80th Commemorative Book

Institute of Mental Health/Woodbridge Hospital

heartening minds

Every individual matters. At the Institute of Mental Health/Woodbridge Hospital (IMH/WH),

we dedicate our hearts to looking after the mental vibrancy, resilience and

well-being of people’s minds – loving hearts,

beautiful minds – always.

When you are feeling low,we will be there to support you

in more ways than one.

Whenever you set foot on our doors,we put our heart and soul into

seeing to your every need.

Whenever you need to talk about your breakdown,

we will give you our heartfelt attention and listen without judgement.

10 heartening minds

messagePresident S R Nathan

“In order to succeed, people need a sense of self-efficacy, strung together with resilience to meet the inevitable obstacles and inequities of life,” said Albert Bandura, the Canadian psychologist.

In our urban situation, we have a fair share of the maladies that arise from the stresses of city life and related health problems. Anxiety about inter-personal and neighbourly difficulties, alcoholism, being jobless for a long time and financial troubles are not unknown. Such challenges and stresses can be a terrible and unbearable ordeal for some. It is crucial that they be made to believe in their ability to cope and tide over such life’s challenges and be able to bounce back from tough times and setbacks.

In spite of surface appearances, it helps to understand that some odd everyday behaviours may be because of mental disorders undiscovered. Often this depends on the mental characteristics of the person and his or her physical environment. Fearful of the stigma of mental illness, people are reluctant to bring up the matter for the attention of medical professionals.

Whether it is genetic-based, work-stress induced or age-related, it is estimated that one person in five will be affected by a mental disorder at some stage in life. With this statistic in mind, it is regrettable that, instead of being supportive, social stigma still exists and surrounds people who are undergoing or recovering from mental disorders.

The presence of mental disorders should not be seen as a personal failure. Once in a while all of us need a helping hand to regain our balance, so there is no shame in seeking help. In fact, it would be

foolish not to do so and suffer needlessly. And all of us should offer our support to those who are afflicted by mental disorders.

The Institute of Mental Health/Woodbridge Hospital (IMH/WH) has come a long way, from its custodial care days at rural Yio Chu Kang to its present modern hospital and community-based care and research centre in the heart of Hougang.

IMH/WH is now at the forefront of psychiatry and mental healthcare in Singapore and is one of the leaders in the area of mental healthcare research regionally. Additionally, IMH/WH has taken the lead in the introduction of many initiatives in public education and rehabilitation.

From groundbreaking research into the genetic factors of mental illnesses, to preventive efforts such as mental wellness programmes that reach out to workplaces, active rehabilitation care and shared care with employers and general practitioners respectively, IMH/WH has been diligent in its efforts in transforming the mental healthcare landscape in Singapore. I am confident that IMH/WH’s continuing efforts will come to fruition as it strives to achieve its 2012 vision of becoming the leading mental health centre in Asia.

I congratulate all IMH/WH staff, past and present, on 80 years of excellent mental healthcare for Singapore and the region. I am confident that you will continue to shine brightly and hearten the minds of those you care for, by empowering them with self-belief and mental resilience.

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messageMr Michael Lim Chairman, National Healthcare Group

Within the National Healthcare Group’s (NHG) vision “Adding years of healthy life”, mental wellness is certainly an indispensable component. Led by the Institute of Mental Health/Woodbridge Hospital (IMH/WH), mental healthcare in Singapore has taken giant progressive strides.

IMH/WH’s transformation over the past 80 years is marked with numerous advancements and achievements. Foremost in significance is the fact that IMH/WH is no longer an isolated institution detached from the community. Expanding from its former primary role in custodial care for the mentally ill, today, IMH/WH is a full-fledged, tertiary specialist hospital, complementing hospital-based care with more community-based care initiatives aimed at promoting mental wellness, raising public awareness on the importance and benefits of prevention, and early detection and treatment of mental disorders.

Recognising that poor mental health is a debilitating, chronic ailment that is often undiagnosed and untreated, the Ministry of Health appointed the National Mental Health Committee in 2005 to address this concern. Co-chaired by A/Prof Wong Kim Eng, Chairman, Medical Board, IMH/WH, the committee developed the National Mental Health Blueprint (NMHB) in 2006. Focusing on four key strategic areas, Mental Health Promotion, Integrated Mental Health Care, Developing Mental Health Manpower and

Research, the Blueprint aims to enable the community with access to comprehensive, community-based and cost effective mental health services.

