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Fan Fang
Kaitlyn Fung


The community psychiatric service in Hong Kong started after a mass murder by a man with severe mental illness (SMI). Fear-based stigmatization remains common in the community. Although recovery-oriented care gradually takes root in Hong Kong, it flourishes mainly within the mental health sector. People with SMI remain isolated from the rest of the residents. Recovering-citizenship might help fill the service gap and facilitate a true social inclusion of people with SMI in the community. However, we need to pay attention to several possible challenges when adapting the recovery citizenship concept in Hong Kong. First, citizenship is a complex concept for people in Hong Kong. Second, the New Public Management (NPM) regime adopted in the social welfare sector significantly impacted the services for people with SMI. Third, traditionally, “Face Concern” is a potential cultural barrier for people with SMI and their families to connect to society fully. In respect of these challenges, implementing qualitative and quantitative research to capture the exact meaning of citizenship to Hong Kong people is the first essential step in putting this theoretical framework into practice. Meanwhile, we should bear in mind that recovering citizenship should be promoted in the whole community with the assistance of peer support staff instead of only in the mental health community. Last but not least, the recovering citizenship activities should also include the family of the people with SMI rather than solely targeting the individuals. 

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FANG, F.; FUNG, K. WHEN IT COMES TO EAST: REFLECTIONS ON TRANSFERRING THE PRINCIPLES AND PRACTICE OF RECOVERING-CITIZENSHIP TO HONG KONG. Cadernos Brasileiros de Saúde Mental/Brazilian Journal of Mental Health, [S. l.], v. 13, n. 35, p. 43-63, 2021. Disponível em: https://periodicos.ufsc.br/index.php/cbsm/article/view/82125. Acesso em: 10 ago. 2022.
Artigos originais
Biografia do Autor

Fan Fang, Kwai Chung Hospital

BS, M.S.Sc., Department of Clinical Psychology, Kwai Chung Hospital, Hong Kong SAR, China.

Kaitlyn Fung, Tuen Mun Hospital

 BS, M.S.Sc., Psychological Behavioral Unit, Tuen Mun Hospital, Hong Kong SAR, China.


ABERBACH; JOEL D; CHRISTENSEN, TOM. Citizens and Consumers. Public Management Review, 7(2), 225–246. 2005

ALDERLEY, H. M., WHITLEY, R. Family influence in recovery from severe mental illness. Community Mental Health Journal, 51, 467–476.2015

BOX, R. C., MARSHALL, G. S., REED, B. J., REED, C. M. New public management, and substantive democracy. Public Administration Review, 61(5), 608-619.2001

BRAY, M; LEE, W. O. Education, democracy and colonial transition the case of Hong Kong. International Review of Education, 39(6), 541-560.1993

BREWER, B. Citizen or customer? Complaints handling in the public sector. International Review of Administrative Sciences, 73(4), 549–556.2007

BRUCE, L. IMANI Breakthrough honored for transformational work in the community. Retrieved from https://medicine.yale.edu/news-article/21995. 2019

CARITAS HONG KONG. A Survey Report on the Acceptance of Psychiatric Halfway House. Hong Kong: Central Community Service Centre of Caritas Hong Kong.1987

CHAN, K., EVANS, S., CHIU, M. Y. L., HUXLEY, P. J., & Ng, Y. L. Relationship Between Health, Experience of Discrimination, and Social Inclusion Among Mental Health Service Users in Hong Kong. Social Indicators Research, 124(1), 127–139.2015

CHAN, K., EVANS, S., Ng, Y. L., CHIU, M. Y. L., HUXLEY, P. J. A Concept Mapping Study on Social Inclusion in Hong Kong. Social Indicators Research, 119(1), 121–137.2014

CHAN, K. K. S., FUNG, W. T. W. The impact of experienced discrimination and self-stigma on sleep and health-related quality of life among individuals with mental disorders in Hong Kong. Quality of Life Research, 28(8), 2171–2182.2019

CHEN, E. S. M., CHANG, W. C., HUI, C. L. M., CHAN, S. K. W., LEE, E. H. M., CHEN, E. Y. H. Self-stigma and affiliate stigma in first-episode psychosis patients and their caregivers. Social Psychiatry and Psychiatric Epidemiology, 51(9), 1225–1231.2016

CHEN, F. P., LAI, G. Y. C., YANG, L. . Mental illness disclosure in Chinese immigrant communities. Journal of Counseling Psychology, 60(3), 379–391.2013

CHEN, S. X., MAK, W. W. S., LAM, B. C. P. Is it cultural context or cultural value? unpacking cultural influences on stigma towards mental illness and barrier to help-seeking. Social Psychological and Personality Science, 11(7), 1022–1031.2020

