Speech by Dr Amy Khor, Senior Minister Of State for Health at the National Council of Social Service-Caregivers Alliance Limited’s Conference on ‘Celebrating Caregivers and Peers; Journeying Together’

Mr Keith Chua, Chairman, CAL,

Ms Tina Hung, Deputy CEO, NCSS,

Distinguished guests,

Ladies and Gentlemen,

        Good Morning. I am delighted to join you today, and appreciate the opportunity to interact with all the caregivers who have taken time off from their busy schedules to attend this conference on a Saturday.

2.    Mental conditions come in various forms, and may occur at all stages of life. As our population ages, we may expect to see a rise in mental health conditions such as dementia and depression, as these are more prevalent among the elderly. Whatever the condition and their stage in life, persons with mental conditions need to be well cared for and supported within the community. They will benefit from social, psychological, emotional and financial support from their family members and, importantly, a primary caregiver to anchor their care.

3.    Caregivers like you play a crucial role and are often the pillar of support for your loved ones. More often than not, caregivers have to devote their time and energy to take on the caregiving role on top of their other social and professional roles and commitments. But, at the same time, caregiving is also a rewarding and empowering experience. There are services available to enhance one’s confidence and capability in caregiving. The Ministry of Health (MOH) recognises the importance of the caregiver’s well-being and that even as they give of themselves in caring for their loved ones, in turn, there should be adequate support provided for them. This support can be provided in five main areas, namely early identification, caregiver training, respite care, caregiver support from counsellors and peers, and relieving the cost of caregiving through financial support which may be in the form of subsidies. This wide range of resources has been made available to provide better access to care and to prevent caregivers from feeling burnt-out and isolated.

Early Identification

4.    Early identification of mental health issues can facilitate caregivers to seek help for their care recipients early, and better prepare them for the caregiving journey. When detected early, persons with mental health conditions can receive timely treatment and interventions to better manage their symptoms before they worsen and enable them to maintain their independence for as long as possible. One service that facilitates this is the Community Resource, Engagement & Support Team (CREST). CREST provides screening for early identification of people with or at-risk of depression and dementia. They also help caregivers locate the right care and assistance in the healthcare and social service systems.

Caregiver Training

5.    It is also essential that caregiver training programmes are available for caregivers to obtain skills and information on illness management. One of the programmes available is the Singapore Association for Mental Health (SAMH)’s Family Link Programme (FLP). This programme caters for caregivers of persons with depression, bipolar disorder or schizophrenia. It aims to equip caregivers with a better understanding of mental health conditions, as well as communication and management skills necessary to care for their loved ones. Another service which provides such support is the Community Intervention Team (COMIT). COMIT provides case management services which includes caregiver support to ensure that more holistic care is provided. Counsellors, occupational therapists, psychologists, nurses and programme coordinators from COMIT are embedded in the community to provide counselling, psycho-education and training services for caregivers so as to reduce caregiver stress or burnout.

Respite Care

6.    Besides training our caregivers, MOH is working to make respite services more accessible to relieve the stress of caregiving. For caregivers of persons with dementia, there is the Eldersit service available for caregivers to enable some respite and take short periods of time off their caregiving responsibilities. There are also helplines such as the Singapore Silver Line (1800-650-6060) and the National Mental Health Helpline (6389 2222) for caregivers to make enquiries and seek advice.

Caregiver Support from Counsellors and Peers

7.    The Voluntary Welfare Organisations (VWOs) working with the National Council of Social Service (NCSS) have also played a crucial role in providing caregiver education and peer support. For example, the Caregivers Alliance Limited (CAL) has supported about 3,000 caregivers in the last three years through their caregiver support programmes. The peer support between caregivers can be a very powerful resource. Caregiver support platforms allow an exchange of ideas to overcome their challenges and an assurance that they are not alone in their journey.

8.    I would like to share an example of how we have worked with our community partners to provide caregiver support. John is 43 years-old and was diagnosed with mild schizophrenia. He was referred by one of our GP partners to Sliver Ribbon’s programme - The Linkage. John’s mother was his sole caregiver, and was his source of emotional and financial support. While John received treatment from his GP and underwent psychosocial counselling at The Linkage to enable him to cope with his condition, John’s mother, who was undergoing a lot of caregiver stress at that time, also received basic counselling at Silver Ribbon. She joined caregiver support groups which enabled her to pick up tips that help ease her burden in caregiving. John’s mother became a source of inspiration for other caregivers when she shared how she overcame challenges in caring for her loved one with other caregivers at the Youth Support Group programme. Having undergone the rehabilitation programme, John is now gainfully employed. His mother continues to encourage him to go for regular follow-up treatments and to take his medication. Through such examples, we can see the important role caregivers play in the recovery of their loved ones, and we hope to continue providing support to help you with your caregiving duties.

Financial Support

9.    Apart from these various support programmes, MOH also seeks to ensure that mental health treatment is affordable. Last year, we increased subsidies for outpatient treatment and drugs for low- and middle-income patients. Pioneers also receive additional subsidies. Patients can see their subsidised bills reduced by up to half, more for Pioneers.

10.    Medisave can be used for chronic conditions including psychiatric conditions such as major depression, bipolar disorder and schizophrenia under the Chronic Disease Management Programme.  Earlier this year, MOH also introduced Flexi-Medisave, whereby elderly patients can use up to $200 per year from their Medisave accounts to pay for their outpatient medical expenses. There are also subsidies under Community Health Assist Scheme (CHAS) for these same mental health conditions, enabling patients to pay less when they see their CHAS GP for their mental health conditions.

11.    MediShield Life will replace MediShield on 1 November 2015. Those with pre-existing illnesses can now obtain insurance coverage under MediShield Life, without exclusions.

12.    Financial support is also provided via grants. For caregivers looking after frail elderly or persons with moderate disability, they can tap on the Caregivers Training Grant and Foreign Domestic Worker Grant to help with their caregiving roles. We hope that caregivers and their loved ones can benefit from these initiatives.

13.    Today, I hope that through the exchange of personal experiences and inspiring stories, all of us can have a better understanding of mental health conditions and how best to meet the challenges of caring for our loved ones with mental health issues. I would like to acknowledge and thank the caregivers in our midst for your selfless love, sacrificial giving, and the time and effort that you have put into caring for your loved ones. We hope to continue working with NCSS, CAL and other stakeholders to strengthen our services and policies to better support you.

14.    I would also like to thank NCSS and CAL for organising this meaningful event, and I wish all caregivers the very best as you continue your care giving journey.