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TEDx Taipei 林知遠 花蓮玉里精神病院的故事
1. Beyond the Walls
The Stories of Yuli Veterans Hospital
Resources never meet the needs.
But creativity always turn things around.
Chih-Yuan Lin
Yuli Veterans Hospital
3. Yuli Veterans Hospital
• Yuli with barely thirty thousand inhabitants
accommodates multiple ethnic groups of
people.
• In addition, thousands of people throughout
Taiwan who suffer chronic and severe mental
illness have been transferred to Yuli Veterans
Hospital ( YVH ).
5. The Patients in YVH
The Mentally Ill
in general
present
Minority: the most dysfunctional
and treatment-refractory
The mentally Ill
in YVH
past The Mentally Ill
in general
Minority: veterans
and
dependents
The Mentally Ill
in YVH
6. The patients in YVH are the most dysfunctional and
treatment-refractory with multiple needs.
7. • For decades, YVH was the most
disgraceful and disadvantageous mental
hospital in Taiwan.
• It was the symbol of stigma, ostracism
and no hope. The “Alcatraz Island” for
the mentally ill in Taiwan.
8. Questions
• What if the patients cannot return to
their community of origin?
• Can we build an environment where
they can resume normal life and reclaim
their dignity in Yuli?
9. Shaped By Vision
Wandering no more,
we find our “new home”
and resume our new life
in this beautiful town
between the meandering river
and gorgeous mountains.
10. Therapeutic Community of YVH
In the Yuli model we extend the therapeutic
community beyond the walls of Yuli Veterans
Hospital to the Yuli town.
From hospital to community, a continuous and
balanced treatment model.
11. Home is Where You Make It
-- Therapeutic community, Yuli Model
--
These puppets were made by a mentally ill veteran.
His home, where he never returned since he left,
Was on the other side across the Taiwan Strait.
He put the puppets on his bed in hospital
And worshiped them at dawn and dusk,
In memory of his heart-broken parents
Sending him away to army.
After he died,
I kept them in my studio for nearly 20 years
To remember all the patients
Who could only return their homes
And see their families in dreams.
Huang, Ai-Ling
20
21. Outlines of YVH Reform
Diversify and Enrich the Service Programs
22. Four Components of YVH Services
Medical
Support
Residential Employment
Program Program
Case
Management
23. Holistic Medical Support
• We provide continuous psychiatric and
medical care under one administrative
roof, which minimizes problems with
referral as well as barriers associated with
distance and transportation.
24. Intensive Case Management
• Multidisciplinary teams provide
outreach assertive case management.
• To help keep clinical stability but also
work like social ties between the
patients and their immediate social
environment.
25. Employment-Oriented
Vocational Rehabilitation
Three groups in the program:
1 hospital-based training
2 community-based training
3 supported employment
26. Vocational Rehabilitation Worksites
supported Worksites of
employment work community
(full-time) work
11 patients at training patients
29
4 worksites at
8
supported hospital work
worksites
Employment work training programs
part-time
52 patients at 213 patients at
25 worksites 24 worksites
27. Vocational Rehabilitation Worksites
supported Worksites of
employment work community
(full-time) work
11 patients at training patients
29
4 worksites at
8
supported hospital work
worksites
Employment work training programs
part-time
52 patients at 213 patients at
25 worksites 24 worksites
28. Vocational Rehabilitation Worksites
supported Worksites of
employment work community
(full-time) work
11 patients at training patients
29
4 worksites at
8
supported hospital work
worksites
Employment work training programs
part-time
52 patients at 213 patients at
25 worksites 24 worksites
29. Vocational Rehabilitation Worksites
supported Worksites of
employment work community
(full-time) work
11 patients at training patients
29
4 worksites at
8
supported hospital work
worksites
Employment work training programs
part-time
52 patients at 213 patients at
25 worksites 24 worksites
30. Vocational Rehabilitation Worksites
supported Worksites of
employment work community
(full-time) work
11 patients at training patients
29
4 worksites at
8
supported hospital work
worksites
Employment work training programs
part-time
52 patients at 213 patients at
25 worksites 24 worksites
32. Residential Program for Recovery
• High quality accommodation
• Vocational focus
• Empowerment and recovery-
oriented
• Integration with the community
• Multidiscipline service team
• Now there are 240 patients in the
residential program
34. An insect-bitten tea-leaf
Is not necessarily imperfect.
It can still produce
Fragrance and sweet of honey
By rolling and baking
With love and care.
36. Euwdia Social Club
Rock Climbing Dancing Class
Easter Festival Dinner
Picnic
Cooking Training
Recreational Group
X’mas Party Lunch Delivery Service
37. Field studies about Yuli Stories
Asian Models of Excellence in Psychiatric
Care and Rehabilitation
Akiyama T, Chandra N, Chen CN, Ganesan M, Koyama A, Kua
EE, Lee MS, Lin CY, Ng C, Setoya Y, Takeshima T, Zou Y.
International Review of Psychiatry. 2008 Oct; 20(5):445-51
http://www.ncbi.nlm.nih.gov/pubmed
38. Mental Hospital Reform in Asia:
the Case of Yuli Veterans Hospital
Chih-Yuan Lin, Ai-Ling Huang, Harry Minas, Alex Cohen
International Journal of Mental Health Systems, 2009 3:1
http://www.ijmhs.com/content/3/1/1
39. -
Listening to the Whispers in the Desert
Psychiatric Rehabilitation, Yuli Model
Ailing Huang
40. WHO
5th International Conference on Mental Health System Development
in Taiwan , to be held in T aipei, , October 7 -9, 2007
2006
2007
WHO
2007/10/7 10/9 7-9, October 2007
---------------------------------------------------------------- ------------------------------------------------
10/7 -10/8 7-8, October ( Taipei Medical University)
10/9 9, October (Yu -Li Veterans Hospi tal)
Major issues
1. 1.The epidemiology of mental disorders
2. 2.The effectiveness of treatments
3.Major barriers to mental health system development
3.
4.Community mental health service s and challenges
4.
5.Hospital reform and challenges
5.
41.
42. What are the core values of Yuli
Stories?
• The decent facilities, services or even
researches??
• Resources never meet the needs but the
creativity and entrepreneur spirit turn the
disadvantages into advantages, and turn the
obstacles into opportunities!
• Try hard and venture jointly to avoid being
stuck in the middle, “M”.
43. What are the core values of Yuli Stories ?
We believe the patients deserve the better
life in Yuli than the life they would have
back their home and community of
origin!!
44. Would their “new home”
survive and even thrive in the future?
Home, not only Wandering no more,
A place or we find our “new home”
A group of people, but also and resume our new life
A number of shared memories in this beautiful town
A sense of belonging between the meandering river
A bond of affection and gorgeous mountains.
45. Call for Action
Would the younger generation have the courage
and vision to carry on this belief and mission,
and to keep reinterpreting the Yuli stories?
The stories may shed light on the reform of
psychiatric services in Taiwan.
46. Broken Bottle
If possible
Please let me hold a handful of clean water
from Siouguluan River for you.
If you could
Please for me put a bundle of rape flowers from
the riverside.
Or
Let the pieces of my body
turn into the wind-bells attending you in the
porch.