CHIEN, W. T., YEUNG, F. K. K., CHAN, A. H. L.Perceived stigma of patients with severe mental illness in Hong Kong: Relationships with patients’ psychosocial conditions and attitudes of family caregivers and health professionals. Administration and Policy in Mental Health and Mental Health Services Research, 41(2), 237–251.2014

CHIU, M. Y. L., CHAN, K. K. L. Community attitudes towards discriminatory practice against people with severe mental illness in Hong Kong. International Journal of Social Psychiatry, 53(2), 159–174.2007

CHIU S; WONG, V. Hong Kong. In A. Walker, & C.K. Wong (Eds.), East Asian welfare regimes in transition (pp. 73-94). Policy Press.2005

CHOU, K. L., MAK, K. Y., CHUNG, P. K., HO, K. Attitudes towards mental patients in Hong Kong. International Journal of Social Psychiatry, 42(3), 213–219.1996

CHUNG, K. F., TSE, S., LEE, C. T., CHAN, W. M. Changes in Stigma Experience Among Mental Health Service Users over Time: A Qualitative Study with Focus Groups. Community Mental Health Journal,55(8), 1389–1394. 2019

CHUNG, K. F., TSE, S., LEE, C. T., WONG, M. M. C., CHAN, W. M. Experience of stigma among mental health service users in Hong Kong: Are there changes between 2001 and 2017? International Journal of Social Psychiatry, 65(1), 64–72.2019

COGAN, N. A., MACLNTYRE, G., STEWART, A., TOFTS, A., QUINN, N., JOHNSTON, G., ROWE, M. “The biggest barrier is to inclusion itself”: the experience of citizenship for adults with mental health problems. Journal of Mental Health, 0(0), 1–8.2020

COMMISSION EQUAL OPPORTUNITIES. Study on the challenges encountered in the siting of integrated community centres for mental wellness and other social welfare facilities in Hong Kong.2016

CORRIGAN, P. W., SHAPIRO, J. R. Measuring the impact of programs that challenge the public stigma of mental illness. Clinical Psychology Review, 30(8), 907–922.2010

CUI J., LANCASTER, K., NEWMAN, C. E. Making the subjects of mental health care: a cross-cultural comparison of mental health policy in Hong Kong, China and New South Wales, Australia. Sociology of Health and Illness, 41(4), 740–754.2019

DAVIDSON, L., TSE, S. What will it take for recovery to flourish in Hong Kong? East Asian Arch Psychiatry, 24, 110–116.2014

EDUCATION BUREAU. Liberal studies curriculum and assessment guide.2015 (secondary 4 - 6). Retrieved from https://ls.edb.hkedcity.net/file/C_and_A_guide/201511/LS_CAGuide_e_2015.pdf

EIROA-OROSA, FRANCISCO JOSÉ; ROWE, MICHAEL. Taking the concept of citizenship in mental health across countries. Reflections on Transferring Principles and Practice to Different Sociocultural Contexts. Frontiers in Psychology, 8, 1020–1020.2017

EVANS-LACKO, S., LONDON, J., JAPHET, S., RUSCH, N., FLACH, C., CORKER, E., THORNICROFT, G. Mass social contact interventions and their effect on mental health related stigma and intended discrimination. BMC Public Health, 12(1), 1. 2012

FOOD AND HEALTH BUREAU. Mental health review report. 2017 Retrieved from https://www.fhb.gov.hk/download/press_and_publications/otherinfo/180500_mhr/e_mhr_full_report.pdf

IMMIGRATION DEPARTMENT. (n.d.). General information on Chinese nationality. 2017. https://www.immd.gov.hk/eng/services/chinese_nationality/general_info.html

GOVERNMENT SECRETARIAT HONG KONG. Overall review of the Hong Kong education system, Hong Kong Government.1981 Retrieved from http://www.edb.gov.hk/attachment/en/about-edb/publications-stat/major-reports/edsys_e.pdf

HWNAG, K. K.Guanxi and mientze: conflict resolution in Chinese society. Intercultural Communication Studies, 7, 17–42.1997

HO, D. Y. F., FU, W., Ng, S. M. Guilt, shame and embarrassment: Revelations of face and self. Culture and Psychology, 10(1), 64–84.2004

HONG KONG GOVERNMENT. Aims and policy for social welfare in Hong Kong: A White Paper, Hong Kong: Government Printer.1965

