P195: The evolution of a community mental health team in Singapore: Community Psychogeriatric Programme

Abstract

Mental health issues in the elderly were often overlooked in the past, with mental illness often being underdiagnosed, undiagnosed or misdiagnosed. As such, mental healthcare in the elderly was often insufficient, leading to significant adverse outcomes in individuals and caregivers, as well as an added burden to the healthcare system.

The Community Psychogeriatric Programme (CPGP) was set up in Changi General Hospital in 2007 to serve the Eastern Region in Singapore. CPGP comprises of a multidisciplinary team of psychiatrists, psychologists, nurses, medical social workers, occupational therapists, a physiotherapist and administrative executives. The programme objective is to provide community mental health services for early detection and treatment of psychogeriatric disorders and to allow aging-in-place within the community. This is achieved through collaborating with social and healthcare agencies, as well as caregivers, to meet the needs of the elderly to maintain them in the community for as long as possible.

Over the past 16 years, the proportion of Singapore’s population aged 65 and above have grown, mental health literacy in Singapore has improved, and community mental healthcare providers have increased. CPGP’s community partnerships multiplied, including social eldercare agencies such as dementia daycare centres, general medical practitioners in Primary Care Clinics and Community Hospitals, and residential facilities such a sheltered homes and nursing homes. The CPGP team pivoted to focus more heavily on networking with community partners, training and upskilling them with knowledge of geriatric mental healthcare and empowering them to provide care and support in the community setting. The goal was to right-site care, promoting early detection and intervention in the community. Home based consultations or nursing home consultations, including telepsychiatry, were reserved for elderly patients who really could not access specialist psychogeriatric outpatient services in the hospital.

Looking back on the work CPGP has done, this is a reflection of our journey, reviewing the strategies we have employed to improve community psychogeriatric care, our achievements thus far, and the challenges we have been faced with as the healthcare landscape evolved in Singapore.