 50%) to strengthen manpower and supervisory support. Under the Lump Sum Grant subvention system, NGOs operating ICCMWs have the flexibility to deploy the subvention in arranging suitable staffing according to the service needs of that district, including social workers, psychiatric nurses, occupational therapists and other supporting staff, to ensure service quality and meet service needs of that district. SWD will continue to keep in view the development of ICCMW in order to meet public demand.

(3) Currently, among the 24 ICCMWs, 13 are already providing services in permanent accommodation. Suitable sites have been identified/reserved as premises for six other ICCMWs, and fitting-out/building works or district consultation are being/will be carried out. Five ICCMWs, located in Yau Tsim Mong, Tseung Kwan O (South), Tsuen Wan, Eastern District and Northern District respectively have yet to identify suitable permanent accommodation. During the transition period, ICCMWs without permanent accommodation are operating in temporary office or as temporary service points in other suitable premises of their operators through the existing facilities and networks in their respective districts or in commercial premises rented with SWD's subsidy.

     SWD will continue to identify suitable permanent accommodation for the remaining five ICCMWs through various channels, including keeping in close contact with relevant government departments such as the Lands Department, Planning Department and Housing Department, in order to reserve premises for ICCMW purpose at the planning stage of new development or redevelopment projects. Besides, SWD will closely monitor the availability of government property and school premises which will become vacant as a result of service re-engineering, and actively identify vacant public housing units that can be converted or renovated for providing ICCMW services.

(4) With the implementation of ICCMW services and the Case Management Programme, SWD and HA set up in 2010 a three-tier collaboration platform to facilitate cross-sectoral communication at central, district and service delivery levels.

     At central level, SWD headquarters, HA Head Office and NGOs meet regularly to discuss service strategies and explore models of collaboration.  

     At district level, the District Social Welfare Officers of SWD and HA's cluster heads of psychiatric services regularly liaise with the service operators (including ICCMWs) in the district and relevant government organisations to jointly co-ordinate community support services with a view to enhancing cross-service and cross-sectoral collaboration at the district level, and co-ordinating and rationalising efforts in resolving operational problems encountered, thereby facilitating effective delivery of ICCMW services.

     At the service delivery level, ICCMW caseworkers maintain close liaison with HA's case managers, and discuss and co-ordinate on matters such as case referrals and arrangements for rehabilitation services according to the guidelines on collaboration. ICCMWs refer suspected cases to the Community Psychiatric Services of HA for clinical assessment and psychiatric treatment, while HA also refers suitable patients to ICCMWs for follow-up action. Besides, cross-sectoral and multi-disciplinary case conferences on individual cases are also held by ICCMWs and HA on a frequent basis to jointly draw up suitable rehabilitation plans for discharged mental patients and arrange medical treatment and community support services for them.

(5) To enhance communication and collaboration among stakeholders under the Case Management Programme, and to better respond to patients' needs and social needs, a Task Group, comprising HA, SWD and relevant NGOs, has been established to review the current service collaboration and prepare the draft "Service Framework of Personalised Care for Adults with Severe Mental Illness" (service framework). The Task Group expects to complete the first draft of the service framework in early 2015 for stakeholder consultation including relevant service providers and patient groups. The Task Group anticipates that the service framework will be promulgated in 2015-16.

Ends/Wednesday, January 7, 2015
Issued at HKT 13:55

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