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Mental health initiative seeks to reach beyond stigma

First introduced in 2012, the pilot initiative has benefited more than 4,500 people, with its outreach programmes reaching out to more than 21,000 to date.

SINGAPORE: Anxiety, insomnia and helplessness – Pauline (not her real name) recognised these could be symptoms of mild depression while taking a mental health survey at a community event nearly one-and-a-half years ago.

Worried that her friends would probe, the 65-year-old quietly filled in a form with her contact details so that experts could reach her to tell her more about these symptoms. It eventually led to regular counselling sessions with a social worker.

People such as Pauline – who avoid seeking help for their mental health conditions because of stigma – are the ones the community mental health and dementia support network led by the Agency for Integrated Care (AIC) hopes to reach out to.

FEAR OF PUBLIC STIGMA

First introduced in 2012, the pilot initiative has benefited more than 4,500 people, with its outreach programmes reaching out to more than 21,000 to date. It plans to put in place full integrated networks – already available in the northern and central regions – in the east and west by 2016.

Divided into three levels, the first level – the Community Resource Team (CREST) – is the initial point of contact for identifying residents who are at risk of mental health issues. Besides linking them to services and assistance as well as providing emotional support to clients and caregivers, outreach programmes are also organised.

Dr Tan Weng Mooi, chief of the Community Mental Health Division at AIC, noted that CREST is embedded in the community to raise the public’s mental health awareness and identify people who are at risk of mental health conditions – such as dementia or depression – or those who tend not to seek help in fear of public stigma.

“Left on their own, these clients and caregivers may not recognise the onset of mental illness or know where to seek help, and potentially delay treatment,” she said.

CREST then taps the existing community networks of Senior Activity Centres and voluntary welfare groups to do its work.

Clients who are referred to the next level, the Community Intervention Team, will see allied health professionals such as mental health counsellors, nurses and psychologists to receive counselling, psychosocial therapeutic interventions and support services. Complementing their efforts are general practitioners who can encourage patients to seek help early. So far, 63 GPs have been recruited. The target is 100 by 2016.

Medical care and treatment are provided to clients with mild to moderate mental health conditions at the last level – the Assessment and Shared Care Team – which consists of multidisciplinary care teams led by doctors.

Ms Khoo Shu Wen, manager at Thye Hua Kwan CREST@Central , said it would usually first assess residents – asking about their family background, medical conditions, financial situation and if they displayed any signs of causing harm to themselves or others, for instance – before deciding where to refer them.

While some are open about their mental health conditions, others do not accept that they have any, she said, adding that they would still try to engage the latter group so they do not fall through the cracks.

Pauline was one example of those initially apprehensive about seeking help. Her counselling sessions with CREST took place after a social worker made regular visits to her home. “The social worker took the initiative to look for me, talk to me and visit me frequently ... I was grateful for that, because I didn’t dare to ask anyone about my symptoms,” said the retiree in Mandarin.