KRAMER, E. J., KWONG, K., LEE, E., CHUNG, H. Cultural factors influencing the mental health of Asian Americans. The Western Journal of Medicine, 176, 227–231.2002

LAM, C. S., TSANG, H. W. H., CORRIGAN, P. W., LEE, Y. T., ANGELLl, B., SHI, K., LARSON, J. E. Chinese lay theory and mental illness stigma: Implications for research and practices. Journal of Rehabilitation, 76(1), 35–40.2010

LAM, W. Depoliticization, citizenship, and the politics of community in Hong Kong. Citizenship Studies, 9(3), 309-322.2005

LEE, E. W. Y.Governing post-colonial Hong Kong: Institutional incongruity, governance crisis and authoritarianism. Asian Survey 39(6), 940–959.1999

LEE, J. C. Y.The changing context of public sector reform and its implications in Hong Kong. In A. B. L. Cheung and Jane C. Y. Lee. (Eds.), Public Sector Reform in Hong Kong: Into the 21st Century. Hong Kong: the Chinese University Press.2001

LEE, E. W. Nonprofit Development in Hong Kong: The Case of a Statist? Corporatist Regime. Voluntas (Manchester, England), 16(1), 51-68.2005

LEE, E. W. Y, HAQUE, M. SHAMSUL.The new public management reform and governance in Asian NICs: a comparison of Hong Kong and Singapore. Governance (Oxford), 19(4), 605-626. 2006

LEE, S., LEE, M., CHIU, M., KLEINMAN, A. Experience of social stigma by people with schizophrenia in Hong Kong. British Journal of Psychiatry, 186(2), 153–157.2005

LEUNG, J. C. The advent of managerialism in social welfare: the case of Hong Kong. Hong Kong Journal of Social Work, 36(1n02), 61-81.2002

LI, X. H., ZHANG, T. M., YAU, Y. Y., WANG, Y. Z., WONG, Y. L. I., YANG, L., RAN, M. S. Peer-to-peer contact, social support and self-stigma among people with severe mental illness in Hong Kong. International Journal of Social Psychiatry. 2020 Oct 16;20764020966009

LIU, H. K. The impact of transition from British to Chinese rule on social service delivery systems In Hong Kong. Policy and Politics, 47(2), 331-352.2019

LO, W. H. A century (1885 to 1985) of development of psychiatric services in Hong Kong - with special reference to personal experience. Hong Kong Journal of Psychiatry, 13(4), 21–29.2003

MAK, W. W. S., CHEUNG, R. Y. M. Psychological distress and subjective burden of caregivers of people with mental Illness: The role of affiliate stigma and face concern. Community Mental Health Journal, 48(3), 270–274.2012

MAK, W. W. S., CHEN, S. X., LAM A. G., & YIU, V. F. L. Understanding distress: the role of face concern among Chinese Americans, European Americans, Hong Kong Chinese and Mainland Chinese. The Counseling Psychologist, 37(219–248)2009

MAK, W. W. S., WU, C. F. M. Cognitive insight and causal attribution in the development of self-stigma among individuals with schizophrenia. Psychiatric Services, 57(12), 1800–1802.2006

MATHEWS, G., MA, J., & LU, D. Hong Kong, China: learning to belong to a nation. London; New York: Routledge.2008

PONCE, A. N., ROWE, M. Citizenship and community mental health care. American Journal of Community Psychology, 61(1–2), 22–31.2018

ROWE, M; DAVIDSON, L. Recovering citizenship. Israel Journal of Psychiatry and Related Sciences, 53(1), 14.2016

SALAMON, L. M.Partners in public service: government-nonprofit relations in the modem welfare state. Baltimore, Md: Johns Hopkins University Press.1995

SCHAAP, L; VAN TWIST, M.W.The dynamics of closedness in networks. In W.J.M. Kickert, E.H. Klijn, & J.F.M. Koppenjan (Eds.), Managing complex network, London: Sage Publications, pp. 62-78.1997

SCHENK, C. R. Banks and the emergence of Hong Kong as an international financial center. Journal of International Financial Markets, Institutions & Money, 12(4-5), 321–340.2002

SEEMANA, N., TANG, S., BROWN, A. D., ING, A. World survey of mental illness stigma. Journal of Affective Disorders, 190, 115–121.2016

SIU, B. W. M., TSANG, M. M. Y., LEE, V. C. K., LIU, A. C. Y., TSE, S., LUK, H. S. M., LEUNG, Y. L. Pathway to mental health recovery: A qualitative and quantitative study on the needs of Chinese psychiatric inpatients. BMC Psychiatry, 16(1), 1–11.2016

