Aung Clinic · Atlas

1. Introduction

Version followed: the Aung Clinic as documented in WHO's 2021 technical package Community mental health centres: promoting person-centred and rights-based approaches (section 2.1, data to about 2020), supplemented by the clinic's own team in Goethe-Institut Myanmar's Art & Healing orientation and certificate workshops (2022) and the Edible Art Club project, by the Federation of International Human Rights Museums Asia-Pacific's 2024 profile of Aung MHI, and by press, film and academic pages (Irrawaddy 2019, Documentary.org and Reverse Shot on the film The Clinic, Kyoto University 2023, BMJ Global Health blog 2024, Myanmar Digital News 2026). [source: WHO 2021 CMHC package; Irrawaddy 2019; Goethe-Institut Myanmar; Unseen Art Initiatives; Kyoto CSEAS 2023; FIHRM-AP 2024; MDN 2026]

Status of the documentation (October 2026). The founders' names and roles and the weekly morning art-therapy format rest on the Irrawaddy (2019); activity after the 2021 coup is documented to mid-2024 (Goethe-Institut 2022, Kyoto 2023, BMJ GH blog 2024, FIHRM-AP 2024); state media reported Dr Aung Min's death in September 2026 (MDN 2026). The pathway, team size and session frequencies below are WHO's description of the service around 2020 and are not confirmed for the service as it runs now [uncertain].

What it is. The Aung Clinic (also styled Aung Clinic Mental Health Initiative or Aung Mental Health Initiative, "Aung MHI") is a small, non-profit, free-of-charge community mental health day service in Yangon, Myanmar. It is a service model, not a single therapy: a non-clinical day centre that combines psychiatric assessment and medication with counselling, group, family and art therapy, mindfulness, practical and vocational skills, a cooking club, paid peer support workers, peer and family groups, outreach and rights advocacy. WHO selected it as a good-practice example of a rights-based community mental health centre. [source: WHO 2021 CMHC package, s.2.1; Unseen Art Initiatives]

Who and when. WHO states the clinic opened in 2010 without external funding [source: WHO 2021]. The Irrawaddy (2019) names the owners as a married couple, Dr Aung Min (medical doctor turned artist, writer and filmmaker, who leads the art therapy) and Dr San San Oo (psychiatrist; WHO lists her as consultant psychiatrist, EMDR therapist and team leader). The Kyoto seminar page (2023) spells her name "San Oo Oo"; Goethe-Institut Myanmar (2022), Documentary.org, FIHRM-AP (2024), MDN (2026) and the Irrawaddy all use "San San Oo", so this guide uses San San Oo. Documentary.org adds that she also works at a government mental hospital; FIHRM-AP says she left Yangon Mental Health Hospital in 2010 to use alternative, inclusive methods at the clinic. The dates mostly fit together as different stages: clinic opened 2010 (WHO); the art therapy room, "The Room", opened at Dr Aung Min's home and was running by 2012; the clinic was gradually turned into the Aung Mental Health Initiative, focused on people with severe mental illness, around 2015 (FIHRM-AP 2024), which matches the Edible Art Club's 2015 date for art-based work; the Open Society Foundations funded a community-based art therapy project from 2016, with funding due to end in 2020 (Irrawaddy 2019). [source: WHO 2021; Irrawaddy 2019; Kyoto CSEAS 2023; Goethe-Institut Myanmar 2022; Documentary.org; FIHRM-AP 2024] [uncertain: FIHRM-AP gives 2000 as the year Aung Clinic opened in North Dagon, against WHO's 2010]

