Update on Interagency Taskforce on Mental Health and Well-being and Programmes to Improve Mental Health Literacy

15 Ms Nadia Ahmad Samdin asked the Minister for Health with regard to the recommended strategy by the Interagency Taskforce on Mental Health and Well-being (a) whether the Government will consider elderly mental health as a separate pillar given the increasing proportion and vulnerability of the demographic; and (b) what outcomes and indicators are being set for the work of the Taskforce.

16 Dr Wan Rizal asked the Minister for Health whether the Ministry can provide an update on the Interagency Taskforce on Mental Health and Well-being, especially on its plans to improve mental health literacy among citizens and create an inclusive society for persons with mental health conditions.

17 Ms Tin Pei Ling asked the Minister for Health (a) what recourse is available to caregivers of elderly care recipients when the latter exhibit self-harm or aggressive behaviours which require emergency interventions; (b) whether the restructured hospitals, including the Institute of Mental Health, are equipped to handle these cases; and (c) how can geriatricians and social service agencies play a role in such case management.

The Senior Minister of State for Health (Dr Janil Puthucheary) (for the Minister for Health): Mdm Deputy Speaker, may I have your permission to address Question Nos 15 to 17 in the Order Paper and written Parliamentary Questions (PQs) filed by Mr Christopher de Souza^1,2 for the Sitting on or after 6 July please?

Mdm Deputy Speaker: Yes, please proceed.

Dr Janil Puthucheary: Madam, the Interagency Taskforce on Mental Health and Well-being has conducted a review of existing mental health and well-being programmes and developed preliminary recommendations to support the mental health needs of all members of society, including youths and seniors. The task force's recommendations are aimed at creating a caring and inclusive society, where all can seek help and be supported to achieve mental health and well-being, and can participate meaningfully in our society.

The task force is currently embarking on a consultation exercise from 30 May 2022 to 7 August 2022 to seek the views of the public on its preliminary recommendations. The findings from the public consultation will enable the task force to refine the recommendations and develop a national strategy on mental health and well-being. Following this, indicators will be developed to measure the implementation progress and effectiveness of the strategy.

The task force has proposed 12 preliminary recommendations in three focus areas. The first focus area is improving accessibility, coordination and quality of mental health services. The second is strengthening of services and support for youths' mental well-being. And the third is improving workplace well-being measures and employment support.

Some of the recommendations include designating first-stop touchpoints for easier wayfinding of mental health services, standardising process and systems between social and healthcare providers for better coordination of care and equipping frontline service providers with the relevant mental health knowledge and competencies to support their clients.

For our youths, we want to promote the positive use of technology and social media and propose to develop a parents' toolbox to enable parents to better support their children's socioemotional well-being.

At the workplace, we propose to improve mental well-being support systems and work-life harmony strategies and equip employers with knowledge on supporting persons with mental health needs.

In addition, there is a need to improve access to vocational training and increase job opportunities for persons with mental health conditions.

To promote mental health awareness and literacy in the population, the Health Promotion Board (HPB) launched the national campaign in October 2021 titled "It’s OKAY to Reach Out". The campaign aims to normalise discussions about and increase understanding of mental health issues. The campaign encourages us to reach out for help and, where possible, reach out to provide help. The campaign includes community dialogue sessions, activity-based workshops and educational webinars where participants learn more about mental well-being and equip themselves with practical coping tips as well as how to reach out to seek support and support others.

To complement this national campaign, HPB also rolled out MindSG, an online portal featuring resources curated by mental health experts to provide Singaporeans with credible, reliable and convenient access to important relevant content. HPB will be launching the second instalment of the "It’s OKAY to Reach Out" national campaign in the coming months.

There are existing mental health services to cater to the needs of persons with mental health conditions and their caregivers. Caregivers of elderly care recipients, in particular, those who exhibit self-harm or aggressive behaviours, can call the Institute of Mental Health (IMH)'s 24-hour Mental Health Helpline at 6389 2222 to seek help in managing crisis situations. Where necessary, IMH will also make home visits to provide crisis interventions.

When the acute psychiatric condition is stabilised, the elderly care recipients may be referred for follow-up at the outpatient clinics at the restructured hospitals where their care would be overseen by healthcare professionals trained in mental health, including psycho-geriatricians.

In the community, the Agency for Integrated Care (AIC) has worked with social service agencies to set up community intervention teams which can provide further support for these elderly care recipients through psychosocial therapeutic intervention and counselling.

Mdm Deputy Speaker: Ms Nadia Ahmad Samdin.

Ms Nadia Ahmad Samdin (Ang Mo Kio): Thank you very much. I have two supplementary questions. The first is on my question about the focus on the elderly. I am very appreciative of the three focus areas as well as the 12 recommendations that we are seeking consultations on. However, in 2020, we saw the highest number of elderly suicides since 1991. While in 2021, the number has gone down slightly, it remains to be seen what the future might hold.

