Community-Based Mental Health Plan

Ms Tin Pei Ling asked the Minister for Health (a) if he will provide an update on the roll-out of the community-based mental health plan; (b) what is the reach and effectiveness of mental health professionals mobile teams providing early onsite response and whether its capacity will be increased; and (c) which agency plays the central coordinating role in helping those with psychosis who are not institutionalised and are without caregivers.

Earlier this year, we announced plans to develop community-based mental health services to complement those in our hospitals.

As part of this, we are developing Assessment and Shared Care Teams (ASCAT) to provide specialised mental health care. People with mental conditions can be seen and managed by these teams, which are led by psychiatrists and consist of psychologists, occupational and physical therapists and case managers, at the clinics in the community instead of having to see

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psychiatrists in the hospital. To date, we have set up two ASCAT teams. One is temporarily sited in Khoo Teck Puat Hospital (KTPH) in Yishun and will eventually move to a location outside the hospital; the other is at Ang Mo Kio Polyclinic.

These two teams have seen over 200 patients since commencing services this year in August and October respectively. The ASCATs are also working closely with the community partners in their area, such as Family Service Centres (FSCs), and Senior Activity Centres (SACs), by providing them with training in the care of the mentally ill. These community partners are also able to refer cases to ASCAT. If these pilots are successful, we will expand to six ASCATs by 2016.

For those who require more basic support in mental healthcare, such as counselling and psychotherapy, we have set up two Community Mental Health Intervention Teams (COMIT) to support General Practitioners (GPs) in managing patients with mild to moderate mental conditions. The first team led by O'Joy Care Services, has been operating at Upper Boon Keng since January this year, helping over 80 patients to date. This team covers the elderly with dementia and their caregivers in the northern region, comprising Yishun and Woodlands and the central region, comprising Ang Mo Kio, Toa Payoh and Kallang. Another COMIT team focusing on adults and caregivers has just been launched in Yishun in November this year to cover the northern region. The COMIT teams will be linking with GPs in these regions so that GPs can refer patients who need counselling and psychotherapy to the team. There are plans for 10 COMITs by 2016.

We have also put in place a 24-hour mental health helpline through which community partners, such as FSCs and SACs, can be linked up with healthcare services when they encounter difficult situations. This is supported by mobile teams to provide home visits where further assistance or closer assessment is needed. We are extending this helpline to our community partners in stages. Currently, 12 FSCs have been linked up to this helpline. We intend to reach all SACs and FSCs by March 2013.

For patients with psychosis, which is a more severe form of mental illness, IMH is developing an Integrated Patient Assessment and Continuous Engagement System (iPACE) to ensure that they are cared for appropriately and comply with treatment. Patients under iPACE are assessed to determine what follow-up care they require. Patients who require closer follow-up, such as those with a higher risk of relapsing, would then receive closer monitoring to

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ensure that they receive the care and treatment that they need. Community Mental Health Teams conduct home visits when necessary.

For community support, IMH will refer patients to partners, such as the Singapore Association for Mental Health, Silver Ribbon Singapore, and the Community Rehabilitation Support & Service Programme run by Singapore Anglican Community Services. Such support could include counselling, psycho-social rehabilitation, and assistance with housing or employment issues. Upon discharge, IMH patients are also given contacts for IMH’s contact centre, case managers, and community mental health team.

Moving forward, the Agency for Integrated Care is working closely with IMH, RHs and social agencies to ensure that new services and existing programmes develop into an integrated mental health network so as to provide seamless and continuous care for patients with mental illness in the community, particularly for those with little or no family support.