Some of the current NMHB programmes run by IMH/WH include the Aged Psychiatry Community Assessment and Treatment Service (APCATS) which treats the frail elderly in their own home, the Early Psychosis Intervention Programme (EPIP) which aims to detect and manage psychosis early, and the General Practitioners partnership programme which provides follow-up care for clients who are reintegrating into the community.

Since coming under the wing of the NHG in 2000, IMH/WH’s close synergy with the Group is evident on several fronts – research related expertise sharing, group-wide human resource and electronic information management as well as various other joint community level programmes. This demonstrates that as a Group, we are able to provide the nation with a more holistic care of both the mind and body, truly adding more years of quality life.

I heartily congratulate IMH/WH on their remarkable 80 year journey. We look forward to continue striving together to bring faster, better, safer and cheaper patient care to the people of Singapore and the region.

12 heartening minds

messageDr Lim Suet WunCEO, National Healthcare Group

Since its inception in 1928, the Institute of Mental Health/Woodbridge Hospital (IMH/WH) has grown from strength to strength – in psychiatric training, expanding its services and specialisations, and successfully achieving groundbreaking research – all with the aim of helping scores of patients and their families lead better lives.

IMH/WH’s pursuit for excellence is relentless and their efforts have been recognised both locally and internationally. In 2006, IMH/WH was presented the prestigious State of Kuwait Health Promotion Award by the World Health Organisation (WHO) for its Early Psychosis Intervention Programme (EPIP). The hospital’s continuing efforts in transforming its 25-hectare campus – the Buangkok Green Medical Park – into a bustling medical park has also garnered the Merit award at the inaugural The Enterprise Challenge (TEC) Public Service Innovation Award 2006.

The institution’s quest for innovation meant the undertaking of numerous initiatives, many of which cleverly leveraged the power

of information technology to radically enhance the delivery of psychiatric services to patients. As part of IMH/WH’s Digital Psychiatry 2009 vision, the iPharm system for example, is an NHG-wide integrated pharmacy system, enabling medical teams to prescribe medicine, order supplies as well as clinical and therapy services electronically.

Collaboration with the National Skin Centre has also allowed long-stay patients with skin conditions to be treated via tele-consultation, thereby shortening waiting time whilst improving institutions’ level of efficiency. In addition, IMH/WH’s mobile crisis team is now equipped with hand-held devices that provide updated and accurate patient records on the go.

IMH/WH has indeed come a long way in its 80 years as Singapore’s champion of mental health. As it moves into its ninth decade of service, I would like to express my congratulations for its fulfilment in becoming an innovative centre for psychiatric care and research.

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Eight decades of dedication, excellence and innovation – in small steps or milestone strides – in mental healthcare. It has been a remarkable adventure with many people making a worthy difference, big or small, with IMH/WH. Truly, it gives me great pleasure to celebrate IMH/WH’s 80th Anniversary with all our staff and our partners.

It is a remarkable heritage that has been passed down to us. We strive to build on this rich heritage with our current vision: to be the leading mental health centre in Asia by 2012. To realise it, all our efforts are directed at our mission to promote mental health, be involved in its research and to provide better quality care in terms of outcome and cost effectiveness.

We have come a long way in our journey of de-stigmatisation, starting from our move from Jalan Woodbridge along Yio Chu Kang Road to Buangkok View and the addition of Institute of Mental Health to Woodbridge Hospital in our name in 1993, to becoming part of the National Health Group (NHG) cluster in 2000, to being the first mental health institution in Asia to achieve the Joint Commission International (JCI) Accreditation in 2005, just to name a few milestones.

We now offer a comprehensive range of quality psychiatric, rehabilitative and counselling services. We have eight clinical departments, three clinical service units including a 24-hour Emergency Service, Rehabilitation Psychiatric Service and Psychotherapy Service. Three specialist outpatient clinics operate from Buangkok View while our satellite clinics include

two Behavioural Medicine Clinics, a Child Guidance Clinic and a Community Wellness Centre. Our occupational therapists run three day centres and a Mobile Crisis Team provides continuity of care for our patients in the community.