Status after the February 2021 coup. Work after the coup is documented up to mid-2024. Both doctors took part in Goethe-Institut Myanmar's Art & Healing certificate workshops in Yangon in May–June 2022. Midi Z's documentary The Clinic was filmed at the clinic between 2017 and 2023 and ends in the coup period, with Dr Aung Min shaving his head and becoming a monk. In October 2023 Kyoto University described him as running a clinic with his wife and leading art therapy training in Yangon and ethnic areas. In February 2024 the BMJ Global Health blog described the clinic, in the present tense, as a Yangon community art therapy centre funded by the founders and volunteer groups. In August 2024 FIHRM-AP described Aung MHI as operating in North Dagon, Yangon, in the same compound as the Ten Men film studio, with a weekly Monday-morning community kitchen followed by painting, group talks, "The Room", and an annual "No Trauma No Art" exhibition begun in 2019 (2024 edition documented). Myanmar Digital News (state media) reported that Dr Aung Min died on 6 September 2026, aged 62, and named Dr San San Oo as his surviving wife and co-founder of Aung MHI. [source: Goethe-Institut Myanmar 2022; Reverse Shot; Documentary.org; Kyoto CSEAS 2023; BMJ GH blog 2024; FIHRM-AP 2024; MDN 2026] [uncertain: whether the Yangon day centre still runs as WHO described it, and how the art therapy and the service continue after Dr Aung Min's death; no independent reporting on this has been published]

How change is thought to happen. Recovery comes from being treated as a person with a voice rather than a diagnosis: voluntary, non-coercive help in an ordinary, non-clinical space; choosing among treatment options; expressing experience in one's own words and through art; regaining practical skills, income and social roles; and changing the family and community environment (stigma, conflict, exclusion) rather than only the individual. Participants in the 2020 evaluation linked improvement especially to art and group therapy, better self-management and fewer family and neighbour conflicts. [source: WHO 2021 s.2.1; Irrawaddy 2019] [synthesis: the one-sentence summary of the change model is my condensation of the WHO principles and the founders' published remarks]

2. Framework

No phased protocol, manual, session count or fidelity system has been published; the Aung Clinic is not a licensed programme and no certification is required to work in its spirit. Below is the care pathway as WHO describes it, arranged into stages. [source: WHO 2021 s.2.1] [synthesis: the staging and transition criteria are my arrangement; WHO lists elements, not phases]

Format and setting. Day service open 09:00–17:00 daily; no overnight stays; free of charge, with travel subsidised for people from far away. Over 200 individuals and families supported. No diagnostic group excluded; homeless people can attend during the day. Team (c. 2020): one psychiatrist, one medical doctor who is also an art therapist, five paid peer support workers, plus peer volunteers. Attendance ranges from a few visits to several years. [source: WHO 2021 s.2.1] Documentary.org (on the film) instead says the clinic charges minimal fees and that many patients have alcohol problems; in 2024 the service was described as funded by the founders and volunteer groups. [source: Documentary.org; BMJ GH blog 2024] [uncertain: whether care is free or carries a small fee today; hours, team size and session formats after 2020 are not confirmed by any source opened]

Stage A. First contact and assessment. Goal: understand the person and agree a first treatment plan with them. The psychiatrist assesses and develops the plan jointly with the person; family or friends are involved only with the person's consent. Move on when: the person has chosen which offers to try. [source: WHO 2021] [synthesis: the transition criterion]

Stage B. Recovery planning. Goal: a written, person-led recovery plan covering short- and long-term goals, a crisis plan, family input, medical input, chosen therapies, self-help strategies and advocacy needs, focused on strengths and solutions. Move on when: the person can name at least one goal and knows what happens in a crisis. [source: WHO 2021] [synthesis: the transition criterion]

Stage C. Engagement in the day programme. Goal: regular participation in a self-chosen mix of individual counselling, group therapy, family therapy, art therapy, mindfulness, occupational and vocational therapy, skills sessions and the cooking club; medication reviewed with consent. Peer volunteers help newcomers settle. Typical frequency: art therapy and the cooking club weekly; family peer group monthly; other frequencies not published. [source: WHO 2021; Irrawaddy 2019] [uncertain: frequencies of counselling and group therapy]

Stage D. Continuity and outreach. Goal: keep contact when attendance lapses or crises occur: home visits, telephone and online follow-up, weekend emergency response where needed; advocacy if hospital admission occurs. [source: WHO 2021]

Stage E. Community inclusion and participation. Goal: roles beyond patienthood: work, income from art sales, joining the peer support group, becoming a paid peer worker or advocate, volunteering with newcomers. Ending: not defined in sources; people may continue for years or return as volunteers. [source: WHO 2021; BMJ GH blog 2024] [synthesis: framing as a final stage]

