A Pilot Project: Use of “Sim City”「模擬人生」, a citizenship-based intervention, to enhance community re-entry for psychiatric in-patients.

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Authors (including presenting author) :
Wong KW, Leung YY, Cheng KN, Lo WY
Affiliation :
Occupational Therapy Department, Kowloon Hospital, Hong Kong
Introduction :
Social exclusion is commonly found in people with mental illness. Their lack of valued roles in society made them difficult to access to the mainstream society resulting in dependence in medical care system, which could be a critical factor to discharge in in-patient setting. To fill this service gap, “Sim City”, which was a citizenship-based intervention, was introduced in occupational therapy training. The elements of intervention were modified from the Citizens Project in New Heaven, U.S. and they included: Sim City as a mini-community, skills building, valued roles project, peer mentorship and de-stigmatization. In “Sim City”, a job fair was held every week and patients could apply different job positions (e.g. pianist, café manager, translator, gardener) to serve the “City”. They could volunteer themselves to be peer mentors to share their skills and knowledge through a strength-sharing group leaded by them. Their contribution was rewarded by desired entertainment, acknowledgement from peers and self-fulfillment. This provided a mini-community environment for patients to experience belonging, sense of being needed, valued roles and relationship that they would need to seek in the real community.
Objectives :
The “Sim City” aimed to increase readiness in discharge and community re-entry of psychiatric in-patients.
Methodology :
The “Sim City” was implemented in occupational therapy. Convenience sampling was used. Participants who had attended occupational therapy training before and after the implementation of the “Sim City” from a psychiatric rehabilitation ward were recruited. The participants were invited to complete a survey, which consisted of 15 items and was rated on a 4-point Likert scale to evaluate their changes in life skills and confidence in community living.
Result & Outcome :
Results: 9 participants (6 females and 3 males, aged from 26 to 68) were recruited. According to the survey, all of them either agree or strongly agree that the project could enhance their sense of responsibility to manage their life goals, time and work stress management, self-initiative in planning daily schedule and confidence in returning to community. In addition, all of them either agree or strongly agree that their motivation, feeling of being needed, meaning of attending training were increased after the introduction of “Sim City” in occupational therapy. Conclusion: Preliminary findings suggested the simulated community environment in occupational therapy could improve life skills and readiness in return-to-community for adult psychiatric in-patients. It also results in additional benefit of improving patients’ motivation in attending training.

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