Our innovations continue to win national and international awards. More importantly, patients benefit from these innovations. In the Hospital Management Asia 2007 Conference, IMH/WH was presented with the Most Outstanding Customer Service Category for its relentless efforts in reducing the rate of unplanned re-admissions from 13.8% to 1.04%. Our Early Psychosis Intervention and Prevention (EPIP) programme has also bagged one of the inaugural National Medical Excellence Awards 2008, conferred by the Ministry of Health (MOH). EPIP is now one of the leading programmes of reform and best practice in early intervention in psychotic illness.

The journey thus far has been based on our dedication to improving the quality of life for all with a strong emphasis on community involvement in the process. We will continue to transform our campus and services, increase community outreach efforts through education and mental wellness programmes, establish partnerships in research and volunteer services, and finally, improve mental healthcare by harnessing technological innovations.

It is a fact that none of the above could have been achieved without our staff and many stakeholders. So let us continue together in our journey of heartening minds, of making a difference, as we achieve incremental steps and milestones in the years to come.

messageMr Leong Yew MengCEO, Institute of Mental Health/Woodbridge Hospital (IMH/WH)

14 heartening minds

messageA/Prof Wong Kim EngChairman, Medical Board, Institute of Mental Health/Woodbridge Hospital (IMH/WH)

The combination of IMH/WH staff’s passion, the government’s forward thinking, and Singaporeans’ growing enlightenment, has contributed to the evolution of IMH/WH to what it is today. While IMH/WH was a forgotten mental asylum 80 years ago, today the media regularly seeks IMH/WH’s expert views on various aspects of mental health.

Responsible for some 80% of the public mental healthcare that includes 1,600 inpatients and 33,000 outpatients, IMH/WH is the largest mental health service provider and training centre for mental health professionals in Singapore. Its large patient population augurs well for all forms of clinical and translational research.

Significant changes really took place during the last 20 years, starting with the establishment of the Community Psychiatric Nursing programme in 1988, which heralded the initiation of community psychiatric care of the patients. Over the years, we have gradually diminished the institutional model of care and built up the community model of mental health education, building mental resilience, early detection and early treatment, timely rehabilitation and re-instatement into the community for as normal a life as possible. Family support and adequate community mental health resources, such as the community mental health teams, are crucial.

The inaugural batch of three Master of Medicine (Psychiatry) psychiatrists who graduated in the mid-80s was trained at IMH/WH.

Currently, we are accredited to train 30 Basic and 25 Advanced, Specialist Trainees. While the hospital used to be a posting of ‘no choice’ for medical officers, we are proud that latterly, almost all our medical officers chose IMH/WH as their first choice.

Comprehensive and in-depth psychiatric training of psychiatrists and other mental health professionals at IMH/WH is made possible by the availability of varied sub-specialties and the largest multidisciplinary mental health workforce in the country, as well as a keen eye on continuous improvement in clinical quality and patient safety. We have in our midst two senior pharmacists who scored a first in Asia to be Board Certified Psychiatric Pharmacists.

Strident steps too, have been made in research. We have a vibrant research division with clinician researchers, clinician scientists and visiting scientists, who collaborate with eminent local and overseas research partners, and garner seven-digit grants for projects that include translational research. Meaningful research translates into improved clinical care for our patients.

Serendipity has timed IMH/WH’s 80th anniversary so close to the government’s commitment of $88 million to the National Mental Health Blueprint. Where IMH/WH is concerned, the timing could not have been better as we continue our remarkable journey with the implementation of more beneficial initiatives and programmes in mental healthcare provision.

18 chapter 01: insiders’ insights36 chapter 02: friends and familiars58 chapter 03: the next stage82 milestones86 chiefs – through the years88 translating hope into reality90 acknowledgements

contents

chapter 01:

insiders’ insight

18 heartening minds chapter 01: insider’s insight

I Remember

Eight Years of Inspirational Moments

It was a time when the Institute of Mental Health (IMH), then known as Woodbridge Hospital (WH), was the largest hospital in Singapore in terms of bed numbers at 2,200. It was also a time when WH resided at remote Yio Chu Kang, where its sprawling architecture and forbidding fences upheld the institution’s custodial function.

