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The co-occurrence of mental illness and substance abuse is among the most prevalent mental disorders worldwide. It has become more significant in the United States, Europe, and Hong Kong, and it presents complex issues for both mental health and substance abuse practitioners. This paper explores the historical and conceptual issues on dual diagnosis. In addition, different perspectives on dual diagnosis are crucial for developing public policies and programs to address client needs on the road to recovery. The dominant view on dual diagnosis has been the medical perspective. This paper describes three more perspectives: moralistic, psychosocial risk, and phenomenological. This broader view on dual diagnosis will benefit both policy and service development for this population. [ABSTRACT FROM AUTHOR]

Reflective practice is also a process of self-reflection by concerned professionals. In this paper, the writer tries to revisit the process and psychopathology of self-reflection described by the prominent German psychiatrist, Karl Jaspers (1883-1972). He affirmed that self-reflection involves self-observation, self-revelation and self-understanding. The implications of Jaspers' view of reflective professional practice are also discussed. [ABSTRACT FROM AUTHOR]

Social work education in China has developed dramatically over the past decade. However, because of its unique social, cultural and political background and contexts, its current and future development faces tensions associated with politicization, professionalization and commercialization in the fields of values, social service delivery, social work practice and curriculum development. [ABSTRACT FROM AUTHOR]

The article describes the vocational rehabilitation services of people with mental illness in China. Several vocational rehabilitation services include work therapy station, mental health services in factories, occupational activities in hospitals, welfare factories and enterprise based sheltered workshops. It examines the dilemmas and implications to the future development of vocational rehabilitation services.

This article suggests a push model for analyzing dilemmas between institutional care, community care and family care of mental-health consumers. In the USA community care is overloaded by inappropriate de-institutionalization. In Hong Kong, family caregivers are severely burdened by poor community care and highly institutionalized services. [ABSTRACT FROM AUTHOR]

The author's nine years' experience in developing social work students' practical reflectivity in working with clients with mental illness is described in this article. By means of various teaching strategies, students' different levels of reflectivity were developed. Promise and challenges to social work education are also discussed. [ABSTRACT FROM AUTHOR]

Clients labeled psychotic and having records of violence have long been seen as dangerous and resistant. Within a medical disease orientation, institutionalization, social control, and medication are applied in treating and rehabilitating these clients. By means of a case illustration, this article shows that violence and psychosis are understandable and predictable. From a strengths perspective, clients with psychosis and records of violence are victims of an oppressive social environment. Empathic understanding and normal interactions within a supportive social environment can rehabilitate them and help them to recover in the community. [ABSTRACT FROM AUTHOR]

In terms of the traditional Chinese medical, Confucian and Taoist schools of thought, Chinese concepts of mental health have a strong impact. All these have significant implications for culturally sensitive or culturally competent social work practice in Chinese communities. [ABSTRACT FROM AUTHOR]

Background: This paper is an attempt to describe the historical development of the mental health services in the PRC. Research Methods: An archive of related literature. Findings: The development of the mental health services in the PRC could be divided into several stages: the introduction of mental asylums by western missionaries before 1949; indigenization of the treatment model after the establishment of the PRC (1949-1963). Strong political control governed diagnosis and treatment as well as detention and discharge of mental patients during the Cultural Revolution (1964-1976). Later, because of modernization and reform advocated by Deng Xiao-ping, western models of treatment and rehabilitation were gradually introduced by psychiatrists in the PRC. Nevertheless, dilemmas such as human rights versus political control, community integration versus community control, diversity versus centrality, huge demand but inadequate services seemed to challenge the further development of the mental health service in the PRC. [ABSTRACT FROM AUTHOR]

Depression has long been a problem in our society. In this paper, the writer tries to contrast a disease orientation and a strengths perspective in helping an adolescent with depression. The strengths perspective advocates identifying needs and ability behind client's symptoms and deficits; nurturing individuals' positive mood and hope to recovery; establishing enlightening encounter between worker and client; and developing positive coping in working with individuals with depression. [ABSTRACT FROM AUTHOR]

Family services and intervention for persons with mental illness is crucial in mental health services. In this paper, the writer attempts to describe family intervention and services for persons with mental illness in the People's Republic of China. Family intervention and services like home-based care, guardianship network, family counseling, and psychoeducational programs are only preliminarily developed. Their effectiveness and challenges in future development are discussed. [ABSTRACT FROM AUTHOR]