Exclusions and referral out. Intoxicated people are excluded while intoxicated; acute physical illness goes to the general hospital, with the person welcomed back; violence: de-escalate first, then local authorities (police if necessary) or psychiatric hospital referral after extensive discussion with person and family. [source: WHO 2021]

3. Guiding principles

[source for all unless marked: WHO 2021 s.2.1, organised under WHO's five rights-based criteria]

Respect for legal capacity. Discuss options and let the person choose; get prior consent before any medication; help people who want to reduce medication causing disabling side effects.
Awareness of power imbalance. Staff are trained to notice that their power can sway decisions and to actively reduce it. Practically: offer choices, wait for answers, do not decide for the person even when family pushes. (No formal supported decision-making protocol had been introduced.)
Non-coercion. All services are voluntary; de-escalation before any outside help; negotiate alternatives to hospital, seek voluntary admission if unavoidable, and advocate for quick discharge if admission is involuntary.
Person's own words. Avoid biomedical jargon and stigmatising labels; encourage people, families and ethnic community members to describe distress and healing in their own terms. Practically: mirror the person's vocabulary, not diagnostic terms.
Blend with local practice. Combine recovery approaches with practices already meaningful locally, such as meditation and art.
Holistic, integrated care. Medication, counselling, groups, medical care and vocational training belong in one place; the initiative states that an integrated approach is critical to long-term well-being. [source: Unseen Art Initiatives]
Non-clinical setting. A homely, non-hospital space reduces stigma; in the founders' documentary context the walls are covered in patients' drawings and patients are invited back for meals. [source: WHO 2021; Screen Daily review of The Clinic]
Consent governs family involvement. Family and friends join only with the person's agreement; families are, however, consulted before any hospital referral.
Strengths and solutions. Recovery plans focus on what the person can do and wants.
Participation. Peers are paid, take part in decisions and lead advocacy; informal service-user feedback shapes practice.
Community inclusion. Work on discrimination in education and employment, find jobs, generate income through art.
No forcing in art. Dr Aung Min's rule: "never force patients to draw or to teach them". Practically: no instruction in technique, no judging of quality; quiet alternatives allowed. [source: Irrawaddy 2019]
Accessibility. Free, no diagnostic exclusion, travel subsidy, overnight stays arranged with churches and monasteries for people from outside Yangon.

4. Intervention inventory

How to read this section: "Documented" lines restate what the sources say the clinic does. Sources give almost no session-level procedure, so most step detail is my own [synthesis] of how a clinician would deliver the documented element consistently with the clinic's principles. Written for a clinician working in, partnering with or adapting this kind of day service. [source: WHO 2021 s.2.1 unless marked]

4.1 Initial assessment and co-produced treatment plan

Purpose / when: first contact for everyone, any diagnosis, including homeless people.
Documented: psychiatrist assesses and develops the treatment plan with the person; external supports (family, friends) involved only with consent.
Steps [synthesis]: (1) Meet the person first, alone if they wish, even if family brought them. (2) Ask what has been happening in their words and what they want help with. (3) Do the psychiatric and physical-health assessment; screen for intoxication (defer if intoxicated), acute medical need (refer to general hospital, invite back) and current risk. (4) Lay out the menu: counselling, groups, family work, art, mindfulness, skills, cooking club, medication options. (5) Ask whom, if anyone, they want involved and how. (6) Agree first steps and write them down together.
Example language (illustrative): "How would you describe what's been going on, in your own words?" / "Here is what we offer. Which of these feels worth trying first?" / "Your mother came with you. Would you like her to join part of this conversation, or not today?"
Watch for: family answering for the person; you slipping into diagnostic labels; the person agreeing passively. Working: the person makes at least one active choice.

