Beyond the Walls
The Stories of Yuli Veterans Hospital
       Resources never meet the needs.
   But creativity always tur...
Yuli
Yuli Veterans Hospital

• Yuli with barely thirty thousand inhabitants
  accommodates multiple ethnic groups of
  people.
...
Yuli Veterans Hospital started from a
very humble beginning in 1957
The Patients in YVH

               The Mentally Ill
               in general
present
                                   ...
The patients in YVH are the most dysfunctional and
     treatment-refractory with multiple needs.
• For decades, YVH was the most
  disgraceful and disadvantageous mental
  hospital in Taiwan.
• It was the symbol of stig...
Questions
• What if the patients cannot return to
  their community of origin?
• Can we build an environment where
  they ...
Shaped By Vision
                     Wandering no more,
                 we find our “new home”
                 and resu...
Therapeutic Community of YVH

In the Yuli model we extend the therapeutic
community beyond the walls of Yuli Veterans
Hosp...
Home is Where You Make It
                 -- Therapeutic community, Yuli Model
                                --
       ...
Outlines of YVH Reform
   Renovating the Facilities
1999
Residential
Program for
Retirement
1999 Residential Program for Retirement




           Recreational Center
2000
Residential
Program for
Recovery
2007 Psychiatry Inpatient Acute Ward
2007 Psychiatry Inpatient Acute Ward
2007 Psychiatry Inpatient Chronic Ward
2007 Yuli Mental Health Research Center
2009 Community Rehabilitation Center
           ( Pu Shih Syue Yuan )
Outlines of YVH Reform
Diversify and Enrich the Service Programs
Four Components of YVH Services


              Medical
              Support

Residential             Employment
Program ...
Holistic Medical Support
• We provide continuous psychiatric and
  medical care under one administrative
  roof, which min...
Intensive Case Management
• Multidisciplinary teams provide
  outreach assertive case management.
• To help keep clinical ...
Employment-Oriented
    Vocational Rehabilitation

Three groups in the program:
1   hospital-based training

2   community...
Vocational Rehabilitation Worksites



           supported     Worksites of
     employment work     community
          ...
Vocational Rehabilitation Worksites



           supported     Worksites of
     employment work     community
          ...
Vocational Rehabilitation Worksites



           supported     Worksites of
     employment work     community
          ...
Vocational Rehabilitation Worksites



           supported     Worksites of
     employment work     community
          ...
Vocational Rehabilitation Worksites



           supported     Worksites of
     employment work     community
          ...
Residential Program for Recovery
Residential Program for Recovery

• High quality accommodation
• Vocational focus
• Empowerment and recovery-
  oriented
•...
( green leaf-
hopper             )
An insect-bitten tea-leaf
Is not necessarily imperfect.
It can still produce
Fragrance and sweet of honey
By rolling and b...
Yuli Community Rehabilitation Center
         Euwdia Social Club 2006
Euwdia Social Club



   Rock Climbing                                    Dancing Class



                        Easter ...
Field studies about Yuli Stories
Asian Models of Excellence in Psychiatric
 Care and Rehabilitation

Akiyama T, Chandra N,...
Mental Hospital Reform in Asia:
the Case of Yuli Veterans Hospital

Chih-Yuan Lin, Ai-Ling Huang, Harry Minas, Alex Cohen
...
-
Listening to the Whispers in the Desert
 Psychiatric Rehabilitation, Yuli Model




                  Ailing Huang
WHO
5th International Conference on Mental Health System Development
 in Taiwan , to be held in T aipei, , October 7 -9, 2...
What are the core values of Yuli
              Stories?
• The decent facilities, services or even
  researches??
• Resourc...
What are the core values of Yuli Stories ?

  We believe the patients deserve the better
  life in Yuli than the life they...
Would their “new home”
       survive and even thrive in the future?
Home, not only                       Wandering no mor...
Call for Action
Would the younger generation have the courage
and vision to carry on this belief and mission,
and to keep ...
Broken Bottle
If possible
Please let me hold a handful of clean water
   from Siouguluan River for you.
If you could
Pleas...
Thanks for Your Attention
TEDx Taipei 林知遠 花蓮玉里精神病院的故事
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TEDx Taipei 林知遠 花蓮玉里精神病院的故事

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  • TEDx Taipei 林知遠 花蓮玉里精神病院的故事

    1. 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
    2. 2. Yuli
    3. 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 ).
    4. 4. Yuli Veterans Hospital started from a very humble beginning in 1957
    5. 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. 6. The patients in YVH are the most dysfunctional and treatment-refractory with multiple needs.
    7. 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. 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. 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. 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. 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
    12. 12. Outlines of YVH Reform Renovating the Facilities
    13. 13. 1999 Residential Program for Retirement
    14. 14. 1999 Residential Program for Retirement Recreational Center
    15. 15. 2000 Residential Program for Recovery
    16. 16. 2007 Psychiatry Inpatient Acute Ward
    17. 17. 2007 Psychiatry Inpatient Acute Ward
    18. 18. 2007 Psychiatry Inpatient Chronic Ward
    19. 19. 2007 Yuli Mental Health Research Center
    20. 20. 2009 Community Rehabilitation Center ( Pu Shih Syue Yuan )
    21. 21. Outlines of YVH Reform Diversify and Enrich the Service Programs
    22. 22. Four Components of YVH Services Medical Support Residential Employment Program Program Case Management
    23. 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. 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. 25. Employment-Oriented Vocational Rehabilitation Three groups in the program: 1 hospital-based training 2 community-based training 3 supported employment
    26. 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. 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. 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. 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. 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
    31. 31. Residential Program for Recovery
    32. 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
    33. 33. ( green leaf- hopper )
    34. 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.
    35. 35. Yuli Community Rehabilitation Center Euwdia Social Club 2006
    36. 36. Euwdia Social Club Rock Climbing Dancing Class Easter Festival Dinner Picnic Cooking Training Recreational Group X’mas Party Lunch Delivery Service
    37. 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. 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. 39. - Listening to the Whispers in the Desert Psychiatric Rehabilitation, Yuli Model Ailing Huang
    40. 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. 41. 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”.
    42. 42. 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!!
    43. 43. 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.
    44. 44. 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.
    45. 45. 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.
    46. 46. Thanks for Your Attention
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