Five years on
As we reported in 2020, the first well-being centre specifically catering for Hong Kong’s ethnic minorities began operations in 2019. The Ethnic Minority Well-Being Centre was set up by the Zubin Foundation, an NGO seeking to improve the lives of the city's marginalised ethnic minorities.
Funding by the Lee Hysan Foundation was instrumental in making this happen, and in 2021 Croucher funded an evaluation of the effect of the direct counselling and the production of a report.
We recently caught up with Shalini Mahtani, founder and CEO of the Zubin Foundation, to get an update on the progress of the Centre. We also spoke to Professor Eric Chen from the Department of Psychiatry at Hong Kong University, who was responsible for the initial project evaluation.
Mahtani told us of the extra problems created by COVID just as the project was getting underway, exacerbating economic problems for the community as well as isolation. During that time, the Centre’s services were more needed than ever.
“We really pivoted to an online provision…that I think was the saving grace for some, but it also meant some couldn't participate. But the technology really did work in our favour because it meant at least for those who could get some time on their own, they could give us a call.”
In outlining the need for this project, Chen placed it in the context of a bigger picture of mental health issues in Hong Kong. “Mental health services for the general population in Hong Kong are already stretched in terms of resources and manpower, as well as negative stigma. Individuals in the minority population with mental health problems suffer from a further disadvantage in the need for services with appropriate cultural and language adaptation.”
Looking back, had the Centre served the purpose it set out to achieve?
“Oh, I think hugely so,” Mahtani told us. “We’re now providing the service to those who have mental health needs who are 18 years and above. I think also there’s the change of mindset that takes place when people refer other people—you know, people saying to someone else, 'This has helped me.’ And we also now have a children's counselling centre,” she added.
Eric Chen added, “The programme successfully trains and deploys counsellors and caseworkers with ethnic minority (EM) backgrounds according to a protocol-based service design with the support of local and international academic colleagues. This approach is strategically designed to supplement the mainstream community mental health services. One noteworthy success of the pilot model is the completion of a randomised controlled study, thus providing important evidence for the efficacy of the model in its context.”
And for Mahtani, there’s a second great achievement: “We have used this as an opportunity to engage further with the government on the needs of a community that is fast growing. And the government is now supporting this project, which was always our aim. Last year, the government agreed to fund the Centre on a pilot basis for two years, and we’ve had the funding since December 2023.”
Chen agreed on the importance of government support: “Overall, government support is instrumental in ensuring the long-term viability and success of the wellbeing centre. It provides the necessary resources, recognition, and collaborative opportunities to enhance the centre’s impact and contribute to a more equitable mental health care system in Hong Kong.”
An example of the collaboration that Chen refers to is what happens with those patients deemed at risk of suicide or suffering from addiction. These cases can’t be seen at the centre because they require a psychiatrist, and the Centre doesn’t have one. In such cases, individuals are referred to local to government centres, Integrated Community Centres for Mental Wellness (ICCMW). Mahtani told us, “Our challenge right now is: How do we work with those ICCMWs? Because this is all new; no one's done it before. And so, we're trying to figure this all out.”
Mahtani feels gratitude to all the supporters of the project, including Lee Hysan and Croucher. But above all, she feels it towards the users of the Centre.
“These individuals who don't know us put their trust in us. And some of the issues are very intimate. They're very personal, and they are multi-generational. So I feel gratitude, but I also feel responsibility. Because they've trusted us, we now need to help them. And helping them is not just the one-to-one, which is massive in and of itself, which is what we set out to do. But it's also about making sure that they know they're not alone.”
Chen can see how the Centre has evolved to work with the community and address wider issues. “The Centre has enhanced its community outreach efforts, working to raise awareness about mental health and reduce stigma within EM communities. These initiatives have been crucial in encouraging more individuals to seek support, thereby broadening the centre’s impact. Furthermore, the Centre has embraced data-driven approaches, using feedback and outcomes to refine its interventions continuously.”
Mahtani confirms that this wider approach is part of the strategy. “One of the other things we've started to think about as an organisation is, look at how we feed this knowledge into the mainstream.”
Chen sees lots of learning points emerging from the project. “Firstly, it has highlighted the significant role that cultural and linguistic barriers play in preventing EMs from accessing mental health services. It’s shown that culturally adapted interventions are essential in overcoming these barriers and providing effective support. Secondly, the project has underscored the importance of employing culturally competent counsellors who can relate to the unique experiences and challenges faced by EMs. Thirdly, the project highlighted the importance of having protocol-based service design so that fidelity could be maintained for future upscaling.”
Chen’s point about culturally competent counsellors is echoed by Mahtani as she outlines some of her ideas for the future.
“More doctors are going to be seeing clients who come from the EM population, but if they don't understand their cultural background, then they're not asking the right questions. At the moment, social workers, teachers, and health practitioners have no component of their degree which is focused on marginalised communities,” she told us.
“So, can we produce a certificated course for them? Our work doesn't stop after the one-to-one counselling; it's also about what we learn and what we can share.”