4.2 Recovery plan (including crisis plan)

Purpose / when: after assessment; revisited as goals change.
Documented contents: short- and long-term goals; crisis plan; family input; medical input; specific therapies; self-help strategies; advocacy needs; strengths- and solution-focused.
Steps [synthesis]: (1) Ask about a good day and a meaningful future (work, family, faith, art). (2) Turn this into one short-term and one long-term goal. (3) Crisis plan: early signs the person notices, what helps, whom to call (clinic phone, weekend contact), what they do and do not want if things get worse, which family members to inform. (4) Record medical input and the person's own medication preferences. (5) List self-help strategies already used (e.g. meditation, prayer, drawing). (6) Note advocacy needs (job, school, discrimination, rights). (7) Give the person a copy.
Example language (illustrative): "If things got very hard again, what would you want us and your family to do, and what would you not want?"
Watch for: plans written by staff for the person. Working: the person can say what is in their plan.

4.3 Medication with prior consent and support to reduce

Purpose / when: where the person chooses medication; also when side effects are disabling.
Documented: medication offered as one option; prior consent required; help available to reduce medication with disabling side effects.
Steps [synthesis]: discuss benefits, side effects and alternatives in plain language; record consent; review side effects at every contact; if the person wants to reduce, plan any reduction jointly with the prescriber, slowly, with the crisis plan updated and early-warning signs agreed. No dosing guidance is given here.
Example language (illustrative): "This is optional. Let's go through what it may help with and what it may cost you, then you decide."
Watch for: consent given under family pressure; abrupt self-discontinuation (offer supported reduction instead of disengagement).

4.4 Individual counselling / talk therapy

Purpose / when: for most attenders; content chosen by the person.
Documented: individual counselling and talk therapy offered; team leader is an EMDR therapist. [uncertain: no source says which counselling model or whether EMDR is routinely used in the clinic]
Steps [synthesis]: follow the person's agenda; use their vocabulary; link work to recovery-plan goals; integrate their own coping (meditation, faith, art).
Example language (illustrative): "You called it 'my heart being heavy'. Tell me more about the heaviness."
Watch for: professional language intimidating the person (WHO names this explicitly). Working: the person speaks more freely and brings their own topics.

4.5 Group therapy

Purpose / when: shared experience, reducing isolation; highly valued in the 2020 evaluation.
Documented: group therapy offered; format and frequency not published. [uncertain]
Steps [synthesis]: fixed time; agree ground rules (confidentiality, no forced speaking); check-in round; theme chosen by members; close with what each takes away. Peers may co-facilitate.
Example language (illustrative): "Anyone can pass. What's one thing from this week you want the group to know?"
Watch for: one voice dominating; staff lecturing. Working: members respond to each other, not only to staff.

4.6 Family therapy

Purpose / when: conflict at home, stigma within the family, caregiver burden; only with the person's consent.
Documented: family therapy offered; evaluation participants reported fewer family and neighbour conflicts.
Steps [synthesis]: agree with the person what may be discussed; give each member time; reframe blame into shared problem-solving; agree concrete changes at home; plan follow-up.
Example language (illustrative): "What would a calmer week at home look like for each of you?"
Watch for: family seeking control or hospitalisation; the person silenced. Working: fewer fights, more autonomy at home.

4.7 Art therapy ("The Room")

Purpose / when: expression, self-worth, sense of achievement, reconciling with oneself; for anyone who wants it, including people with severe conditions.
Documented: weekly sessions, including a morning session, led by Dr Aung Min in "The Room", which opened at his home and was running by 2012. People paint on paper; the medium changed from paper to canvas after the Open Society Foundations began funding the community-based art therapy project in 2016. An artist once taught technique (e.g. colour rules), which seemed to harm some participants, so teaching was stopped. Rule: "never force patients to draw or to teach them". People who do not want to draw may write poems or do quiet activities. Repetitive imagery (one man painted the same figure for years) is accepted. The aim is a space to explore the mind, not a hunt for "creative" output. [source: Irrawaddy 2019] Participants found comfort and peace in painting; survivors of violence attend, and a former participant now volunteers in support groups. [source: BMJ GH blog 2024] The initiative's guiding idea is that every person is an artist; participants paint what they cannot say, and doctors and participants paint, cook and eat together. [source: FIHRM-AP 2024] Dr Aung Min died in September 2026 [source: MDN 2026]; who now leads the sessions is not published. [uncertain: group size, session length, current leadership and whether sessions are online or in person are not published]
Steps [synthesis]: (1) Set out paper, paint, brushes; later offer canvas to those who continue. (2) Invite, never require; offer writing or quiet sitting as equals. (3) Give no technical instruction or aesthetic judgement. (4) Optional sharing at the end, in the person's words. (5) Keep and date work; with consent, include it in the collection.
Example language (illustrative): "There's no right way here. Paint, write, or just sit with us." / "Would you like to say anything about it, or let it speak for itself?"
Watch for: distress when trauma images emerge (slow down, ground, offer counselling); pressure to perform. Working: continued voluntary attendance, pride, calmer affect.