SUEN, Y. N., CHAN, K. W. S., SIU, L. T. T., LO, L. H. L., CHEUNG, C., HUI, L. M. C., CHEN, Y. H. E. Relationship between stressful life events, stigma and life satisfaction with the willingness of disclosure of psychotic illness: a community study in Hong Kong. Early Intervention in Psychiatry, 1–11.2020

SCOTTISH RECOVERY NETWORK. Citizenship programmes: the experience of students in Scotland and the US. 2017 https://www.scottishrecovery.net/resource/citizenship-programmes-the-experience-of-students-in-scotland-and-the-us/

SULEIMAN, E. N. Dismantling Democratic States, Princeton, NJ: Princeton University Press.2003

SOCIAL WELFARE DEPARTMENT. (1965). Departmental Report (Hong Kong: Government. Printer.1965

SOCIAL WELFARE DEPARTMENT. Social Welfare Services Lump Sum Grant Manual. Edition 2. Hong Kong: Government Printer.2000

THE STANDART. MINDSET College scholarship and award ceremony recognizes Mindset College students' unremitting effort. 2020. Retrieved from https://www.thestandard.com.hk/breaking-news/section/4/161744/MINDSET-College-Scholarship-and-Award-Ceremony-recognizes-Mindset-College-students%27-unremitting-effort

TSAI, J. From antiforeignism to popular nationalism: Hong Kong between China and Britain, 1839–1911. In M.K. Chan (Eds.), Precarious balance: Hong Kong between China and Britain, 1842–1992 (pp.9–25). Hong Kong: University of Hong Kong Press. 1994

TSANG, H. W. H., TAM, P. K. C., CHAN, F., CHEUNG, W. Stigmatizing attitudes towards individuals with mental illness in Hong Kong: implications for their recovery. Journal of Community Psychology,31(4).2003

TSE, S., CHEUNG, E., KAN, A., Ng, R., YAU, S. Recovery in Hong Kong: Service user participation in mental health services. International Review of Psychiatry, 24(1), 40–47.2012

TSE, S., SIU, B. W. M., KAN, A. Can recovery-oriented mental health services be created in Hong Kong? struggles and strategies. Administration and Policy in Mental Health and Mental Health Services Research, 40(3), 155–158.2013

TUNG, C. H. Speech at the celebration of the establishment of the Hong Kong SAR, July 11997A (www.info.gov.hk/ce/speech/cesp.htm).

TUNG, C.H. Speech by the Chief Executive, Mr Tung Chee Hwa, at the Conference on the Review of the Implementation of the Charter for Youth, 1997, Speeches and statements of the Chief Executive of the Hong Kong SAR, Hong Kong.1997 (www.info.gov.hk/ce/speech/cesp.htm).

TUNG C.H.Policy Address by the Chief Executive to the Provisional Legislative Counci, Hong Kong: Hong Kong Government Printer.1997

TUNG, C.H. (1998a) Speech by the Chief Executive at DGS Annual Speech Day Speeches and statements of the Chief Executive of the Hong Kong SAR, Hong Kong.1998 (www.info.gov.hk/ce/speech/cesp.htm).

TUNG, C.H. Policy Address by the Chief Executive to the Legislative Council Hong Kong: Hong Kong Government Printer.1998

TUNG, C.H. The 1999 Policy Address, Hong Kong: Government Printer.1999

THORNICROFT, G., MEHTA, N., CLEMENT, S., EVANS-LACKO, S., DOHERTY, M., ROSE, D., HENDERSON, C. Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet, 387(10023), 1123–1132.2016

WONG, F. K. D., LAM, Y. K. A., POON, A. Knowledge and preferences regarding schizophrenia among Chinese-speaking Australians in Melbourne, Australia. Social Psychiatry and Psychiatric Epidemiology, 45(9), 865–873.2010

YANG, L. H. Application of mental illness stigma theory to Chinese societies: synthesis and new directions. Singapore Medical Journal, 48(1), 977–985.2007

YIP, K. S. A Historical Review of Mental Health Services in Hong Kong (1841 to 1995). International Journal of Social Psychiatry, 44(1), 46–55.1998

YOUNG, D. K. W., Ng, P. Y. N. The prevalence and predictors of self-stigma of individuals with mental health illness in two Chinese cities. International Journal of Social Psychiatry,62(2), 176–185.2016

ZHANG, Z., SUN, K., JATCHAVALA, C., KOH, J., CHIA, Y., BOSE, J., HO, R. Overview of stigma against psychiatric illnesses and advancements of anti-stigma activities in six Asian societies. International Journal of Environmental Research and Public Health, 17(1).2020