Dr Tsoi Wing Foo was WH’s Medical Superintendent from 1971 to 1979. He recalled that the public tended to associate mentally ill people with violence even though many of them were not violent, and called such people ‘insane’. “At that time, the press would report a violent crime and then highlight the person’s mental illness. So that did not help with the hospital and patients’ image,” recalled Dr Tsoi.

Intimidating architecture and fences, and the press portraying and fanning the stereotypical image of violent, mentally ill people – these factors significantly reinforced WH’s custodial image, where mentally unsound individuals were kept apart from the public. WH was largely seen as a place of mental illness and confinement, and not as a place of mental wellness and rehabilitation. There was much to be done and Dr Tsoi stepped up to the task.

Pioneering Moves

In 1972, the Child Psychiatric Clinic, now known as the Child Guidance Clinic, was established during Dr Tsoi’s time. “The clinic was running, but in an informal way. It was only when Dr Wong Sze Tai completed his specialised training in child psychiatry in the United Kingdom and came back to WH that the Child Psychiatric Clinic was officially started,” Dr Tsoi explained.

Another breakthrough change that Dr Tsoi set out to accomplish was to allow voluntary patients to be admitted into WH for treatment. The Mental Disorders and Treatment Act was thus amended in 1973

to enable people to approach and be admitted into WH. The change was adapted from the British Mental Health Act 1959.

In 1974, the Changi Prison Psychiatric Hospital was established. A joint initiative between the Ministry of Health (MOH) and WH, Dr Tsoi recalled, “It was better to have a hospital in Changi Prison. This addressed the rare instances of inmates who were sent for observation or who were detained for treatment under the Criminal Procedure Code to escape from custody.”

Major steps were also undertaken to make the rehabilitation of patients a stronger factor in addition to the existing long-term custodial approach of patient care in WH.

“We acquired a vacant Gurkha barracks at View Road, off Admiralty Road. We carried out some minor conversions and established it as the View Road Hospital for the rehabilitation of patients in 1975 with the aim of placing them with jobs outside the hospital,” Dr Tsoi recollected.

“I named it as a ‘hospital’ because if I had called it a rehabilitation centre, WH would not be allocated an additional post of Medical Officer, which WH was in very short supply of. Later on, I found out that View Road Hospital had to be decommissioned because it could not meet certain specified requirements of the Hospital Act!” recounted Dr Tsoi with a smile.

There were only five clinic rooms cum offices for psychiatrists at WH. As the number of psychiatrists increased, there was a need to acquire more rooms. Ward 21 of WH, which was close to the pharmacy and the administration area, was a welcome addition when it was converted into the new Psychiatric Outpatient Department. Outside the hospital, there was the psychiatric outpatient clinic at Lim Ah Pin Road that was run by WH.

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Dr Tsoi Wing Foo

It is important to contribute to the well-being of people however little that contribution

may be. Even if it is little for each individual, still, it adds to the total pool for humanity and

Singapore, and that is not little indeed.


“Psychiatric outpatient clinics in the community at that time made use of the clinic rooms of other hospitals or general outpatient clinic’s facilities and occupied one or two rooms. The Lim Ah Pin Psychiatric Outpatient Clinic was the first dedicated psychiatric clinic in Singapore that was administered by WH,” Dr Tsoi shared.

With the establishment of the View Road Hospital and WH’s additions to the number of outpatient clinics, significant progressive steps were achieved for the rehabilitation of clients at the community level.

Challenging Times, Good Times

During his tenure, Dr Tsoi increased WH’s bed numbers from 2,200 to 2,500. He recalled, “There were less than 15 doctors, including psychiatrists, at that time and very few allied staff: about two

occupational therapists, five social workers and three psychologists. Of course, with such few staff, we got to know each other very well. The staff were very dedicated, especially the nurses, who really knew their patients.”

Besides the challenge of looking after WH’s large number of inpatients – an everyday duty that the staff smartly met – the budget was considerably limited too. To stretch the allocated budget and to improve the level of comfort and services, the team at WH displayed a certain degree of ingenuity and improvisation.

“During the British withdrawal from Singapore, we went to the deserted barracks and offices and collected furniture for our own use. In addition, when the police changed their uniforms, we took over the old ones for our patients’ use. We were into recycling a long time ago!” Dr Tsoi revealed with a hint of amusement.

