CREST and COMIT Referral Statistics by Source in Past Three Years and Assessment on Appropriate Care Tiers

Dr Hamid Razak asked the Coordinating Minister for Social Policies and Minister for Health (a) in each of the past three years, how many referrals have been received by Community Outreach Teams (CREST) and Community Intervention Team (COMIT) workers as broken down by referral source, such as step-up, step-down or self-referrals; and (b) how does the Ministry assess whether referrals are appropriate to the intended tier of care.

This reply will also address similar questions raised by the Member scheduled for today's Sitting. The Ministry of Health (MOH) currently does not track the registration status of Community Outreach Teams (CREST) and Community Intervention Team (COMIT) professionals.

Since 2025, minimum qualifications have been established to ensure consistent competency across CREST and COMIT staff. CREST and COMIT professionals also receive training to achieve competencies defined in the National Mental Health Competency Training Framework. This includes participation in regular case discussions with psychiatrists from our public hospitals.

From 2022 to 2024, CREST supported over 19,000 clients a year on average. Each professional managed about 90 clients per year, with clients receiving six to seven sessions annually, with an average programme duration of one and a half years before discharge. Of the referrals received, self-referrals, referrals from other agencies and step-down referrals from hospitals and primary care accounted for 46%, 41% and 13% respectively.

From 2022 to 2024, COMIT supported over 14,000 clients a year on average. Each professional managed about 70 clients per year, with clients receiving five to 11 sessions annually, with an average programme duration of one year before discharge. Of the referrals received by COMIT, step-down referrals from hospitals and primary care, referrals from other agencies and self-referrals accounted for 41%, 36%, and 23%, respectively.

The Practice Guide for Tiered Care Model for Mental Health provides referral criteria and guidance to CREST and COMIT.

MOH, together with the Agency for Integrated Care, maintains close monitoring of service capacity of CREST and COMIT to determine future care model including resourcing of manpower, to ensure that quality care is delivered sustainably to meet the needs of our residents.