Care for Persons with Mental Disabilities

Mr Hri Kumar Nair asked the Minister for Health in respect of persons with mental disabilities (a) what are the criteria for admitting them to the Institute of Mental Health (IMH) and Government hospitals; (b) who will bear the costs of their treatment; and (c) whether IMH and the Government hospitals currently have the capacity to admit such persons referred to them and, if not, what steps are being taken to increase their capacity.

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Mr Speaker, most patients with mental health conditions are cared for in the community as outpatients. Patients with more severe mental conditions, such as schizophrenia and depression with risk of suicide, may be admitted for a period for closer monitoring and treatment. Other patients may be admitted for diagnostic investigations, monitoring of responses to treatment and management of concomitant medical or surgical conditions. The decision to admit them is based on the clinical assessment of the patients by their doctors.

For a small group of patients who may pose a risk to themselves or those around them, the Mental Health (Care and Treatment) Act 2008 provides for involuntary admissions for inpatient monitoring under stringent criteria and protocols.

The 3M healthcare financing framework and subsidy system for patients in our public healthcare system are applicable to patients with mental health conditions as well. MediShield will also be expanded to cover inpatient treatment for psychiatric conditions. Patients can also apply to Medifund for financial assistance where necessary.

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Currently, there are about 2,000 hospital beds across our public hospitals dedicated to mental health patients, with the majority, or 90%, in the Institute of Mental Health (IMH). IMH has an average occupancy rate of about 80% over the past three years and has sufficient capacity for new patients.

Since the National Mental Health Blueprint was rolled out in 2007, my Ministry has worked to strengthen core services for mental health conditions. This includes improving early diagnosis and intervention for mental health disorders, and promoting awareness and understanding of mental health issues. As announced at COS 2012, we are now building on this foundation to develop a new community-based mental health plan. For example, we are developing Assessment and Shared Care Teams (ASCAT), which are specialist-led mental health teams based in the community, in order to improve access to mental health care. We are also developing Community Mental Health Intervention Teams (COMIT) to provide improved access to counselling and psychotherapy services in the community. To better support community service providers who encounter patients with mental illness, we are also developing a helpline, supported by a mobile response team, that they can tap on for information and assistance.

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