In any case, the vocabulary around elderly mental health is much less socialised. Many still consider it very taboo and I think —

Mdm Deputy Speaker: Ms Nadia Ahmad Samdin, please ask your question.

Ms Nadia Ahmad Samdin: Yes. Sorry. So, my question is, will the task force consider focusing, as a special focus area, on the elderly's mental health and their caregivers as well?

The second part is, I appreciate focus area 1, but I think we need to be realistic that in order to have better access, quality and coordination of these services, we also need to have more resources because AIC and other agencies tend to be really overstretched. All the good work that is done in support —

Mdm Deputy Speaker: Ms Nadia Ahmad Samdin, ask your question, please.

Ms Nadia Ahmad Samdin: Does the task force plan on providing more manpower and resources, other than just raising literacy and providing education?

Dr Janil Puthucheary: I thank the Member for her questions. Mdm Deputy Speaker, if I may address the second one first. The task force is not planning only on raising literacy and providing education. We are looking at the entire strategy and the way in which we approach the deployment of resources, training of professionals, referral of clients across the ecosystem as well as the relationship between the healthcare and social care parts of our mental health infrastructure.

Within that space, there will be a need to look at the allocation of resources and the deployment of personnel. But I think we have to start at getting the strategy and systems in place first. Then, the task force will move on to other subtasks following on from that. Indeed, it is important to consider the needs of and support for the elderly who have mental health illnesses and those of their caregivers.

I would make three broad points.

The first is that for the seniors' mental health, we need to look at it a little bit differently partly because they often have concomitant, associated chronic health conditions. Both need to be dealt with together, holistically. So, it is a combined mental and health approach. That is what the professionals have been doing already.

Which is the second point, that is, that there are resources that are available, there are professionals working in this space. I mentioned the psycho-geriatricians and the other teams in my earlier answer. Another example would be the "Live Well, Age Well" programme, which is funded by MOH and jointly implemented by HPB and the People's Association, to augment existing seniors' programmes with a focus on mental well-being. More than 13,000 unique seniors participated in the programme in 2021.

The third point is that some of the efforts that we are making around the larger strategy of mental health will directly improve access to, and services for, the elderly, for example, the extent to which we are looking at the community care providers to bring some of these services closer to home, including, for example, eldercare centres.

Mdm Deputy Speaker: Dr Wan Rizal.

Dr Wan Rizal (Jalan Besar): Thank you, Mdm Deputy Speaker. I thank the Senior Minister of State for sharing the recommendations.

I hear the efforts by the interagency task force in reaching out and getting this. My question is, for those who are not reaching out, are there plans to increase these nodes or networks to allow them to be, in a way, screened or detected, so that we can prevent issues in terms of mental health?

Dr Janil Puthucheary: Mdm Deputy Speaker, yes, we do want to increase the awareness of the need for mental health screening among the healthcare professionals and social care professionals that are working in this space, as well as to provide them with tools to do the screening and then, the onward referral. So, that is very much part of our strategy.

Mdm Deputy Speaker: Ms Tin Pei Ling.

Ms Tin Pei Ling (MacPherson): I thank the Senior Minister of State. I would like to ask about IMH, which is usually the first port of call for the elderly exhibiting self-harm and aggressive behaviours, possibly induced by certain types of dementia, for example. Caregivers are often at a loss. Apart from calling the hotline for remote assistance, sometimes, they will choose to go to IMH. I would like to ask whether there have been instances where they had to be turned away or is the capacity at IMH sufficient to deal with such cases?

Related to that, sometimes, caregivers may feel that it is more expeditious to send the elderly to a nearby restructured hospital because, if there is self-harm, there may be personal danger. They may feel that it is safer to send the elderly to those settings. So, are restructured hospitals equipped to support such instances?

Dr Janil Puthucheary: Madam, I thank the Member for the questions. The issue of dealing with an elderly patient who has a mental health condition and who then has a caregiver requiring assistance to deal with that situation, there is not a single solution – just as there is not a single archetype or a single set of challenges.

Indeed, the helpline is there for advice as well as to coordinate onward referral. Indeed, the family, the caregiver, can bring the senior to IMH if that is where they think the mental health condition is best dealt with and they can bring them to the restructured hospitals which are also equipped to deal with vulnerable persons, persons who are entirely dependent and people with acute mental health conditions deteriorating. The restructured hospitals and their emergency departments are equipped.

At the beginning, the Member talked about IMH being the first port of call. One of the things that we are looking at within the task force is to perhaps shift that perception that IMH has to both be the first port of call as well as the only port of call. I hope that is not what she was characterising the situation as.

We really do need a wider surface area, a wider spread of nodes, networks, the community organisations, the healthcare community as well as the social care community to participate in that response to support the mental health needs of our seniors. That is part of what the task force is going to try and do.