Mould Our Future With Enhancing Children Emotional Wellness Today 為未來, 重構兒童情緒健康

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1 Mould Our Future With Enhancing Children Emotional Wellness Today 為未來, 重構兒童情緒健康 Esther TANG, Team Leader, Adolescent Early Intervention Service Scarlet POON, In-Charge, Integrated Community Centre for Mental Wellness Service Development Baptist Oi Kwan Social Service

2 Twofold approaches to enhance children emotional wellness Provide family based emotional support School based emotional wellness education

3 Previous Studies Children of mentally ill parents: Low in psychological well- being, social functioning and academic achievement Risk in developing range of diagnosable psychiatric conditions and behavioral disorders Limited socialization outside home (Pietsch and Cuff, 1995)

4 For example: Depressed parents Emotional withdrawal, pessimistic cognitions, low motivation unpredictable, random parenting style, depending on their emotional availability and frustration tolerance Has difficulties to support the socio-emotional needs of children

5 Family approach in Stand By You Service Service targets: Children and adolescents between the age of 6 and 15 whose family members suffer from mental and emotional difficulties. Objectives: Enhance mental wellness of those children through the provision of psychosocial and community support service. Enhance their positive protective factors with focus on personal development and resilience by providing more supportive and positive life experience.

6 Diagnosis of MI Family Members Type of MI Schizophrenia Depression Bipolar Anxiety Disorder Personality Disorder OCD Unknown Other No. of MI Family Member

7 Family based approach Emotion Parents Reacting by emotion Parenting Children Emotion

8 Family based approach Family Counseling Psycho-education Parent-child Art therapy Programs Parenting group Proving a quality of time and chancing the focus on positive experiences : 媽媽終於有時間同我一齊玩

9 Family based approach Home refurbishment scheme Effective way for worker engagement and provide better living environment to family Acquire knowledge for addressing their children's needs and concerns Reduce stress and diminish their helplessness feeling: 亞女成日走嚟走去, 就係唔係主動自己做功課, 除咗鬧就已經無其他方法, 擁有了自己的書檯, 我可以專心同主動做功課, 唔需再同媽咪嘈 Before After

10 Family Support with mental health focus Mentorship program Home visiting Support and caring to the children and providing timeout for parents and relieve their stress: 好彩噚晚搵到姐姐, 如果唔係我都唔知點算, 睇住佢喊到唔收聲, 我即刻心都煩埋 HappyOurs Hotline ( 童開心熱線 ) Extension of family support system Having a sense of being listened, understood and accepted: 一聽到話開心姐姐會打電話來, 呀女就好開心 Strengthening children s awareness to share their thinking and feelings, as well as awareness to seek help: 姐姐, 你下星期幾時打俾我, 我要寫落日曆度

11 Family Support with mental health focus Life enrichment programs Building up of family capitals and network: 好開心我係度認識咗其他家長, 佢地係 whatsapp 度叫我同亞仔嚟參加活動 higher acceptance of receiving ICCMW services for themselves Widen life experience: 我地平時好少一家人出去玩, 都吳知有咩地方去, 我同媽媽經常去既地方係屋企.. Enhancing emotional state: 我同仔女係呢度參加多 D 活動, 出來行下心情都好好多, 唔使係屋企亂諗野 Mutual Support Elements Being buddies: having fun together, sharing common secrets and feelings: 我唔會同朋友講媽媽 D 野, 因為唔想人地知道屋企人有精神病

12 Because From our past experiences, intervention provided for children solely is not enough Well- being of children is significantly affected by their parents' mental state, emotion stability, parenting style and the parent-child relationship

13 Case Summary Background: Wong, 10 years old, Female, Single family(living with mother and mother has been stuffing from depression at ), New immigrant Presenting problem:(self approach)adhd, Higher anxiety reaction, No friends What s SBU provided? Family based counselling:to find out the family communication pattern. In this case we have find that there are two main problem : 1. Wong s anxiety was coping from her mother and her mother has too much worry and unsettle issue, such as: Her marriage, her role of new immigrant. etc. 2. There is a cycle between family, Wong s mother always complain her daughter didn t Art therapy : handling her inner self, including the anger and anxiety coming from her family. Psych-education group : To more understand her mother. Big Brother and Sister project and : Building up her social support network Family Program:Building up her social network and higher quality time with her mother. Love@ Home (Home refreshment project):provide a better environment for Wong study.

