The Equal Opportunities Commission (EOC) has released today (7 July 2016) the findings from the “Study on the Challenges Encountered in the Siting of Integrated Community Centres for Mental Wellness and other Social Welfare Facilities in Hong Kong”. The Study revealed that the challenges faced by the Integrated Community Centres for Mental Wellness (ICCMWs) is another example of the “Not in My Backyard” syndrome. Instead of solely blaming the selfishness of some leaders and residents of the community, the Study illustrated that the public misunderstanding of persons with mental illness and mental health facilities is the underlying reason for such resistance, which is intensified by the less than perfect public consultation process. The EOC believed that there is room for improvement in the public consultation process, and requested the Government to consider increasing the land supply for social welfare use.

Prof. Alfred CHAN Cheung-ming, the EOC Chairperson explained the purpose of the Study: “The Government announced in the 2009-2010 Policy Address that ICCMWs would be set up in all 18 districts in Hong Kong to provide all discharged mental patients, persons with mental illness, their families and carers, as well as persons with suspected mental health problems and other residents living in the community with one-stop, district-based and convenient support services and rehabilitation services. However, the Government and the service operators have repeatedly faced opposition and difficulties when trying to identify permanent sites for the ICCMWs. In view of this, the EOC decided to conduct this Study to examine the difficulties in securing permanent accommodation for ICCMWs, and help eliminate misunderstanding of the nature of services of ICCMWs and discrimination against persons with mental illness.

The Study featured interviews with the persons-in-charge or representatives of all 24 ICCMWs (a total of 28 persons) across the 18 districts to understand the issues of providing services at temporary sites, the difficulties in securing permanent sites for the ICCMWs, in particular, the challenges faced by ICCMWs during public consultation. The Study also examined two cases of strong community opposition – one concerned the opposition to the setting up of an ICCMW in Wu King Estate, Tuen Mun, while the other concerned the case of resident opposition to the first proposed site of the Tung Chung Special School. In addition, the issues that emerged from the problematic siting, including the unsatisfactory size and quality of both temporary and permanent sites, as a result of community opposition, were also detailed in the report.

In respect of the issues that arose during the public consultation on the siting of the ICCMWs, the Study showed that out of the 24 ICCMWs, 19 had conducted public consultation. Among these, 6 ICCMWs, according to their persons-in-charge, encountered no objection during the process. The service operators/interviewees of 4 ICCMWs did not take part in the public consultation exercise. The persons-in-charge of the remaining 9 ICCMWs said that there was opposition during public consultation and the most frequently raised reasons for opposing to the setting up of an ICCMW were: “Persons with mental illness / ex-mental patients have a propensity for violence”; “Service users of ICCMW would cause disturbance to the residents”; “The setting up of an ICCMW will attract persons with mental illness to congregate in the neighbourhood”; and “The setting up of an ICCMW will have a negative impact on the law and order of the neighbourhood”. Overall, while community leaders and residents might recognise that the ICCMWs are necessary, they maintained the “Not in My Backyard” attitude and opposed to locating the facilities in their locality.

According to the consolidated views of the persons-in-charge of the ICCMWs, community leaders played a determining role in the public consultation. Where community leaders did not support the siting, it would be very difficult for the Social Welfare Department to obtain residents’ support. Also, the approach for public consultation varied between districts. There was no standard rule as to how the consultation should be conducted, and how long the process should take. Very often, the public consultation relied solely on the community leaders to convey the relevant information, such as on the proposed site and the nature of services, to the residents, whereas details about the proposed site are rarely disclosed directly to the residents by the relevant departments. Such a lack of transparency contributed to the misunderstanding of the nature of services of the ICCMWs. Furthermore, the approach in handling the opposition also varied, with some Government officials retreating and some standing firm.

“The above-mentioned reasons of objection reflect that the persons who opposed to the proposed permanent sites of ICCMWs did not fully understand or even misunderstand mental illness. Such misunderstanding very often arises from a lack of awareness of mental health issues, and is closely linked to prejudice and even discrimination,” said Prof. Chan. “Indeed, persons with mental illness and ex-mental patients are often stigmatised as having a propensity for violence. Once such stigmatised label is repeated often enough, people will believe it,” said Prof. Chan.

Because of the opposition from local communities, a number of ICCMWs have to operate in temporary accommodation or identify alternative sites, leading to a number of issues, including the unsatisfactory size and quality of both temporary and permanent sites. As at February 2016, only 14 out of the 24 ICCMWs are operating in their permanent sites. In fact, 10 ICCMWs (42%) are still providing services in temporary site/accommodation. The terms of tenancy, as well as the size and location of the temporary sites all affect the quality and quantity of service, and may even hinder the provision of certain services. For example, owing to the insufficient drop-in service which allows the service users to visit the ICCMWs without making appointment in advance, the incentive for service users to visit the ICCMW has been reduced. As a result, service users would have fewer opportunities to seek help from social workers. In addition, some counselling services have to be provided in fast food restaurants due to space constraints of the temporary accommodation of ICCMWs, which is not satisfactory.

Prof. Chan added, “The community resistance encountered by the ICCMWs cannot just be ascribed to the selfishness of the leaders and residents of the community. Instead, we should be concerned about the misunderstanding of persons with mental illness underlying such resistance. While the imperfect public consultation deepened the misunderstanding of the services and service users among the local residents, which in turn intensified the voice of opposition against these facilities, the supply of land for social welfare use is insufficient to meet the demand.”

Based on the findings, the EOC has made a number of recommendations for action by the Government and other key stakeholders. These include refining and regularising the public consultation exercise, and enhancing mental health education of community leaders and the public. Specifically, the EOC has recommended the establishment of a community liaison group in each district to provide a platform for residents to express their views and to continue monitoring the operation of the ICCMW after it has moved into the neighbourhood. There should also be more proactive release of information to the public, and the provision of direct channels for communication with residents. The Government is also recommended to take a more proactive approach in identifying and supplying land for social welfare use, such as making use of vacant Government premises to alleviate the space constraints of temporary accommodation of ICCMWs, and requesting urban renewal projects and private development projects to incorporate more social welfare facilities.

In addition, the EOC suggested that the Commission should be empowered to take legal action in its own name to stop discriminatory behaviour and improving supply of social welfare land use. “The Government should introduce amendments to the relevant legislation to enable the EOC to take remedial action in its own name where appropriate, that is, to apply to the court for declaratory and/or injunctive relief in its own name against discriminatory acts, in particular in respect of harassment and vilification.” said Prof. Chan. “According to the Report on Case Study of Kowloon Bay Health Centre released by the EOC in November 1999, the victims of discrimination were afraid that disclosing their identity would further intensify the discrimination against them. This deterred them from seeking redress through the complaint handling mechanism and the remedial actions of the EOC. If the EOC can file a suit to the court in its name, the situation that no legal action can be taken due to the lack of a complainant can be avoided, and the discriminatory acts can be stopped.”

Dr. Ferrick CHU, Director of Policy, Research and Training of the EOC concluded at the press conference: “In combating the stigma and prejudice associated with mental illness, we need the co-ordinated efforts of the Government – in mapping and making long-term planning for the social welfare and mental health policies, and the support of community leaders, residents and indeed everyone of us. The fact is we should recognise that mental health is not someone else’s problem. Every one of us – whether it is our family, friends, colleagues or even ourselves – may experience mental health problems at some point in our lives. We must play our part and strive to build a society of greater inclusion and acceptance, such that all of us can enjoy a fair chance of getting treatment, achieving recovery and leading a healthy, fulfilled life.”

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Equal Opportunities Commission
7 July 2016