SEVERAL Members of Parliament questioned the adequacy of the rehabilitation of the mentally ill in Singapore, and called for more support to be given to them to help them recover fully.
Their comments followed last month's attack on their parliamentary colleague, Mr Seng Han Thong (Yio Chu Kang), and a threat made against another, Ms Denise Phua (Jalan Besar GRC), by men who had been treated for psychiatric problems.
Among those who raised the issue was Dr Lily Neo (Jalan Besar GRC), who asked whether patients should be discharged into the community if they lacked family support to get them to continue with their medication and follow-up treatment.
'Is the best of care in the community for psychiatric patients with insufficient family or community support, or is the best of care in having regular follow-up with psychiatric nurses and psychiatric docs, even if it means institutionalisation?' asked Dr Neo.
Dr Lam Pin Min (Ang Mo Kio GRC) asked if hospitals here had a system of monitoring mentally ill patients' recovery in the community, and intervening if they defaulted on their treatment.
'This is important because the omission of any medication and necessary medical review by the professional can actually lead to other potential complications or even pose a threat to the safety of the patient or even the community at large,' he said.
'We have heard cases where patients were discharged, defaulted follow-up, omitted medication or were lost to follow-up until something big happened in the news.'
Health Minister Khaw Boon Wan acknowledged the MPs' concerns, but stood by the practice of rehabilitating the mentally ill in the community.
He said: 'We have been trying very hard over the years to de-stigmatise the mentally ill, and I was very worried that the (Seng Han Thong) case would push our efforts back several years...
'No doubt there are such patients out there who need help, but mental illness is a wide range of illnesses, and many are reversible if we give them a chance, if we give them jobs, if we are able to accept them in the community.
'You institutionalise them, lock them up in the mental asylum - which is a traditional way of doing things in the last century - they don't improve, they just go downhill.'
Things would hopefully improve after Medisave is extended to two common mental conditions - schizophrenia and depression - this year, he said.
The Health Ministry would be able to get an idea of how well patients were being managed in the community through progress reports from participating general practitioners and psychiatrists in private practice, and best practices could then be identified and shared, he said.
Madam Cynthia Phua (Aljunied GRC) called for more psychiatric day-care centres to be set up to provide support for the mentally ill in the community.
Mr Khaw agreed that more had to be done, not just by increasing resources, but also by improving coordination between the medical professionals and the voluntary community groups.
Madam Halimah Yacob (Jurong GRC) wanted dementia patients to be allowed to use Medisave for outpatient treatment, and mental conditions to be insured under MediShield, to ease the financial burden of 'a long-term, debilitating illness'.
Although he said he was 'sympathetic' to her cause, Mr Khaw was not in favour of implementing her suggestions for now.
Those from the middle-income group who can afford it can buy riders to cover mental illness, he said.
Besides, treatment of mental illnesses was more heavily subsidised than other conditions in public hospitals, he noted.
Saying that including mental illnesses would push MediShield premiums up, he added: 'I doubt this is the time to talk about raising MediShield premiums.'
Any revision would 'presumably be when the economy has fully recovered', he said, adding: 'We will put a file record for whoever is the health minister to take a look at mental illness.'