14 We therefore advocate. Use of Family Approach Interventions for the whole family, both parents and children Hence, cooperation with other helping professions is in need

15 Referral Source Internal referral SWD HA Others NGO School Self Unknown No. of Case

16 Referral Source Referral Source Internal referral SWD( 社會福利署 ) MSW IFSC PCP CPN OT Others NGO School Self Unknown No. of Case

17 Medical Setting (medicine) SWD (Social welfare) Community ( Social Network) Family ICCMW (Parent emotional support) School (Academic/ Social expression) SBU

18 Medical Setting (medicine) SWD (Social welfare) Community ( Social Network) Family ICCMW + ICCMW SBU (Parent (Family emotional emotional support) support) School (Academic/ Social expression) SBU

19 REACH program (Singapore) (Response, Early Assessment and intervention in Community mental Health A community partnership program) Involves a partnership between the ministry of education and the ministry of health School centred, has involved Singapore's nearly 400 schools

20 Function of REACH teams Clinical services in collaboration with school counselors and government agencies; and sorting patients for secondary and tertiary care Training for school counselors in identifying mental health disorders Integrating care by promoting linkages between schools, social and community agencies, family doctors and mental health service providers including coordinating inter agency consultations and case conferences Mental health promotion programs in schools and social service agencies data/assets/pdf_file/0006/510792/singapore_pp79 84.p

21 Positive Behavior Support (PBS) in U.S. schools A widespread strategy used in schools in the U.S. Prevention for All Students: promoting positive behaviours; implementing rewards and consequences system; identifying students with patterns of problem behavior who may need more specialized interventions. Different levels of Interventions for Students: identifying students in one of primary, secondary and tertiary categories for intervention and support based on level of risk or problem behaviour; cross system support team with community mental health and family involvement. Collaboration and Support from Community Partners: obtaining support from families, the mental health system, the school district, the state, and the community. file/pbis%20issue%20brief.pdf

22 Kidsmatters (Australia) The four components of KidsMatter are: A positive school community Sense of belonging and inclusion within the school Collaborative involvement of students, staff, families and the community in the school Social and emotional learning for students Effective social and emotional learning curriculum taught regularly to all students Opportunities for students to practise and generalise SEL skills Parenting support and education Effective parent teacher relationships Provision of effective parenting information, education and skills training Opportunities for families to develop support networks Early intervention for students experiencing mental health difficulties Processes for addressing the needs of students experiencing mental health difficulties education about how to recognise students in need facilitation of access to early intevention and identification of referral pathways

23 Prevention of Children Mood Disorders Pilot Program : 樂天 Buddies 計劃

24 Pilot program : 樂天 Buddies 計劃 Primary prevention: Parents talk 如何培養樂天孩子 Secondary prevention Screening of students higher in depressive mood Afterschool psycho educational group for students having depressive disposition Tertiary intervention Therapeutic group Casework (art/play/family therapy)

25 樂天 Buddies 小組 (Pilot Run) Coordinating with personnels of 4 primary schools to arrange for mental health screening Conducting preventive groups afterschool at 3 schools for students with subclinical mood problems Content of group modified from FRIENDS, an Australian school anxiety/depression preventive program

26 Outline of Group Session 1 : Introduction Session 2 : Knowing your feelings and responses Session 3 : Thoughts, feelings, behaviour; helpful thoughts vs. unhelpful thoughts Session 4 : Challenging unhelpful thoughts Session 5 : Coping with difficulties in small steps Session 6 : Getting support Session 7 : Problem solving skills Session 8 : Appreciating and rewarding oneself Session 9 : Review, putting it together Session 10 : Revision Game and celebration

27 樂天 Buddies 小組

28 Group Material

29 樂天 Buddies 小組

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31 樂天 Buddies 小組 Feedback from some participants: 好玩 知多咗情緒既野 會試下用 d 方法 Feedback from some parents 佢好鍾意去個小組 黎左小組之後好似在家少咗發脾氣 焦慮情況改善咗

32 Limitation and Difficulties Time of each session is limited and some students have resistance to stay after school Ideal if program can be within school curriculum Program design accommodating children s learning characteristics

33 Conclusion Enhancing children mental wellness must start with concerning parents emotional health, parenting and multi disciplinary family support approach, and make mental health service accessible for the family. Efforts should emphasize preventive care for high risk children and family. Developing more inter communication with district community partners is important. In most desirable condition, children mental wellness service provider (eg SBU) included in ICCMW, and initiate cooperation between schools, family service and medical sector for consolidating parents emotional and their recovery support, and also children welfare Introduce preventive work at schools in order to benefit all children Mental Wellness Community education (Including school programs) basing on prevention and early intervention of suspected mental illness aspects both for children and adults. More attention need to be paid to cultural context and cultural competence like new immigrants adjustment.