En voyage to mental wellness: Prof Fiona Ho and students champion low-barrier services

“Why would you see a doctor when you’ve caught the flu, but not when your heart is ‘sick’?” Prof Fiona Ho of CUHK Department of Psychology and her students Vincent Wong and Eliz Lam fill us in at InnoPort about their newly founded social enterprise Wellness Travellers, as well as ranting about the stigmatisation and marginalisation of mental issues.

Surely the question they posed cannot be simply answered. Before drilling down into the serious bit, we warm up with the cosy trio.

In stark contrast to the stereotypical professor-student combo, Fiona easily blends in with her students – be it style or speech. The zestful professor even appears more like a student than the other two, often unveiling her witty side and leaving everyone roaring in laughter.

A steep climb in academic pursuit

Becoming Assistant Professor at such a young age – an elite student she must be? That is, in fact, not quite the case.

“I was in the remedial class for almost every subject in Form 5. Didn’t fare well in the science stream – failed both Chemistry and A. Maths. The school had half given me up and stopped teaching me, only ordering me to recite every single sentence, commas included.” We barely took our seat before Fiona starts merrily revealing her “scars”, openly recounting her bumpy ride. If you have just been through the torture of public exams, her story is good news – your fate is not sealed by one test.

Despite taking the long way, she made it into university after her associate degree and studied psychology, as she found it “quite interesting”. She eventually obtained her doctorate degree from the University of Hong Kong, becoming an expert in sleep disturbances and low-intensity psychological interventions.

A dramatic coming from behind – while most take years to complete their postgraduate studies, Fiona did hers in superman speed.

“It’s forced.” She explains how she started her PhD with a Specialization in Clinical Psychology right after her MPhil, thus getting exempted for a year. Within three years she finished her clinical psychology training and practice that usually takes two years, then wrapping up her thesis in the last year.

Says a lot about her mastery in stress management.

 

Figuring out their bearings

“My background is similar to that of Vincent.” Fiona turns the tables around and goes on “interviewing” her students/partners. “He was a rebellious student, who would have thought he’d do a PhD!” She points at the gentleman next to her, cueing him to share his soap opera-like experience, which got him fixated on the promotion and research of community mental health.

The young Vincent paid no heed to studying. Having maybe a little too much energy, he once climbed atop a bridge and accidentally fell on his back, winding up unconscious, “the doc told my mum that it came down to my will whether I pulled through that night. It’s like the typical TV scene.” This not only made him a news figure, but also left him with psychological trauma that prompted him to seek help from a clinical psychologist.

So happens that this isn’t the last time he confronts mental issues head-on. During his tertiary studies, he volunteered in a “Hong Kong depression index survey”, inviting residents near Yau Tong Estate to take part. “I approached a pavilion and chatted with a lady. She fished her phone out and showed me a pic of a pill case, asking if I could check what drug it was.”

Turns out the mother retrieved the case in secret from the garbage bin in her son’s room. “I looked it up – it was an anti-depressant,” recalls Vincent, “It was a bolt from the blue; the question to which she was afraid to find the answer has been on her mind for over a year. At the end, the lady sought help from the social worker on duty and received appropriate support.” It was then he made up his mind to pursue psychology. He is particularly eager to get in touch with the community, promoting mental health and resilience of the public.

His target coincides with that of Fiona, on top of their similarity in life experiences, no wonder they make great friends who engage in much verbal sparring and playful banter. Following her PhD graduation, Fiona was shortly employed at the Education University of Hong Kong before joining CUHK in 2017. Vincent also began his PhD studies in CUHK’s Department of Psychology after his master’s degree.

“Eliz (current MSSc Clinical Psychology student at CUHK) is the polar opposite – she’s a top student! Studied economics and business, got a job at Big 4 (accounting firms), then worked in a bank. One day she gave that all up to study psychology!” Fiona so describes the reserved girl next to her.

Even so, Eliz had her frustrations. She may have secured an enviable position upon graduation, yet somehow, she felt something wasn’t right. “Started to look for my direction; so jealous of those with a passion. I wanted to do something that fires me with enthusiasm. Work takes up such a large portion of life, you know.” She recalls the days when she was at a loss – not that long ago, in fact.

Despite the mismatch in values, she wasn’t in a hurry to quit her job. Instead, she volunteered and took short-term psychology courses. Soon enough, she made up her mind to do a full-time MA in Psychology.

Earning an MA doesn’t guarantee a spot in clinical psychology (CP) though, not to mention getting the professional qualification – the programme is extremely competitive. The University of Hong Kong and CUHK together only take in 38 students per year. “There are only 500 to 600 CPs across the territory,” Fiona makes plain the extreme local shortage of professional psychological services.

“Those getting into CP are few, but the investment is high. Yet she (Eliz) went for it – says a lot about her determination!” commends Fiona.

