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Nancy Chau

CSRP Responding to No-Suicide Contract 有關「不自殺契約」的爭議

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有關「不自殺契約」的爭議

近日大家都為到網路上廣傳的「不自殺契約」而議論紛紛,質疑其成效及可靠性。就有關議論,不少心理學家已發表回應,指出「不自殺契約」實為輔導工具,當求助者透露自己有自殺念頭時,由輔導員或心理學家決定是否適合使用,而在一般情況下不會廣泛派發給學生。

「不自殺契約」於七十年代由精神科醫生及心理學家設計。當時「不自殺契約」被視為防止自殺的慣例,因此大部分的精神科醫護人員及心理學家於受訓時均會學習到如何運用此工具。然而,在二千年代有大量學術研究指出「不自殺契約」不一定能有效防止自殺。

英國預防自殺的學者Tony White指出,前線的輔導專家在使用「不自殺契約」的同時,必須明白契約背後的理論才能發揮其功效(White, 2011)。「不自殺契約」不單止是一份文件,在使用此契約時,專家應與求助者共同討論有關個人責任 (Concept of personal responsibility)、契約的意義 (Theory of contracts)及早期決定的理論 (Theory of early decisions)。契約本身能否有效減低自殺的機率雖然具爭議性,可貴的是在輔導及簽訂契約的過程中,前線輔導人員與求助者同行並讓其感受到被關懷。假若沒有關愛,契約也只不過是一份冷冰冰的文件。

近半年所發生的學生輕生事件實在令人痛心疾首。雖然不一定每人都能為預防自殺走到最前線,但培養關愛氣氛,關心身邊的親友,絕對是你我也能做得到的事。如欲獲得更多資訊,請瀏覽本中心 #與你同行 #WeCare網頁。

*White, T. (2011). Working with suicidal individuals: A guide to providing understanding, assessment and support

Press Conference – From Compensation to Rehabilitation
不止賠償 更要「重返工作」

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From Compensation to Rehabilitation

A Social Review of the Employees’ Compensation Insurance System in Hong Kong
Research Findings Release

In Hong Kong, about 200 fatal and 55,000 to 60,000 non-fatal cases resulting from work-related accidents and diseases have been recorded each year. Occupational rehabilitation with an emphasis on early and comprehensive intervention immediately after injuries has demonstrated to be the international best practice in disability management post occupational injuries. The practice, however, has not beenProfessor Paul Yip listened attentively during the Q&A session widely adopted in Hong Kong. To have an understanding of the underlying reasons, the Centre for Suicide Research and Prevention (CSRP), Department of Social Work and Social Administration of the University of Hong Kong (HKU), has conducted a consultancy project jointly with the Employees’ Compensation Insurance Residual Scheme Bureau (ECIRSB) to review the Employees’ Compensation system for local workers.

The CSRP held a press conference on 14 Dec 2015 to release its latest research findings and recommendations from the project on restoring the well-being of injured workers. Press release is available in both English and Chinese. The Powerpoint presentation is available in Chinese.

At the press conference, Professor Paul Yip presented the latest statistics on work-related deaths and injuries in Hong Kong, and on compensation insurance claims, such as the demographic characteristics of the workers who filed insurance claims, the types of common injuries, and number of working days lost from injury. He also spoke about the major problems in the current system, namely a compensation-focused culture and the physical and psychological barriers that hinder the success of return-to-work for injured workers, such as stress from family and employers, and the loss of self-esteem. Recognizing the challenges encountered by injured workers on the road of recovery, professor Yip stressed the importance of primary, secondary and tertiary prevention strategies and called for a collaborative effort of building a worker-centered system.

DSC00037Doctor Sheung Wai Law, an honorary clinical associate professor from the Department of Orthopedics and Traumatology of the Chinese University of Hong Kong (CUHK), shared a success story of implementing a multidisciplinary rehabilitation model with the focus on early intervention – the  Multidisciplinary Orthopedics Rehabilitation Empowerment (MORE) Programme. This programme has demonstrated great success in facilitating early and safe return-to-work for injured workers. With the positive impacts brought by the MORE programme, the project hopes to initiate efforts of expanding the programme, so more injured workers can gain access.

Last but not least, the CSRP would like to express gratitude to all the stakeholders who contributed to the project and those who provided utmost support for the project’s effort in propelling meaningful changes for workers health and social well-being of Hong Kong.

Join our focus group on altruism and well-being (with compensation) / 招募聚焦小組參與者 主題:有關助人與福祉 (補貼車馬費)

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A Qualitative Study on Altruism and Well-being

Join our focus group on altruism and well-being (with compensation)

You are cordially invited to join our focus groups on altruism and well-being in HK. Your participation and sharing will be very much appreciated and contribute to making Hong Kong a better society. To compensate for transportation and time, each participant will receive $100 HKD cash after completing the focus group. Refreshments will also be provided at the focus group.