4.8 Art exhibitions and income sharing

Purpose: public recognition, anti-stigma, income.
Documented: exhibitions (e.g. "The Room", Yangon 2019, about 70 works; joint Yangon exhibition January 2023; an annual "No Trauma No Art" exhibition of work made through trauma-informed care, begun in 2019, with a 2024 edition prepared with a film crew); participants share profits from sales. [source: WHO 2021; Irrawaddy 2019; Unseen Art; FIHRM-AP 2024]
Steps [synthesis]: get explicit consent per work for showing and selling; agree how the artist is named (or not); agree the profit split in advance; prepare participants for public comment.
Watch for: exploitation or exposure of identity against wishes.

4.9 Mindfulness and meditation

Purpose: self-regulation using a locally familiar practice.
Documented: mindfulness offered; recovery approaches blended with meditation. Format not published. [uncertain]
Steps [synthesis]: short guided breath or body attention; respect the person's own tradition; allow eyes open; stop if dissociation or flashbacks emerge.
Example language (illustrative): "If your own practice already helps you, let's start from that."

4.10 Occupational, vocational and practical-skills sessions

Purpose / when: rebuilding daily-living competence, confidence and employability.
Documented: occupational and vocational therapy; vocational skills training; sessions in reading, basic money management, mathematics, life skills and carpentry.
Steps [synthesis]: link each session to a recovery-plan goal; small graded tasks; peers model skills; record progress the person can see.
Example language (illustrative): "You said you want to help at your aunt's shop. Shall we practise the money side this week?"
Watch for: sessions becoming babysitting with no goal. Working: skills used outside the clinic.

4.11 Weekly cooking club

Purpose: social connection, practical skill, belonging.
Documented: weekly cooking club; peer volunteers help new attenders sit, talk and cook together [source: WHO 2021]. In 2024 this ran as a weekly community kitchen on Monday mornings, followed by a painting session [source: FIHRM-AP 2024]. In the related Edible Art Club (Singapore partner strand), each weekly gathering cooked one meal, then made art, then reflected as a group; the Myanmar and Singapore groups exchanged via Zoom and observed each other's workshops. [source: Unseen Art] [uncertain: whether a group reflection follows the Yangon kitchen and painting as it did in the Edible Art Club]
Steps [synthesis]: pair each newcomer with a peer; shared tasks suited to ability; eat together; brief reflection.
Example language (illustrative): "Come and chop with us; no need to talk unless you want to."
Watch for: fire and knife safety with people who are very distressed or sedated. Working: newcomers return the following week.

4.12 Paid peer support workers and peer volunteers

Purpose: hope, modelling, shared power, welcome for newcomers.
Documented: five paid peer support workers in the team; peers trained in basic counselling, meeting management, writing and organisational skills and the CRPD; peers take part in decision-making; a former participant now volunteers in support groups. [source: WHO 2021; BMJ GH blog 2024]
Steps [synthesis]: recruit from experienced attenders; pay them; train as above; define roles (welcoming, co-facilitating groups, follow-up calls, advocacy); give them a seat in team decisions; supervise and support their own wellbeing.
Watch for: peers used as unpaid staff; tokenism; peer burnout.

4.13 Peer support group (rights and advocacy)

Documented: about 30 members focused on capacity-building, advocacy and rights under the UN CRPD; have liaised with other disability organisations; five women lead women's rights advocacy (two paid, plan to pay all five).
Steps [synthesis]: member-led meetings; staff attend only by invitation; offer training (rights, meeting skills); support joint action with disability organisations.
Example language (illustrative): "What do you as a group want to change, and what would you like from staff?"