Family caregiving is very important in psychiatric rehabilitation for people with mental illnesses. By reviewing related studies, the writer describes the situation of family caregivers for people with mental illnesses. Studies showed that only 16.8% of them received psychiatric rehabilitation services. The other 83.2% relied on their family caregivers as the only support in their rehabilitation process. Forty percent of people with mental illnesses were cared for by their mothers. However, most of these family caregivers were fatigued and at risk of mental breakdown. [ABSTRACT FROM AUTHOR]

Starting with Jaspers in 1910, subjective psychotic experiences of people with schizophrenia became an important area in treatment and rehabilitation of people with schizophrenia. Nevertheless, this area of study is overshadowed by the statistically and diagnostically oriented DSM movement. In this article, the writer tries to re-visit various approaches in understanding subjective psychotic experiences of people with schizophrenia. It seems that subjective psychotic experiences represent persons' inner feelings; their spontaneous struggle in their process of treatment and rehabilitation. All these experiences are meaningful for the persons with psychiatric disabilities. In this paper, the writer tries to show that empathetic understanding of subjective experience can help individuals to re-establish a meaningful relationship with people with schizophrenia and motivate them to become involved in their own rehabilitation process. [ABSTRACT FROM AUTHOR]

Spirituality and religious coping is an important and rapidly expanding field in recent years. For the Chinese, traditional Taoism may still have a strong impact on the mental health of Chinese people. Taoistic concepts of mental health stress the transcendence from self and secularity, the dynamic revertism of nature, integration with nature and the pursuit of the infinite. Compared with western concepts of mental health, Taoism advocates self-transcendence, integration with the Law of Nature, inaction and infinite frame of reference instead of social attainment, self-development, progressive endeavor and personal interpretation. By means of a case illustration, the writer tries to describe its impacts on help-seeking, stress and coping, and the meaning of life of a Chinese family. Its generalization to different types of Chinese communities is also discussed. [ABSTRACT FROM AUTHOR]

In a qualitative study of parental influence on and response to self-cutting of adolescents in Hong Kong, findings showed an unhappy childhood because of overdemanding parental expectation, parent-child conflicts, and marital discord. Supportive parents helped children to resolve frustration and interpersonal conflicts behind self-cutting behaviors. However, some parents, overwhelmed with guilt, frustration, incapability, and anxiety in dealing with their children's self-cutting, might overreact and provoke further cutting. [ABSTRACT FROM AUTHOR]

Discusses the impact of traditional Chinese religious beliefs and superstitions on the psychopathology of mental illness in Hong Kong, China. Effect on contents, manifestation and meaningfulness of delusion and hallucination; Information on the Budhist gods; Historical background on Taoism.

Dual diagnosis has gradually become a problem among adolescents in Hong Kong. In working with persons with dual diagnosis, professionals are accustomed to use a disease model in diagnosis, treatment, and rehabilitation. By means of a case illustration, the writer tries to contrast a disease orientation and a strengths perspective in working with persons with dual diagnosis. The disease orientation stresses: addiction and mental illness; intoxication and dependence; symptoms and diagnosis; detoxification and treatment; confusion and control as well as resistance and labeling. The strengths perspective focuses on: decoding frustration and emptiness from addiction; searching for strengths to satisfy normal needs; establishing social support and encouraging participation in a healthy environment; re-anchoring self-confidence and capability development as well as maintaining empathetic trust. In this case, with the strengths perspective, the writer successfully helped an adolescent to re-build his self-confidence and re-establish a healthy social support system to live a normal life. [ABSTRACT FROM AUTHOR]

Presents a study that described a mutual-aid group implemented in a psychiatric half-way house in Hong Kong, China. Background on mutual-aid groups; Information on the psychiatric rehabilitation in Hong Kong; Stages of the development of the mutual-aid group.