For further details, please visit our website: http://csrp.hku.hk/invitation-letter-altruism (the details are available in English, Traditional Chinese, and Simplified Chinese)

You are welcome to disseminate this message on your social networks.

Thank you very much for your attention!

Best regards,

HKJC Centre for Suicide Research and Prevention, HKU

———————————————————————————————————
招募聚焦小組參與者 主題:有關助人與福祉 (補貼車馬費)

我們是來自香港大學的研究團隊,現誠邀您參與一項有關助人與福祉的關係的研 究。您的參與和分享將為我們的研究提供寶貴數據,亦將對改善香港的社會福祉作出重要貢獻。我們將向每名完成聚焦小組的參與者提供港幣100元正作為車馬費,以示謝意。小組討論時亦將會提供簡便小食及飲品。

詳情請訪問我們的網站:http://csrp.hku.hk/invitation-letter-altruism (繁體中文、英文、簡體中文三個版本可供參考)

歡迎您將此訊息轉告您的親友,邀請更多人士參與我們的研究。

非常感謝您的關注與支持!

香港大學香港賽馬會防止自殺研究中心

World Mental Health Day 2015

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全人健康:尊重與關愛 / Holistic Health: Respect and Care

撰稿:鄭雅心 / By Mabel Cheng

本年度世界精神健康日(World Mental Health Day)的主題為精神健康與尊嚴。對於健康,社會向來很重視。坊間處處都能找到預防生理疾病及養生的資訊,唯獨是忽視了成就全人健康的另一重要元素:精神及心理健康。情緒病在東方文化中可算是個大眾忌諱的話題。每提起情緒病,總會有人覺得不安、避而不談、或對患者有先入為主的負面評價,而造成歧視等問題。這是因為大多數人對於情緒病都有所誤解,認為患上情緒病的人必定是「壞人」、「心理變態」、或是「極度負面」、「失去理智」的人。無可否認這些負面的標籤在不知不覺間剝削了精神病人應得到的公平對待。本年度的主題–尊嚴,所指的正正就是當事人自身的價值和被尊重的權利。

心理疾病,其實就是心靈上的一場傷風感冒,每個人亦有機會患上。與其他的身體疾病一樣,患病並不是個人選擇,所以也不應影響當事人的價值。生病也許代表其免疫系統暫時戰敗,需要休養及被照顧。而「生病」,從來都不是人自身的「錯」。較早前的一套本地電影《暴瘋語》帶出了一些好例子。故事講述范國生劉青雲飾)因為痛失愛子,情緒過度低落而患上精神分裂,於病發時錯手殺害妻子而被判入精神病院作長期治療。數年後,其主診醫生周明傑(黃曉明飾)認為國生已康復並決定讓他重新投身社會。然而,重獲自由的國生因為其患病紀錄及經歷而受盡種種歧視,使他再度感到情緒低落,臨近崩潰。同時,在他的住所附近發生了一宗命案,國生一度被認定是殺人兇手。無論國生怎樣努力為自己辯護也是徒勞無功。最後,他選擇了為自己沒有犯的過錯而認罪。對他來說,被社會歧視的痛苦程度與坐冤獄的分別實在不大。在被診斷為精神病患者的瞬間,彷彿已被社會判決「終生監禁」。精神病這個標籤無情地奪去了他的自由、人權、及被尊重的權利。

試想想,癌症病人從治療中復原過來,總會得到很多祝福和鼓勵。相反,精神病康復者不但未必得到所需的支持,反而還須承受歧視的眼光和不公平的對待。要解決歧視問題,首先我們先要明白精神病及情緒病並不是可恥之事。能引發精神病的因素很多,包括生理、心理、環境、生活壓力、支援網絡等等。其實每個人都潛在著「生病」的機會,當人生出現突如其來的轉變,例如失業、意外、喪親等的事情,而又未能適當地處理自己的情緒,患上精神或情緒病的機會便大大提高。電影中有三個角色患有精神病,包括主角范國生國生的岳母(鮑起靜飾),及國生的精神科主診醫生周明傑。故事中三個角色均來自不同的社會階級及教育背景。唯一相同的,就是每個角色都各自面對著某些悲痛的經歷,例如失去至親。大部分的精神病患者所背負著的,不單是社會的歧視目光,可能還有造成病發的一些慘痛經歷。在批判、歧視、指責、取笑之前,何不先理解對方的苦處,或至少給予一份基本的尊重?

