Woodbridge Hospital – British psychiatry in Singapore

Woodbridge Hospital opened in 1928. At the time, the British Governor of Singapore stipulated that the medical superintendent should be an officer ‘with some taste for gardening and farming who will help to make the patients interested in such pursuits. Must have attended lectures at the Mental Hospital, Denmark Hill. Must possess the Diploma of Psychological Medicine.’ The decree of the Maudsley connection is heeded even to this day – every local medical superintendent or director has had training at the Maudsley and possesses the DPM or MRCPsych; but horticultural predilection is no longer a requirement.

The hospital was initially built as a 2500-bed asylum. It expanded to almost 3000 beds after 70 years. Woodbridge Hospital was one of the largest hospitals in Asia. In 2000 it was decided that it should be downsized and the governance restructured. Community psychiatry was emphasised and Professor Norman Sartorius from the World Health Organization suggested two services – the community addiction medicine programme and early psychosis intervention programme. The training and research units amalgamated to form the Institute of Mental Health.

For many years doctors from the hospital were sent to Britain for postgraduate education. Many were trained by eminent British psychiatrists such as Aubrey Lewis, Michael Rutter, David Goldberg, Eric Taylor, John Copeland, Paul Rogers and Robin Murray. However, after 1987, the National University of Singapore with the assistance of Professor Philip Seager from the Royal College of Psychiatrists (UK) started a local training programme for the Master of Medicine (Psychiatry). Research interest has grown gradually over the years and an outstanding project by the doctors was ‘A 20-year follow-up study of schizophrenia in Singapore’ which was initiated by Dr Tsoi Wing Foo.

Unfortunately, Woodbridge Hospital, like other asylums the world over, has sometimes been perceived by the public as a shameful place. A successful anti-stigma campaign led by Dr Lee Cheng took place in 2001 with a tagline ‘winning hearts and minds’. It was important not just for the patients but also for the morale of staff.

The best of British psychiatry, with emphasis on ‘soft skills’ like meticulous history-taking, is still taught in the medical school. However, doctors know they do not have the luxury of time and cannot practice as in British hospitals. Lack of human resources, heavy workload and cultural differences mean that there should be a different approach in clinical practice, especially in the provision of psychological therapy. All these were discussed at a recent Teachers of Psychiatry meeting in Singapore, where some Asian leaders of psychiatry shared their experiences, work stress and favourite leisure activity, which fortuitously was gardening, a hobby decreed by His Majesty’s Government in 1928.