Incorporating Neuro-developmental Conditions in Existing Tiered-care Mental Health Model to Ensure Holistic Care

13 Dr Hamid Razak asked the Coordinating Minister for Social Policies and Minister for Health (a) whether the current tiered-care mental health model explicitly includes individuals with neurodevelopmental conditions, such as attention deficit hyperactivity disorder (ADHD) and autism, who have co-occurring mental health needs; and (b) if not, what clinical pathways and funding support are available when such individuals seek public psychiatric or psychological care.

The Senior Minister of State for Health (Dr Koh Poh Koon) (for the Coordinating Minister for Social Policies and Minister for Health): The current tiered-care model is organised by severity and complexity of mental health needs, not specific diagnoses. And so, it applies to individuals with ADHD and autism who have co-occurring mental health needs.

In the community, such individuals can access free or subsidised services like the Response, Early Intervention and Assessment in Community Mental Health (REACH) for children, the Centre of Excellence for Youth Mental Health in Singapore (CHAT) for adolescents and young adults, and the Community Integrated Health Team (CIHT) by Happee Hearts Movement for adults.

Specialist psychiatric services are also available at our public Specialist Outpatient Clinics (SOCs) where eligible patients, including those with neuro-developmental conditions, can receive means-tested subsidies of up to 70%. Those who still face difficulties paying for their bills, can approach medical social workers at our public healthcare institutions for assistance such as MediFund.

Mr Speaker: Dr Hamid Razak.

Dr Hamid Razak (West Coast-Jurong West): Thank you, Speaker, Sir, and I thank the Senior Minister of State for the reply. In my earlier Parliamentary Question, the Ministry did respond that each professional of our Community Resource, Engagement and Support Teams (CREST) sees about 90 clients per year. The Community Intervention Team (COMIT) professional sees about 70 clients a year, and these clients receive a number of sessions per year. So, I want to give my appreciation to the CREST and COMIT teams on the ground.

So, they are seeing all these different clients, I am just wondering how are the frontline teams actually guided to differentiate between these clients, whose primary issue may be neuro-developmental, rather than the usual anxiety or mood disorders, and whether there are plans to equip them with the skill-sets to recognise these conditions and thereafter, refer them for subsidised care in our restructured hospitals.

Dr Koh Poh Koon: Sir, I thank the Member for his questions. The National Mental Health Office has a collaboration and close interaction with many of our social partners that provide some of these services in the community. We do interact with them. If they feel that there are areas in which they need to be strengthened in terms of capabilities, we would be happy to work with them to conduct awareness courses for them.

But generally, I think our more experienced counsellors that are providing services to these clients with neuro-developmental needs, if they do feel that there is something beyond what they can handle, if they feel that there is an element of co-occurring mental illnesses like depression, for example, I think they, being from a counselling background, will pick up on depression because they have dealt with other non-neuro-developmental clients in other aspects of their work as well. And if they do detect some elements of depression, we would encourage them to refer onwards for specialist assessments. And if need be, work with other healthcare partners providing a higher tier of service to co-manage these clients, if necessary.