Pioneering ethnic minority centre tackles mental health issues

20 December 2020

Mental health issues within Hong Kong’s ethnic minority communities have rarely been highlighted until recently. Now a ground-breaking well-being centre is seeking to address this situation through the provision of services specifically catering for these groups.

The Ethnic Minority Well-being Centre was set up in September 2019 by the Zubin Foundation, an NGO seeking to improve the lives of the city’s marginalised ethnic minorities. The centre is run in partnership with the University of Hong Kong (HKU)’s Department of Psychiatry.

Commencing January 2021, the Croucher Foundation will also be supporting part of an innovative two-year project connected to the centre, along with the Lee Hysan Foundation.

The city’s largest ethnic minorities hail from Indian, Pakistani, Nepalese, Filipino, Thai, and Indonesian cultural backgrounds. Some families have been established in Hong Kong for generations, others are more recent arrivals. Members cover the spectrum from poor to wealthy.

According to a 2019 Hong Kong government report, total numbers stood at about 653 000 constituting 8.7 per cent of Hong Kong’s 7.5 million population. This includes some 390,000 foreign domestic helpers.

For Shalini Mahtani, founder and CEO of the Zubin Foundation, the gap in mental health services was first revealed when her organisation was contacted by a mother concerned that her teenage son had not left his home for several months. Professional psychiatric counselling was arranged on a pro-bono basis.

When Mahtani raised the issue of mental health at a subsequent meeting of the Zubin Foundation’s youth council, one highly educated 21-year-old women also confessed she had tried to take her own life the previous weekend. “The meeting just stopped,” Mahtani recalled.

Further investigation indicated specific mental health issues within the ethnic minority community, related to forced marriage, domestic violence, and poor parental relationships.

As noted by the Zubin Foundation and on HKU Department of Psychiatry’s website, it has been estimated that approximately 44,000 individuals from the city’s ethnic minorities may be suffering from mental health issues.

However, if people from these backgrounds seek mental health support via mainstream channels offered by Hong Kong’s Hospital Authority, and are referred to a psychiatrist, this often means undertaking highly sensitive consultations in English, which is unlikely to be the native language of either the service provider or service user.

“There’s an obvious language barrier, plus a big difference in culture,” Mahtani said. Sensitivity to forced marriage was one clear example, she noted.

As a start to closing this gap, the Ethnic Minority Well-being Centre now offers psychiatric counselling services in Hindi/Urdu and English two days per week over two locations in Hong Kong.

The centre is currently serving over 40 clients, ranging in age from 13 to 65 and encompassing a comprehensive range of ethnic minorities. While all genders are catered for, the majority of clients are female. A waiting list for its services has already had to be set up.

“We are typically dealing with marital issues, domestic violence, unemployment, depression, and anxiety,” Winnie Ng, Zubin Foundation’s project director, said.

The Croucher Foundation’s involvement was triggered by a desire to make a charitable donation following the cancellation of the Foundation’s 40th anniversary celebrations, scheduled for December 2019.

Advice was sought from former Croucher Foundation trustee Mr Wong Yan Lung in his capacity as Chairman of the Hong Kong government’s Advisory Committee on Mental Health on a possible charitable donation in the area of mental health and well-being.

It was Wong, also a former Secretary for Justice in Hong Kong, who highlighted the work of the Ethnic Minority Well-being Centre and connected the Croucher Foundation and Lee Hysan Foundation to the Zubin Foundation.

The two-year mental health intervention programme that the two foundations will support has five components.

Direct counselling to more than 100 service users, capacity building to expand services to five days per week spread across three locations, and a public education and awareness programme will be supported by the Lee Hysan Foundation.

Meanwhile, the Croucher Foundation will fund an evaluation of the effect of the direct counselling and production of a report; and the design of a new service protocol, including assessment, intervention, follow-up and referral process, for future reference.

These two components will be led by the HKU Department of Psychiatry, headed by Professor Eric Chen Yu Hai.

The evaluation and development of the future service will also be carried out in consultation with Professor Dinesh Bhugra, CBE, professor of mental health and diversity at the Institute of Psychiatry at King's College London. Bhugra is a former president of the Royal College of Psychiatrists.

“This has not been done before in Hong Kong, with regard to counselling, and culturally and linguistically appropriate mental health interventions,” Mahtani said.

Research published by Bhugra has indicated that in an increasingly globalised world, migrants, refugees, and asylum seekers show higher-than-expected rates of mental illness and that cultures and cultural identities strongly influence presentation, help-seeking, and therapeutic alliance.

“Cultures influence how psychiatric disorders present, how they see their illnesses. and how they seek help,” said Bhugra, who became involved in the work of the Zubin Foundation to help the development of services accorded to migrants.

Mahtani hopes that the programme will encourage the government to recognise that this sector of the population needs more assistance, and that the service proves to be a valuable intervention that merits long-term funding.

“There has never before been any special health service for different ethnicities, and cultural diversity and inclusion are not yet subjects [that] are embraced by local health providers. We are behind in this area in Hong Kong,” Mahtani said. “That’s why this project is pioneering.”