Measures in Community Healthcare System to Help Identify and Support Children and Young Persons Affected by Adverse Childhood Experiences

Assoc Prof Razwana Begum Abdul Rahim asked the Minister for Health what programmes or resources are available within the Government and the community healthcare system to help identify and support children and young persons affected by adverse childhood experiences.

I thank Assoc Prof Razwana for raising three separate Parliamentary Questions to the Ministry of Health (MOH), Ministry of Education (MOE) and Ministry of Social and Family Development (MSF) in relation to adverse childhood experiences (ACEs). MOH will be addressing the question from the community health and healthcare angle.

As stated in the MSF reply, actually the ACEs effect can be mitigated or prevented. Nevertheless, several programmes are in place to identify and offer support to those who have been exposed to ACEs. The Institute of Mental Health's (IMH's) programme on Forensic Rehabilitation, Intervention, Evaluation and Network Development Services, or FRIENDS for short, provides integrated multidisciplinary assessment and intervention for youth victims of abuse. IMH also conducts a Resilience Programme which enhances the well-being and resilience of children whose parents have mental illnesses, through family-based psycho-education workshops.

Additionally, children with signs of exposure to ACEs may be identified when they present at the KK Women's and Children's Hospital (KKH). KKH has two programmes to support children with ACEs. Firstly, the Anchor Start programme provides timely and comprehensive screening for young children up to six years old with suspected abuse and neglect as well as counselling and psychoeducation for the affected children and their families.

Secondly, KKH's Project RESTORE – REach the unreached, STrengthen Our community to support and REspond to families – trains community partners to provide psychological support and therapy to traumatised children and their caregivers.

Community mental health services, such as Youth Community Outreach Teams or CREST-Youth, and Youth Integrated Teams or YITs, also provide mental health support to youths with mental health needs arising from stressors, such as ACEs.

I thank the Minister of State Rahayu for her response in explaining the various interventions to support children with ACEs. I have one supplementary question. In terms of ensuring that healthcare professionals are adequately trained to recognise and address ACE; and in terms of partnership existing between schools and social services to provide comprehensive mental health support for the children, would the Ministry consider implementing screening for ACE in clinics to identify at-risk children early, prior to them coming into the programmes that are already available in the system?

There is already training for our healthcare providers and clinicians to look out for signs and symptoms of ACEs. When the clinicians see these signs and symptoms, like distress and parental neglect, they can ask more questions and identify some of the issues and would already make the appropriate referrals. So, there is already that approach that we take to try and catch them early.

But this takes a whole-of-Government, whole-of-society effort – and that is also why you have asked questions of all the different Ministries. We, indeed, work together because you see children at different touch points and you want to make sure that everyone who interacts with them will be able to identify and help and catch them early. So, that is the direction we are going.

We try and go as upstream as possible with MSF and MOE taking care of building stronger families. We train the professionals to understand and identify this and we want to proliferate this to as many touch points as possible so that they can be caught early.

We do acknowledge that there is a need to go upstream and we do need to have a broad-based approach involving many different partners in this effort.