Reaching out to the mentally ill

The Government aims to grow the pool of help options available for the mentally ill. An important group is the general practitioners, who can help stable psychiatric patients reintegrate back into the community.
The Government aims to grow the pool of help options available for the mentally ill. An important group is the general practitioners, who can help stable psychiatric patients reintegrate back into the community.PHOTO: ISTOCKPHOTO

More community organisations, GPs and VWOs helping those with mild or moderate illness

When administrative assistant Yvonne Heng, 23, was diagnosed with borderline personality disorder at Khoo Teck Puat Hospital (KTPH) in March, her psychiatrist felt she would need long-term counselling.

He referred her to Clarity Singapore, a non-profit organisation for mental health endorsed by the Catholic Archdiocese of Singapore, in addition to her monthly visits to see him.

Said Ms Heng: "I had a lot of things bottled up inside me. After I opened myself to them, I felt better. I felt that I had finally found someone who could listen to me." She learnt to manage her anger and, after several sessions, she stopped harming herself.

She still goes for counselling once a month, and enjoys it. "When I see my psychiatrist, I feel like I am going to the clinic, I am sick. But at Clarity, they make me feel very comfortable," she said. "I don't feel like I am going for counselling. I feel safe."

Clarity, which started operations in 2011 and in September opened a second centre, is one of a growing number of community organisations that help those with mild or moderate mental illness. Others include helplines, family service centres, and voluntary welfare organisations, such as the Singapore Association for Mental Health.

A LISTENING EAR

I had a lot of things bottled up inside me. After I opened myself to them, I felt better. I felt that I had finally found someone who could listen to me.

MS YVONNE HENG, 23, who was diagnosed with borderline personality disorder and referred to Clarity Singapore

The Government aims to grow this pool to reach out to more people, in line with a worldwide focus on managing a patient's mental health within his community.

An important group is the general practitioners, who can help stable psychiatric patients reintegrate back into the community.

There are currently 100 GPs here who are trained to do so, up from four in 2005. They work with the Institute of Mental Health (IMH) under its Mental Health GP (MH-GP) partnership programme and handle patients referred to them by IMH, which itself runs a few clinics at polyclinics.

"When we started the programme in 2003, there were no similar programmes in Singapore. We had to generate awareness and reach out to GPs who we knew personally to join the programme," said Dr Alvin Lum, deputy director of the MH-GP programme.

The benefits, though, are clear, as GPs are a stable point of contact for patients and caregivers.

Plus, there is less stigma involved with seeing them, he said.

Importantly, GPs can also pick up patients with mental conditions.

And there is no time to lose. Findings from an IMH study that was released in March showed that as many as 10 per cent of people here above 60 years old may have dementia, said Dr Lum, who is a GP. "With the ageing population, there will be more elderly patients seen at GP clinics. Hence, there will be an increase in patients with dementia seen at the clinics. We will need to prepare for this eventuality."

The Ministry of Health (MOH) is doing just that as it scales up the capacity of community-based dementia care services, among its other efforts.

For instance, MOH aims to raise dementia daycare places, from 650 as of last December, to 3,000 by 2020, said a ministry spokesman.

A bigger network will mean that fewer of those with mental illness would fall through the cracks and go untreated.

Already, Clarity is looking at expanding to other parts of Singapore. It opened its second centre at Agape Village in Toa Payoh, an old housing estate with a fair number of elderly people who may need help, said its executive director Grace Ang.

Its first centre in Yishun Ring Road caters mainly to those living in the north, as part of the Thrive (Total Health Rich in Vitality and Energy) network, a community mental health project by KTPH.

Thrive's network of 18 agencies, including schools and VWOs, aims to help those with mild or moderate mental health symptoms seek and receive help in the community where they live, said Dr Chan Kee Loong, its project director and head of psychological medicine at KTPH.

This also frees up tertiary resources to focus on severe cases, he said.

Dr Chan added that they are "working towards recruiting more primary care practitioners, and grassroots and religious organisations to be part of the programme".

A version of this article appeared in the print edition of The Straits Times on November 24, 2015, with the headline 'Reaching out to the mentally ill'. Print Edition | Subscribe