Caregivers of the violent mentally ill need more help

Caregivers of the violent mentally ill need more help

27 Feb 2014, TODAY

I refer to the report “Man gets eight years for fire that killed dad” (Feb 14).

The man is a psychiatric patient suffering from schizophrenia, and it seems that there are defects in our mental healthcare system that must be corrected to prevent the recurrence of such tragedies.

First, the police must be empowered to take mentally ill patients with violent tendencies to the Institute of Mental Health (IMH), on the request of carers who cannot manage them.

I know the man’s mother, and prior to his offence, she had approached the police to take him to IMH. But she was told that, since he did not commit any crime then, they could do nothing. It is a shame that IMH staff who care for violent patients can be rescued by pressing the emergency button in the ward, but carers who have the task of looking after loved ones with such conditions cannot protect themselves even after they approach the authorities.

Second, although IMH has a mobile crisis team, there is no ambulance service that can take violent patients to the hospital quickly when a crisis occurs. Instead, relatives must call for a private ambulance, which could cost up to S$400.

Third, halfway houses must be built to allow such patients to seek temporary treatment and support before they can return to the community.

Fourth, there are new, atypical antipsychotic drugs that can be used to treat schizophrenia. As these are costly, the Government can provide more subsidies for such medication.

Above all, carers need support, and if IMH cannot provide it, who can?

Raymond Anthony Fernando

MOH’s Reply  

Support for mentally ill and their families a constant work in progress

17 Mar 2014, TODAY

We refer to Mr Raymond Fernando’s letter, “Caregivers of the violent mentally ill need more help” (Feb 27).

We empathise with the caregivers and families caring for the mentally ill. We are committed to providing the caregivers with support, so they can look after their loved ones better.

Patients are assessed to be in a stable condition before they are discharged. If they suffer a relapse, the Institute of Mental Health’s (IMH) mobile crisis team is the first line of help to patients and their families.

A 24-hour mental health helpline (6389 2222) is provided to them. The public may also access the IMH website for the helpline. In addition, the Singapore Anglican Community Services has a mobile team of professionals who conduct home visits and mental health assessments.

Police assistance can be requested when the person exhibits any violent or disorderly behaviour. If the person remains violent or disorderly upon the police’s arrival, the police can refer the patient to the IMH.

Mr Fernando shared that there was no ambulance service to take mentally ill patients to the IMH.

Although the IMH does not have a dedicated ambulance service due to low demand, in cases where families have difficulty paying the private ambulance fees, the IMH can offer reimbursements through the Woodbridge Hospital Charity Fund and the Agency for Integrated Care’s programmes.

To facilitate discharged patients’ return to the community, the IMH collaborates with organisations such as the Hougang Care Centre, Simei Care Centre and Bukit Gombak Group Homes to provide psychiatric rehabilitation, residential and day-care programmes.

Currently, the Ministry of Health subsidises a wide range of antipsychotic drugs, including atypical (also known as second-generation) antipsychotic drugs. Also, the Medication Assistance Fund assists Singaporeans who need non-standard drugs, if they are assessed to be clinically necessary and appropriate, with up to 75 per cent subsidy. Patients can approach medical social workers at public health-care institutions for assistance.

We acknowledge that more can be done and will continue to look for ways to improve collaboration among mental health agencies and voluntary welfare organisations, to better support persons with mental illness and their families.

Daniel Fung, Chairman, Medical Board, Institute of Mental Health

Bey Mui Leng, Director, Corporate Communications, Ministry of Health

Ho Yenn Dar, Assistant Director, Public Communications, Public Affairs Department, Singapore Police Force