SINGAPORE – Three more National University Polyclinics (NUP) will offer psychiatric services for mild to moderate forms of common mental health issues such as depression, anxiety and insomnia by 2024 to anchor such care in the community, andwill also help relieve the increasing load at the hospitals.
By this October, Bukit Panjang polyclinic – which opened last year – will have a Health and Mind clinic, said Dr Benjamin Cheah, the lead of the Health and Mind Programme at NUP, at a media briefing on Tuesday (May 17)
The plan is to expand these services to the other two polyclinics at the rate of one a year, he said. Choa Chu Kang Polyclinic will be up next, followed by Clementi Polyclinic.
The other NUP polyclinics with a Health and Mind Clinic are Jurong, Pioneer, Bukit Batok and Queenstown.
At the same time, the National University Health System (NUHS), which runs the seven NUP polyclinics, is also expanding its geriatric services programme, where it trains polyclinic doctors as well as its community partners such as Lions Befrienders to identify and manage frailty in seniors.
These plans, which NUHS briefly shared to mark the World Family Doctor Day on Thursday (May 19), are in line with the preventive healthcare strategy known as Healthier SG that the Ministry of Health had announced in March this year. It has just launched the Healthier SG public consultation.
Dr Michael Yong, NUHS’ group chief of psychological medicine, said more patients have been seeking help at the polyclinics for mental health issues after the first year of the pandemic.
From March 2021 to Feb 2022, NUHS had 799 community mental health patients, which more than doubled from the 380 it saw in the previous year. The patients’ average age was 41 and about 58 per cent of the 799 patients had either anxiety, depression and/or insomnia.
“It’s unfortunate because in the pandemic we had to close a lot of clinics to focus on Covid efforts,” he said at a media briefing on Tuesday. “As a result, we had patients who relapsed…”
Dr Yong said they also saw new patients who were affected by the fear of Covid-19, Covid information or the lockdown for instance.
“The aim is to continue to have more polyclinics and more GPs trained to manage our mental health patients,” he said.
“This is so we can have more clinic slots, to be able to fast track patients who are very sick because right now, if you look at most departments or the hospitals, the waiting time can go up by one to three months.”
At NUP, the doctors who run the Health and Mind clinic are the ones who will see and treat patients, he said. Patients can usually get an appointment within three working days, said Dr Cheah.
Since NUHS started its Community Mental Health Programme in 2016, some 200 GPs, polyclinic doctors and community partners have been trained to handle patients with mental health issues, and they have seen more than 4,500 of such patients.
About 500 of them were transferred back to GPs or polyclinic doctors for follow-ups, said Dr Yong.
Meanwhile, two more NUP polyclinics – Jurong and Pioneer – will offer geriatric services probably fromSeptember, as more family physicians and nurse care managers are being trained on how to identify and manage frailty in seniors – a growing problem in fast ageing Singapore.
Initiated by Dr Lydia Au, the head of geriatric medicine at Ng Teng Fong General Hospital, the programme began in Bukit Batok Polyclinic and then Choa Chu Kang Polyclinic in 2019 .
Earlier this year, Alexandra Hospital started a similar programme at Queenstown Polyclinic and Clementi Polyclinic.
From July 2019 till March 2022, the programme had completed the assessment of 300 patients. A total of 124 of them were found to have a higher risk of falls.
“We advocate very strongly for our case managers to go into their homes to pick up anything that we can modify,” said Dr Au.
“If the patient is very frail and can’t stand up properly, that I can’t change but what we can change is the attitude towards the patients. We want to make sure that they are well supervised for instance… that there are anti-slip mats in the toilets and grab rails put in.”
The geriatric services programme involves real-time coaching in frailty assessment and so Dr Au and the polyclinic doctor will see the polyclinic patient at the same time. They do a quick assessment, checking if his medications are appropriate for instance, while a geriatric nurse and polyclinic nurse will work together to assess the patient’s eyesight, footwear and so on.
Then, a physiotherapist will assess the patient’s function.
“When we build that system, we also created new pathways to have early access for our patients who require hospital care to come back to the hospital for assessments,” said Dr Au.
She said she also hopes that this model can help caregivers understand how their elderly loved ones will be cared for in a very complex and busy system.
Apart from NUP, the other polyclinics here are under SingHealth or the National Healthcare Group (NHGP).
There are currently 23 polyclinics in Singapore, with more in the pipieline.
For instance, at SingHealth polyclinics, the Health Wellness Clinic caters to patients with mental wellness conditions, such as depression and anxiety. This clinic operates at the Tampines, Outram, Bedok and Punggol polyclinics on certain days.
Dr Guo Xiaoxuan, Clinical Lead of Health Wellness Clinics and Clinic Director of SHP-Punggol, said there are progressive plans to include these services in their new or renovated polyclinics.