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The dedication and camaraderie of the staff was a constant source of inspiration and good memories in work and leisure time amongst WH staff. Dr Tsoi remembered the sports days fondly, at MOH level and at WH level, where the interest was so high that WH organised its own sports day, the only hospital to do so at that time.

Not forgetting WH’s Golden Jubilee in 1978 which was a major milestone and time of delight for the staff, Dr Tsoi highlighted, “For the 50th Anniversary celebrations, besides our usual dinner, there was also an engaging concert with performances by the staff and patients that brought a lot of cheer to everyone.”

Ever active after all these years, Dr Tsoi’s motivation and dedication to caring for the well-being of people has not diminished in the slightest bit. “Patients do recover and remain well, and that is the main thing. It is important to contribute to the well-being of people however little that contribution may be. Even if it is little for each individual, still, it adds to the total pool for humanity and Singapore, and that is not little indeed,” affirmed Dr Tsoi.

Transformative Initiatives

A/Prof Teo Seng Hock was the Medical Director of WH from 1979 to 1996. He first came to WH in 1961 and still remembers the long, fenced-up corridors leading to the separated block-designed wards, grilled gates, barred windows and the general prison-like atmosphere. “The hospital was spread out over 80 hectares and it was quite intimidating or frightening just to walk from one ward to another, especially during the night,” recalled A/Prof Teo on his younger days at WH.

With few doctors on hand to attend to over two thousand patients, A/Prof Teo sang praises of WH nurses and health attendants, “A lot of the work was done by the nurses and health attendants at that time. Teamwork and staff morale were very important and we truly admired the nurses’ dedication to their work. They knew the patients very well and sometimes at night, it’s just one nurse looking after 60 patients.” Other members of the psychiatric team, including psychologists, social workers and occupational therapists also contributed greatly to the care of the patients.


A/Prof Teo Seng Hock

Teamwork and staff morale were very important and we truly admired the nurses’ dedication to their work. They knew the patients very well and sometimes at night, it’s just one nurse looking after 60 patients.

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In 1984, postgraduate psychiatric training was initiated at the hospital. A/Prof Teo explained, “Previously, psychiatrists were sent to England for further training. However, it was limited to only one per year. At that rate, we would never have had enough psychiatrists!

“When we started our own postgraduate training programme, we were able to attract bright doctors and train around three or four psychiatrists per year. In many ways, the training that was provided was more appropriate for our local conditions and culture.”

Throughout WH’s early history, one particular issue that constantly made its unwelcome presence felt was stigma – a dark veil that coloured the public’s perception of WH as a place of screaming and violent patients. Before Dr Tsoi’s work in amending the Mental Disorders and Treatment Act, people were unable to seek treatment at WH on a voluntary basis. Every case that was sent to WH was either through the police and court system, or via referral by doctors.

A/Prof Teo recounted, “Those were the days of custodial care, where only very serious cases were referred to us. The stigma was so strong that some doctors would resign upon their posting to the hospital. Even after the amendment in 1973, many people stayed away because of the stigma. By the time they came to the hospital, they would have become very ill.

“This was very frustrating to us because a lot of psychiatric problems like depression, anxiety and behavioural problems are very amenable to treatment. Because of the stigma, they avoided coming to us until a very late stage when the problem had become serious or chronic. And so, there was a lot of unnecessary suffering.”

Perhaps the biggest visionary change was MOH’s proposal of a new psychiatric hospital in 1984. Ultimately, the goal was to evolve from a largely custodial care model to one of community care for the benefit of all people. The prevention, early treatment and rehabilitation of clients with mental conditions would actively


operate within the community as opposed to late treatment within an institution that would isolate them from everyday life and make it much harder for them to reintegrate into the community.

With MOH’s blessings, A/Prof Teo and his colleagues started to plan for a very different hospital, one that would revolutionise mental healthcare in Singapore with further emphasis on training and new initiatives in mental health promotion and research.

With light-hearted humour, A/Prof Teo mentioned, “It’s not very often that you get a chance to plan a new hospital! With more resources, we were able to develop the concept of community care with more outpatient clinics, prevention programmes and early detection and treatment programmes. Previously, the staff were predominantly involved in clinical care, whereas the new hospital would have adequate resources to provide opportunities for clinical research.”