精神病患及康復者所需要的,不單是一個重新開始的機會,還有一份關愛及同理心-理解他們所面對的傷痛、病患中的苦難、及重生後的掙扎。電影中引用了一句葛萊斯科皇室精神病院患者的絮語:「精神病就像暴風雨,會落在好人和壞人的頭上,誰也無法躲避,雖然是永遠的不幸,但不比其他疾病來得更罪惡和丟臉。」當下社會最需要的,也許是少一點批判,多一點關愛。

改變的第一步是增強大眾對心理健康及心理疾病的知識,減輕歧視出現的可能性。相關機構可從不同途徑,例如網誌、講座、媒體包括電視、電影等來傳遞訊息,首先明白每個人都有患病的風險,其次是增強對心理疾病的基本認識,包括風險因素、治療、症狀等等。社會各界也應攜手合作支持及肯定精神病患及康復者在社區中的參與和貢獻,並為共創平等機會社會盡一份力。

更多有關心理健康的資訊:

心See 180 青少年精神健康計劃

憂鬱小王子之路

Holistic Health: Respect and Care

Healthy diets, nutrition, and exercises seem to be hot topics in our daily lives. Tips on maintaining physical health are often widely spread across the world. However, another important element of holistic wellbeing – mental health, is often neglected in many cultures. One of the main reasons is that mental illnesses are being stigmatized all over the world. People tend to associate negative labels with mental illness, such as violence, irrationality, insanity, and sometimes poverty and the lack of education, and so on. In fact, mental illness is like a fever of your mind; it happens when your mental state is weak and the external stress level is high. Everyone has an equal chance in suffering from mental illness. Data has shown that one in four people suffer from mental health problems at some point over the course of their lives.

With the misconception and stigma around mental disorders, people with mental illnesses often receive unequal treatment in the community, such as the lack of job opportunities, respect from others, and in most extreme case, the human right to make their own decisions of who they want to be. These people bear a lot on their own, including the pain from events triggering their emotional turmoil, side effects of treatment, and the unequal treatment from society. The path of recovery is full of challenges, as many forget they have the right to be respected too.

The theme of 2015 World Mental Health Day is dignity. It is a good time to enhance the awareness of mental health and to ponder what could be done to protect the human rights and dignity of the sufferers of mental health conditions. Let’s start with individual efforts – judge less, care more.

For more information on mental health:

Depressed Little Prince

QEF Thematic Network on Developing Students’ Positive Attitudes and Values

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School recruitment exercise was completed.  In total 27 primary schools and 21 secondary schools joined the thematic network as of 8 Sept 2015. The first training workshop for school teachers on evidence-based practice and programme evaluation in school settings was conducted on 27 Aug 2015. In the new school year 2015-16, the project team will start developing universal programmes for students in developing positive attitudes and values with our core primary and secondary schools.

Evaluation Study for Project WeCan

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Interviews and focus groups with different stakeholders of participating schools and business units of the evaluation study had been completed in May 2015.  The volunteer survey has rolled out in June 2015. Currently, the project team is writing the final report for this evaluation study.

A “Latte Index” – A Reflection of Income Disparity and Social Mobility

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Date: May 8 2015
Feature Speaker: Professor Paul YIP

The latte index measures how many lattes can be brought by an hour of minimum wage. It somehow reflects the purchasing power and quality of life of an ordinary worker. We shall illustrate the latte index for Hong Kong and other countries and discuss its implications. The income disparity and social mobility especially among the youth will be discussed. Read More

Who is Happier in Hong Kong: Those Earning More or Giving More?

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Date: May 22 2015
Feature Speaker: Dr. Qijin CHENG

 

To improve the public understanding and awareness on the relationship between poverty and mental well-being, a series of seminars is held by the Hong Kong Jockey Club Centre for Suicide Research and Prevention, the University of Hong Kong. Dr. Cheng presented the relationship between giving, earning, and happiness.

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Poverty and Well-being in Hong Kong: A Spatial Analysis

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Date: May 29 2015
Feature Speaker: Dr. Shusen CHANG

To improve the public understanding and awareness on the relationship between poverty and mental well-being, a series of seminars is held by the Hong Kong Jockey Club Centre for Suicide Research and Prevention, the University of Hong Kong. In the fourth and the last seminar of the series, Dr. Chang presented a spatial analysis on poverty and well-being, which examined the geography of poverty and suicide and their association in Hong Kong.

Hong Kong’s Gini index, which was an internationally commonly used measure of income disparity, increased from 0.476 in 1991 to 0.537 in 2011 according to the Census and Statistics Department (C&SD) based on household income statistics from past censuses. According to the Hong Kong Poverty Situation Report 2012 published by the Hong Kong Government, the poverty line in Hong Kong was set based on the idea of relative poverty and data collected from the General Household Survey. Individuals of a household would be defined as living under the poverty line if the household income was below 50% of the median monthly household income.

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