Work and employment has long been regarded as crucial for the mental health of human beings. Unemployment may lead to deterioration of physical and mental health. Nevertheless, for adults with psychiatric disabilities, discontinuity of employment is common. They may have various reasons to discontinue their employment. In Hong Kong, only 2.5% of people with psychiatric disabilities discharged from sheltered workshops are able to seek open employment. By means of illustration, the authors will show that traditional Chinese work culture tends to reinforce the discontinuity of employment of adult males with psychiatric disabilities. In Chinese culture, work is a means to occupy time, control misbehavior, show consistency of words and deeds, and to glorify parents and ancestors. All these factors contribute to the fulfillment of an adult male role and identity in traditional Chinese culture. In this case history, instead of finding realistic employment, a male adult with psychiatric disability tried to indulge himself in what he felt was his ideal job to fulfill all requirement as an adult male in Chinese culture. The imaginative ideal job gave him excuses to discontinue open employment. Its implications to vocational rehabilitation with male adults with psychiatric disability are also discussed. [ABSTRACT FROM AUTHOR]

Harry Stack Sullivan's concept of interpersonal psychiatry has been recognized as a landmark in the American psychoanalytic movement, in particular his influence on the development of object-relations theory. He is an influential figure in interpreting the inner experiences of persons with schizophrenia. Psychotic experiences represent a failure of one's self-system and the dissociation dynamism. Delusions and hallucinations are experiences in lost control of self-awareness. The person regresses to dreams or experiences from infancy and childhood in facing spontaneous conflicts and anxiety in interpersonal transaction. As a result, the tripartite self-system is fractured. In this paper, the writer applies Sullivan's concept in interpreting the inner psychotic experiences of a client with schizophrenia. Its implication for clinical social work practice is also discussed. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study of peer responses to self-cutting of secondary school adolescents in Hong Kong. Through semi-structured in-depth interviews with three adolescent self-cutters, their family members, and their peers, the peers' response to adolescents' self-cutting was explored. The findings showed that different peers had different types of influence, as well as different responses to self-cutting. Close and supportive peers were usually the first to discover the self-cutting. They were a source of help, communicating with parents, friends, teachers, and the adolescents themselves. In contrast, non-supportive peers, especially boyfriends or girlfriends, created conflicts that seemed to provoke self-cutting. The findings' significance for social work intervention is also discussed. [ABSTRACT FROM AUTHOR]

Examines the informal community care for mental health consumers in China, Hong Kong. Influence of public discrimination in the community integration; Ways to develop the informal community care projects in the place; Factors hindering the development of informal community care.

The article is a critical review of the community care movement in Great Britain and the U.S. and its implications for social work practice. Parallel to the developments in Great Britain, the communities care movement in the U.S. developed quickly after the Second World War and flourished in the 1970s. The National Mental Health Act of 1946 was passed in 1947. This act created the National Institute of Mental Health to provide research and training grants to develop community-based psychiatric services as well as close down mental-health hospitals. In the 1980s, the practice of community care was under critical review by professionals and policy-makers in Great Britain. In 1986, two important papers, "Making a Reality of Community Care" and "Community Care: An Agenda for Action," were published by the government. In these two reports, the gloomy picture of community care for the mentally ill and other disabled groups was critically reviewed. Similarly, in the U.S., the practice of community care was under criticism. In 1984-5, a Delphi process study found that 42 states had no consensus on the support of chronic mental patients being treated outside institutions.

Presents a response by Kam-shing Yip to a letter to the editor about his article "Taoism and Its Impact on Mental Health of the Chinese Communities," in a 2004 issue of the "International Journal of Social Psychiatry."

Presents letters to the editor referencing articles and topics discussed in previous issues. Description of the subjective and objective experience of depression; Appreciation of the relevancy of articles which appeared in the July 2002 issue of "Social Work."

The article suggests that classical Chinese Taoism may have an insightful reflection in the aftermath of the September 11, 2001 terrorist attacks. Classic Taoism stresses that nature is in a dynamic revertism. Koeing and Spano described this as holistic dualism, which means the recognition of the complementary and interrelatedness of opposites. Positive and negative, wealth and poverty, suffering and blessings, moral and immoral are only but two sides of the same coin. In terms of Taoism, attainment, wealth and reputation as symbolized by the World Trade Center, are not imperishable. Unfortunately, the center became the target for the terrorists. One should rely on perishable things, such as materialism, a strong economy and prosperity. After September 11, none of us can escape from a realization of the issue of life and death. The means to an end, moral and immoral, are relative and complementary. Without immorality, morality can be distinguished. In the September 11 attacks, the immorality of the attacks sparked the patriotism of U.S. citizens. Within a day, the spirit of New York City sublimated from materialism and crime to holy and purified mutual help, humanistic concern and consolidated resilience.

Presents letters to the editor referencing articles and topics discussed in previous issues. "Co-Constructuring Cooperation With Mandated Clients," which focused on how social workers can deal with mandated clients; "Reflections and Farewell," which discussed social work practice.