Clearing the grey areas of mental health

SINGAPORE: Two programmes aimed at the early detection and treatment of mental disorders among the elderly have made inroads into raising the awareness of mental health issues faced by Singapore’s greying population.

The Institute of Mental Health’s (IMH) Aged Psychiatry Community Assessment and Treatment Service (APCATS) and Changi General Hospital’s (CGH) Community Psychogeriatric Programme have screened more than 2,500 elderly persons here and trained various community partners to identify and better manage charges with dementia.

One of the agencies that have benefitted from IMH’s programme is the Man Fut Tong Nursing Home, which also runs a day—care centre for the elderly.

About 20 of its care staff and therapists have undergone more than 70 hours of free training since 2009. Armed with the necessary techniques to screen their elderly clients, staff members have been able to identify those who might be mentally unwell.

For example, a 72—year—old man at the day—care centre was noted to be "very unmotivated" and had lost interest in activities, said Ms P Manchu, manager for rehabilitation services in the home. Further diagnosis conducted by the IMH team confirmed that the man was suffering from moderate depression, which meant earlier medical help could be given.

A CGH spokesperson noted that mental health problems in the elderly often "go undetected until it is too late". Dr Joshua Kua, project director of APCATS at the IMH, echoed this sentiment, citing studies he has conducted in two social day care centres for the elderly.

"Findings have shown that one in five elderly attending these centres have dementia, which might be undetected," he said.

Dr Kua, who is also a senior consultant in IMH’s department of geriatric psychiatry, had started APCATS in 2006 after returning from a medical training stint in Australia.

"I realised then that we don’t have a service here which caters to elderly who are frail and weak and are unable to come to the clinic for treatment," he said.

In 2008, APCATS, which provides direct care to home—bound elderly people with mental health problems, was included into IMH’s National Mental Health Blueprint’s Community Psychogeriatric Programme. That same year, a second component of the programme was launched to train IMH’s community care partners. As of 2010, 69 eldercare agencies have signed up.

More than just equipping care staff with the knowledge and skills to identify mental illnesses, the programme also trained staff in the management and care of the elderly suffering from mental illness.

At Man Fut Tong Nursing Home, Ms Manchu said her staff were able to conduct counselling sessions with the 72—year—old man to plan activities which were more suitable to his needs, "to overcome and manage" his depression.

Dr Kua hopes to reach out to more community partners, to achieve "a multiplicative effect", where well—trained staff members can train others.

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TODAY