07 Feb 2012

In Hong Kong, there are about 600 security companies registered with Security and Guarding Services Industry Authority and are eligible to provide guarding services to housing estates. With increasing emphasizes on early detection of psychosis and importance of community reintegration during the recovery process of patients with psychosis, the role of security officers is becoming more important. Their knowledge about psychosis and skills of interacting with patients would be critical. The needs for security officers to better equipped in handling patients with psychosis have been further revealed by several tragic incidents involving patients and security officers since 2010.

A survey on the knowledge about psychosis of security officers in Hong Kong has been conducted. A total of 78 security officers participated. They were assessed with an 8-item questionnaire focusing on cause, symptoms, treatment and outcome of psychosis. 26% of security officers able to correctly point out the cause of the illness but 67% of them thought stress is the main cause. Half of the security officers can recognise psychotic symptom.

In view of the needs, The Jockey Club Early Psychosis (JCEP) project has organized a series of 16 workshops for the security officers since 2010 with the aim to improve their knowledge about psychosis and skills in interacting with patients with psychosis. Thus far 81 companies and 735 security officers/company managers have participated. A posttraining survey of the same group of security officers revealed that their knowledge about psychosis has improved significantly by 25%. During the training, participants have pointed out their main concerns and difficulties are as followings:

1. Difficulties in handling repeated complaints from patients regarding neighbors eg noises, strange smell and being monitored.
2. Aware of the presence of psychotic symptoms of a resident but not sure how to provide help.
3. Feeling difficult to interact with people with psychosis who appear agitated.

Appropriate interaction and help from the security officers to patients can greatly reduce the likelihood of tension between security officers and patients and support the recovery process of patients in the community. Base on our experiences, here are the suggested simple tips for security officers:

DOs	DON'Ts
Using appropriate tone and slower speed of speech	Avoid loud and fast speech
Be calm, using simple and clear language	Avoid using long and complicated language
Beware of personal safety	Avoid agreeing or disagreeing with the content of the psychotic symptoms
Have local information about psychiatric services ready and make appropriate action when needed

The needs for continue training and support of security officers are obvious. Providing education workshops tailored to the specific needs of security officers will not only allow them to be better equipped but also enhance the process of community reintegration of patients with psychosis. This will continue to be one of the focuses of the JCEP project. However further resources and collaborations will be needed to improve the training of security officers and establishing efficient training system.

About Psychosis

Psychosis refers to a set of symptoms that include hallucinations, delusions, and disorganized thoughts and speech. It is a physiological condition related to an imbalance in certain chemicals in the brain called "neurotransmitters". Multiple aspects of a person’s life can be affected by this condition, including psychosocial wellbeing and functioning. Symptoms can be effectively controlled by medications that modulate neurotransmitter activities, and patients benefit from psychosocial intervention especially during the early stage of the disease. For more information, please visit: www.jcep.hk

About Jockey Club Early Psychosis ("JCEP") Project

Led by the Department of Psychiatry, The University of Hong Kong Li Ka Shing Faculty of Medicine, JCEP is a fiveyear project, set up with $69 million donation from The Hong Kong Jockey Club Charities Trust, organised in collaboration with Hospital Authority, Caritas-Hong Kong and the Mental Health Association of Hong Kong. A multidisciplinary team, comprising social workers, nurses, occupational therapists and researchers, has been set up to serve early psychosis patients aged over 25. It is expected that about 1,000 patients will receive individualised, phase-specific intervention services in the first two to four years after their first episode of psychosis. The team will provide specialised case management and psycho-social interventions by engaging the patients through home visits, phone contact, webbased communication and tracking system. Support for affected families will also be offered to help patients attain a full functional recovery.

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