First polyclinic cluster to offer opportunistic mental health screening to youths for early detection and timely intervention.
Singapore, 9 July 2024 – Mental health is a priority in Singapore’s national agenda, with adolescent mental health a rising concern as one in 10 youths suffer from at least one mental health disorder. The screening of mental health among youths is one key aspect in the National Healthcare Group (NHG)’s ongoing efforts to make community-based mental health services more accessible to youths.
The primary care led ‘AdoLescent Evaluation and Rapid Treatment of Mental Health’ (ALERT) programme offered at NHG Polyclinics (NHGP) highlights NHG’s commitment to better detect youths aged 13 to 17 with physical and mental health issues and help them manage conditions such as depression, anxiety, and insomnia in the community. It is the first polyclinic programme in Singapore to offer opportunistic mental health screening and bring timely care to at-risk youths. Under ALERT, NHG polyclinics in collaboration with the Institute Mental Health (IMH), train Family Physicians and Medical Social Workers on mental health management and jointly hold case discussions to better support people with mental health needs through the seamless sharing of information and integrated care coordination.
Prioritising Youths’ Mental Well-Being
Youth is a phase of life where many transitions take place. Biologically, it is a period which coincides with puberty where individuals undergo physical and hormonal changes which some can find distressing. Psychosocially, it is a phase of life where youths also seek to develop a personal identity and independence, while seeking to gain acceptance from their peers and society. These areas if neglected, with no proper support avenues, can present a high risk for youths to develop mental health problems.
Chief Executive Officer of NHGP, Dr Karen Ng said, “Primary care is often the first point of contact for patients. It is the nexus where preventive care and health promotion come together in support of youth mental health. Through this initiative, we provide an upstream avenue that is youth-friendly and non-stigmatising. We hope youths at risk will be more open to seeking help early, get access to resources that empower them to overcome challenges and alleviate their risk of developing mental health conditions in adulthood.”
Mitigating and Intervening with the Right Care
“While adolescence is an exciting period of growth and change, it can be a tenuous period for some. We want to reach out to youths at risk to help them build their resilience during this crucial period of development and provide them with tangible means to thrive well – physically, mentally, and socially – in the community. With this in mind, we developed and piloted ALERT in November 2021 and officially launched it in April 2023,” said Dr Eugene Chua, Family Physician, Associate Consultant, and Co-lead for NHGP’s mental health programme.
Under the ALERT programme, youths presenting with underlying medical conditions and mental health concerns are identified and followed up by NHGP’s Family Physicians and Medical Social Workers (MSW) on a personalised care plan over a six-month period. The Family Physician will manage the youths’ biological conditions or acute symptoms while the MSW provides psychosocial support and counselling sessions to support their emotional wellbeing. In addition, the MSWs support families by providing psychoeducation to help families understand mental health conditions as well as equipping them with the relevant strategies for them to help their child cope with the conditions. Beyond the polyclinic, the MSWs work closely with community partners such as family service centres and school counsellors to ensure the youths can cope well in the community. Upon assessment that these youths have made improvements in their conditions, and are able to manage their stressors, the youths will then step down from the programme. Thereafter, these youths will be advised and educated on tips on how to maintain good mental wellness.
Since the launch of the ALERT programme, close to 100 at-risk youths have received timely support and effective intervention to deal with their stressors.
Group Chief Executive Officer of NHG, Professor Joe Sim said, “At NHG, we look at a broad suite of solutions to address mental health, including training and hiring more specialists across our Group and creating more capacity at our hospitals, especially at our national specialty centre – IMH. NHG is also actively working with partners to strengthen capabilities upstream and in the community, such as at our polyclinics, and with GPs and schools, to enhance mental health and well-being for youths. We will continue to work on advancing and making mental health more accessible for our residents in Central and North Singapore.”
Upstreaming Mental Health Support for Adolescents
As part of the Group’s holistic approach to care, NHGP actively raises mental health awareness among youths through direct engagements to build their mental resilience. In September 2022, NHGP kicks off its first healthcare-school partnership with Yishun Innova Junior College to improve students’ mental health literacy, strengthen psychological well-being and build mental health resilience. During this collaboration, the ALERT team provided psychoeducation materials and resources for the students and worked with the students to design outreach materials focusing on depression, anxiety and insomnia which are prevalent amongst youths. These outreach materials, including posters, highlight warning signs of mental conditions, and provide self-help resources for mental wellness to encourage positive help-seeking behaviours. These posters, displayed in the school and NHG polyclinics, have reached close to 800 users who accessed mindline.sg, a digital mental wellness platform to raise mental health wellness, via a QR code unique to NHGP.
NHGP is currently working with students from the Diploma in Infocomm & Media Engineering at Nanyang Polytechnic to create other educational materials for young individuals who have psychosomatic symptoms to alleviate their stress symptoms.
Through these collaborations, youths are given opportunities to reflect on mental health issues faced by their fellow youths, evaluate current available resources and play a part in highlighting coping mechanisms for their peers. This is a good start to encourage them to become advocates – a voice for youths and participate in youth outreach efforts.
Future Developments
To provide greater holistic support for youth mental well-being, NHGP has partnered KK Women’s and Children’s Hospital (KKH) to develop the RECAP@NHGP (Resilience in Children and Adolescents with Psychosomatic Symptoms) programme. This programme adopts a stepped-care approach to early assessment, intervention and right siting for youths aged 13 to 17 presenting with psychosomatic symptoms such as recurrent headaches, abdominal pain and chest pain.
Through psychoeducation and counselling, the programme helps to prevent chronic symptoms and improve socio-occupational functioning. The early identification of stressors and mental health symptoms can also help the right siting of care. The RECAP@NHGP programme will be available in NHG polyclinics in 2025.
