More mental health support for caregivers of children with developmental needs

The project comes at a time when Singapore is paying more attention to mental, maternal and child health. ST PHOTO: KUA CHEE SIONG

SINGAPORE - When a parent hears that his or her child has a developmental need, the news can seem like a tsunami breaking, health professionals said.

Caregivers of children with developmental needs will now get more support for their mental health, under a new initiative by KK Women's and Children's Hospital (KKH) and philanthropic organisation Lien Foundation.

The two-year programme, known as DayOne, is named after the emotionally difficult milestone when a child receives the diagnosis of a developmental need.

The project comes at a time when Singapore is paying more attention to mental health as well as maternal and child health.

For a start, the pilot scheme expects to screen 500 caregivers who take their young ones to KKH's department of child development from May. It will focus on families in Punggol, Sengkang and Hougang, due to the higher proportion of young families in these towns.

Intervention will be provided to those in the group who require more support, comprising of counselling, psychological and psychiatric services.

About 100 are expected to need such forms of help.

The project's budget is $3.6 million for two years. About 75 per cent will come from the Lien Foundation, with the rest funded by KKH.

The initiative, which will last until April 2024, will rope in community partners and be scaled up in future if outcomes are positive.

At a media briefing on Wednesday (April 27), Associate Professor Lourdes Mary Daniel, head and senior consultant of KKH's department of child development, said the relationship between caregiver and child is the most important part of child development.

"It is so important to make sure that we look at the needs of the caregiver with as much strength and detail as we have been doing for the child over the last few years."

Ms Majella Irudayam, master medical social worker at KKH and programme co-lead of DayOne, said there is currently no routine screening of caregivers' mental well-being at the point of their children's diagnoses or down the road.

Parents also find it difficult to navigate community resources, she added.

KKH will set up a multidisciplinary team of 15 professionals, including medical social workers, psychologists, psychiatrists, paediatricians and nurses.

It will also redesign clinical processes and services to focus more on the caregiver and ensure more frequent touch points in the patient journey.

Dr Shilpee Raturi, programme co-lead of DayOne from KKH's department of child development, said paediatric professionals also need to see themselves as the first line of defence for mental health needs of the caregivers, beyond the children.

A key part of DayOne will be engaging caregivers at the point of referral - before they visit the clinic with their children - via teleconsultations, which could be phone calls or online sessions. Those assessed to be stressed will have their appointments fast-tracked.

During their first clinic visit, families will be screened and assigned to a four-tier support system ranging from minimal to very high needs. Depending on their needs, the intervention could range from teleconsultations to home visits. This could include providing guidance in parenting skills and child behaviour.

Last year, about 7,000 pre-school children were assessed for developmental needs in Singapore. The majority - 72 per cent - were seen at KKH's department of child development. Among this group, language delay, autism and behavioural problems were the most common diagnoses.

Mr Lee Poh Wah, Lien Foundation's chief executive, said the project aims to tackle two stigmas at once - developmental needs and mental health, which are intricately linked for young families.

Research has shown that caregivers of those with special needs face greater stress and are more likely to have mental health challenges.

Based on KKH data in 2016, 29 per cent of mothers of children with autism spectrum disorder were screened and deemed to be at high risk of depression within six to 12 months of their children's diagnoses.

In another 2021 study on caregivers of children with developmental needs in Singapore during the Covid-19 pandemic, depression, anxiety and stress scores were high.

Ms Majella said: "The day-to-day demands of taking care of a child over a period of time can affect the mental well-being of the parents, causing burnout.

"When a parent receives the news that his child has a developmental need, it's like a crisis. One parent told me that it was like a tsunami hit him."

She added: "They are put through a roller coaster of emotions like guilt, anger, resentment towards themselves, towards society and, unfortunately sometimes, the child. What they need is emotional support, reassurance, positive responses. But how many parents get these?"

Said Mr Lee: "I think our healthcare system has to shift to be more caregiver-friendly, to better identify, engage and support them. So DayOne is a new model of care to help families better navigate their new journey."

At the end of two years, the DayOne team will analyse data obtained from the programme, such as the percentage of caregivers who need support and staffing needs. It also has plans to work with community partners to scale up the project in future.

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