“All thanks to Fiona’s encouragement and support that I’m able to study CP now,” Eliz softly conveys her gratefulness, as Fiona fakes clearing her nose, flipping the warm-and-fuzzy conversation into hearty laughter.

 

Psychology in action

Fiona divulges that two years ago, the idea of starting a social enterprise already formed in her and Eliz’s heads. There was a day when they just stood on the busy Fo Tan MTR platform, discussing for over an hour “what kind of sleep centre Hong Kong would need”.

“A centre dedicated to sleep – while community insomnia is ubiquitous, it can be improved via psychological intervention in place of drugs. Our minds went wild – it would be perfect to have a café, where everyone can come ‘tick tick tick’ (boxes on questionnaires). Then we recommend them great floral teas, and peer support groups.” Eliz excitedly illustrates the blueprint of their business.

“For sure, we left it hanging,” and they parted ways until two years later, when they got to know the very entrepreneurial Karen, a psychology alumna. Complementing each other’s strengths, they took the first step towards actualising their idea.

“Karen took the course Psychology in Action; she was among the few who submitted their homework and did act on their business plan,” Fiona admits that her decision to go forward is attributable to Karen agreeing to take care of the commercial part.

The team was eventually awarded funding by the CUHK Sustainable Knowledge Transfer Project Fund (S-KPF), setting up social enterprise Wellness Travellers, transforming their research into “digestible, low-barrier” but evidence-based mental health services and activities. They strive to help those interested in enhancing their mental wellbeing, and those distressed by general emotional issues.

 

Calling for the UK semi-pro model

“One of the setbacks with Hong Kong’s psychological services is a mismatch in resources!” Fiona explains that not many could afford a 45-minute CP appointment that sets one back HK$1,500 to 2,000. Moreover, low-intensity therapies suffice for the mild anxiety or depression symptoms from which most suffer.

“Low-intensity psychological interventions offered by PWPs (psychological wellbeing practitioners) trained by our Department of Psychology would be perfect in this situation. Takes around six to ten 30-minute sessions; a lot more affordable.” This PWP system has been initiated by the British government and implemented for years – an excellent fit for the local medical system too.

To popularise mental health services, Wellness Travellers also offers night, video and phone counselling options. They are also organising a series of evidence-based lifestyle medicine workshops and groups, promoting whole-person well-being while boosting the public’s resilience as a form of prevention.

“We’ve got sleep, diet, exercise, stress management, Chinese medicine conditioning groups, and more.” Vincent adds that some are more like hobby classes for weekend getaways, “Zentangle and forest bathing are in the greatest demand; the quota fills up upon launching.” They repeatedly make the point that according to literature, lifestyle significantly impacts our mental wellbeing, and the abovementioned integrated interventions are proven to be effective.

The team is committed to elevating the accessibility of psychological services, while eliminating the stigma on mental disorders. The message is loud and clear: We shouldn’t shy away from seeking external help for mental illnesses, in the same way as physical maladies. Wellness Travellers is a timely beacon of hope to the “tsunami” of mental health issues in our times.

To reinforce their professional image, Fiona and Vincent will be taking the Board Certification in Lifestyle Medicine offered by the International Board of Lifestyle Medicine this November. As for their business model, they are focusing on B2B, since a lot of workplaces are the worst hit in terms of mental health. Each team member has their distinct role – Karen is in charge of marketing and operations, Vincent is responsible for the intervention development, Eliz is the treasurer, while two other members Timmy (current CUHK MSSc in Clinical Psychology student) and Cherry (current CUHK psychology student) take care of promotion and administrative work. And Fiona? Besides idea generator, likely the booze supplier.

“Workouts” for your mental strength

Towards the end of our chat, our three interviewees each recommends a book. May you all find some consolation and resonances in these difficult times.

《成為彼此的聆聽者》(Chinese only) by StoryTaler

Fiona: “This book teaches one the art of listening. I’ve heard loads of helpless voices saying, ‘my friend is going through this and that, but I don’t know what to say.’ We are often too eager to respond while overlooking actual listening. I used to distribute to my students listening skill cards I bought from StoryTaler, now you can simply learn from this book.”

The Happiness Trap by Russ Harris

Eliz: “I was doing my MA and applying for CP programmes; not a single interview opportunity landed.” It was obviously hard to take in, “and this book helped me weather the situation. The author utilises ACT (Acceptance and Commitment Therapy) advocated by the “third wave”, underlining the recognition of one’s life goal as the first step. In the face of difficulties, think about what can be done in line with your target, and what are out of your control which you should learn to accept.”

Mind Fixers by Annie Harrington

Vincent: “The author is a historian that studies mental health. Her book delineates the close correlations between psychological wellbeing and various environmental factors, which we should consider when seeking improvement for our mental health. One of the factors is, of course, lifestyle. It prodded me to reflect on the current services in Hong Kong, as well as the importance of promoting lifestyle changes and mental wellbeing in the community.”