4.14 Family support groups and family peer group

Documented: family support groups; a family peer group meets monthly; families learn about rights and advocate for better treatment. Offering safe activity spaces also gives family caregivers respite. [source: WHO 2021; Unseen Art]
Steps [synthesis]: monthly meeting; share experiences; information on rights and non-coercive responses; problem-solving on home conflict; plan advocacy.
Example language (illustrative): "Many families here once thought hospital was the only answer. What helped you find other options?"
Watch for: groups drifting into complaining about the person or planning forced treatment.

4.15 Outreach: home visits, telephone and online follow-up

Documented: outreach visits to homes; telephone and online follow-up when needed; outreach in remote areas to reach ethnic minority communities.
Steps [synthesis]: visit by agreement; meet the person first; review crisis plan; check practical needs (food, travel, medication supply); involve family as agreed.
Example language (illustrative): "We noticed you've not come for two weeks. We wanted to check how you are, no pressure to come back."

4.16 Crisis response, de-escalation and non-coercive hospital referral

Documented: emergencies answered at weekends where necessary; people with suicidal thoughts may stay during the day if a caregiver remains with them; staff trained in de-escalation using role-play that shows how coercive responses hurt; violence: de-escalate, then local authorities or psychiatric hospital; before any referral, extended discussion with person and family to find a non-hospital solution; if that fails, voluntary admission; if involuntary admission happens, advocate against coercion and for rapid discharge.
Steps [synthesis]: (1) Reduce stimulation, speak slowly, offer space and choices. (2) Use the crisis plan. (3) For suicidal thoughts: standard risk assessment, safety planning, lethal-means counselling (safe storage and removal), arrange a caregiver to stay. (4) Discuss alternatives with person and family (more frequent day attendance, home visits, a trusted relative staying, overnight with partner faith organisations). (5) Only then voluntary admission; remain in contact during any stay.
Example language (illustrative): "You're safe here. Nobody is going to grab you. Tell me what you need right now." / "Before anyone talks about hospital, let's look at every other option together."
Watch for: staff escalation; family demanding admission. Working: the crisis resolves without force.

4.17 Community inclusion: employers, schools, media

Documented: work with schools, employers, local organisations and local media on social inclusion; outreach to workplaces to find jobs. [source: WHO 2021]
Steps [synthesis]: with consent, contact employers or schools; explain needs without diagnostic labels; follow up after placement.

4.18 Training of professionals and frontline workers

Documented: training of general practitioners, junior psychiatrists and other mental health workers, influencing psychiatric hospital staff; workshops for the Back Pack Health Worker Team serving displaced ethnic minority communities (about 80 people and families supported); art therapy introduced into mental health training in Yangon and in Karen and Kayan areas; trainees from some groups may carry their own trauma, so training needs extra sensitivity. [source: WHO 2021; Kyoto CSEAS 2023] Goethe-Institut Myanmar's orientation on art and healing was followed by an Art & Healing certificate programme for young people in Yangon in May–June 2022, with statements from Dr Aung Min and Dr San San Oo. It ran over several weeks with a theme per week: basic mental health and abstract painting; self-care and portraits; psychological trauma with automatic writing, then empathic communication and group talk; and finally self-portraits and improvised play. Participants also mention drawing, writing, group conversation and improvised theatre. The aim was to build young people's capacity to support others. [source: Goethe-Institut Myanmar, Art & Healing certificate workshops page] [uncertain: who facilitated each session, the number and length of sessions, and group size are not stated]
Steps [synthesis]: include de-escalation role-play; give trainees choice over trauma-related exercises; offer debrief and support.

4.19 Access supports

Documented: free service; travel subsidy; churches, monasteries and other hosts in Yangon provide overnight stays for people from outside the city; homeless people welcome during the day.
Steps [synthesis]: ask about travel costs and lodging at first contact; build a list of host faith organisations.

4.20 Service-user participation and feedback

Documented: informal feedback from users shapes practice; peers part of decision-making; external qualitative evaluation in 2020 (focus groups and interviews).
Steps [synthesis]: regular open meeting where attenders comment on the service; record what changed as a result.

4.21 Community development in post-conflict areas

Documented: the service takes part in community development and political dialogue in post-conflict areas. No procedure given. [uncertain]

5. Handling problems

Documented challenges and the clinic's responses [source: WHO 2021 s.2.1]

Biomedical beliefs and stigma (families and professionals expect hospital and pills only): ongoing conversations with families and professionals; a non-clinical setting; work with local media; outreach to employers; training that has influenced psychiatric hospital staff.
Power asymmetries (professional language intimidates people, families and ethnic community members, undermining confidence): invite people to speak in their own words and trust their own ways of describing distress and healing; blend recovery work with meditation and art; train new staff to notice and reduce power differentials.
Violence or aggression: de-escalate first; only then local authorities or psychiatric referral; negotiate non-hospital options; advocate for rapid discharge.
Intoxication: exclude only while intoxicated; welcome back afterwards.
Distance from Yangon: travel subsidy; overnight hosting by churches and monasteries.
Trauma in trainees from conflict-affected groups: extra sensitivity in training.
Funding and disasters (rising demand, 2019 flood damage): consider sliding-scale fees, fees for training, art sales; user volunteering.
Art instruction harming participants: stop teaching technique; never force participation. [source: Irrawaddy 2019]

Problems the sources do not address [synthesis throughout, my own guidance consistent with the clinic's principles]

Stuck or passive attenders (attend for years without goals): revisit the recovery plan; ask what a next small step would be (helping in the cooking club, joining the peer group, showing art); accept that a safe place to come is itself a valid goal for some, while still offering roles.
"Resistance" or refusal of offers: treat refusal as a legitimate choice; keep the door open; offer the least demanding option (sitting in the art room, cooking alongside); ask what would make the service more acceptable.
Non-adherence to medication: explore reasons (side effects, cost, beliefs, family conflict); offer supported reduction rather than silent stopping; update the crisis plan; never make attendance conditional on medication.
Overwhelm during art or groups (traumatic images, flashbacks): pause, orient to the room, offer a quiet task or a walk, follow up individually; do not interpret images for the person.
Ruptures (person feels pushed, labelled, or that staff sided with family): name it, apologise for your part, ask what to do differently, offer a different worker or a peer.
Family pressure for coercion or confinement: meet the family separately (with the person's consent for any information shared); acknowledge exhaustion; offer the family peer group, respite through day activities, a crisis plan the person agreed; explain your non-coercive policy plainly.
Consent conflicts (person refuses family involvement but family brings them daily): respect the refusal for clinical content; give the family general information and support only.
Peer worker strain: regular paid supervision, clear role limits, right to step back without losing their place as an attender.
Boundaries in a homely setting (shared meals, gifts, art purchases by staff or visitors): agree transparent rules on purchases and pricing; avoid staff buying work privately without a clear, fair process.
Safety and confidentiality in political crisis: since 2021 people may fear surveillance, conscription or arrest; minimise written sensitive information, agree how online contact is secured, and do not record political views. [synthesis] What is documented: after the coup the founders kept working through art-based training (Goethe-Institut 2022) and community art therapy, describing the turbulent environment and survivors of violence among attenders (BMJ GH blog 2024). [uncertain: how the clinic changed its own procedures (records, online work, location) is not published]
Adapting outside Myanmar: keep the core (voluntary, free or low-cost, non-clinical setting, paid peers, art without instruction, consent-based family work, non-coercive crisis response); swap meditation, faith-based lodging and local media for what is meaningful locally; use WHO QualityRights materials for staff training.

Sources

Sources used:

Not used [uncertain]: the clinic's own website (aungclinicmh.org); Frontier Myanmar (2016) Mending troubled minds; the unpublished 2020 qualitative evaluation cited by WHO; the WHO main guidance (2021) Guidance on community mental health services: promoting person-centred and rights-based approaches.

Related documents cited: World Health Organization (2021). Guidance on community mental health services: promoting person-centred and rights-based approaches. Geneva: WHO. United Nations (2006). Convention on the Rights of Persons with Disabilities.

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