In 1993, the hospital was reorganised and established as the Institute of Mental Health/Woodbridge Hospital (IMH/WH) at its new 25-hectare premises in Hougang – a groundbreaking event that emphasised the organisation as an institute involved in the mental well-being of the community, and not just solely concerned with the hospital side, which managed in-patient care. Reaching Out

Inspired and motivated by the work and commitment of all IMH/WH staff, especially Dr Tsoi Wing Foo, Dr Wong Yip Chong and Dr Paul Ngui, A/Prof Teo strongly believes that it is very important to carry on with the good work despite the inherent challenges of mental healthcare, general lack of recognition and shortage of trained personnel of all grades.

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A/Prof Teo emphasised, “It is important to let patients, and the community in general who are undergoing stressful periods, know that there are people who believe in them, who care about them, who tell them that they’ve got hope.

“Many of the mental illnesses such as schizophrenia or depression, and non-psychotic disorders such as addiction, eating, sleep and mood disorders are common and very treatable. It is important to reach out to them and help them. Once they recover, they become very well indeed.”

The compassion and care for fellow human beings, dignified qualities which are very important in the practice of mental healthcare, is unmistakable – they are also qualities which ultimately, value and respect life.

My Days

Phenomenal Progress through the Years

IMH/WH has a rich history – one treasured by the medical personnel who have served there. The many changes that have taken place over the years reveal the extent to which psychiatry has developed to be the respected medical science it has become today. The medical staff and the combined institutions that form IMH/WH have been the drivers of the phenomenal progress made in the last four decades – progress brought about through improvements in policies, training, research and medication.

In this section, we gain insights from medical personnel who have experienced pre- and post-Buangkok Green Medical Park (BGMP) healthcare, and who have themselves played a major role in the development of psychiatric healthcare at IMH/WH through the years.

The Pioneers of Psychiatric Healthcare

In the 1960s, psychiatry was a fledgling science and not one that most student doctors at the time aspired to, due to the stigma surrounding mental health in the minds of the public. However, for some, the compulsory posting to WH opened doors to career opportunities and a heightened reason to deliver dedicated healthcare.

A/Prof Chee Kuan Tsee, retired and now holding a part-time consultation post at IMH/WH, was one of the few enlightened graduates in 1967 to elect to enter into psychiatric practice. “I joined Woodbridge Hospital as a personal choice because of my interest in psychiatry,” A/Prof Chee explained. However, most graduates had to experience the difference before making it their life’s work.

Dr Leong Oil Ken, Senior Consultant in the Department of Community Psychiatry, was one young medical officer who made the most of the opportunities presented to him when he joined the ranks at WH in 1976. “I hadn’t considered psychiatry when I graduated from medical school. The posting to Woodbridge was my second choice


at the time. It turned out to be the best experience I could have had. In addition, I was offered a fellowship to study psychiatry in the UK to further develop my career, and I returned to Woodbridge with two postgraduate degrees in psychiatry,” Dr Leong remembered.

Most students who completed training at WH elected a career in a different medical field, but Mdm Chua Siew Hong, now Assistant Director of Nursing, was one who chose to return to psychiatry after her studies. She recalled, “I went into surgical nursing after graduation but realised that I missed the human aspect of medicine – the interaction with patients. I requested to be posted back to Woodbridge as I knew that my passions lay in patient care, and these were the patients, above all others, who really needed our help.”

The Good Old Days

The old WH grounds were a sprawling 80 hectares of land housing single storey wards, each separated by their own football field. “The distance between wards was so far,” recounted Dr Cai Yiming, Senior Consultant Psychiatrist, who was Head of Department of Child and Adolescent Psychiatry from 1993 to 2006, “that we had to cycle the grounds to do our rounds!”

The vast space and isolated location of the hospital at the time served to add to the stigma that surrounded WH at the time. “Stories of hauntings made some staff nervous,” remembered A/Prof Chee, “and it could get scary at night, especially for female staff, as the lonely walkways between wards were dimly lit.”

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Mdm Chua Siew Hong

I requested to be posted back to Woodbridge as I knew that my passions lay in patient care,

and these were the patients, above all others, who really needed our help.


Dr Cai Yiming

There was a real sense of family at that time. We considered senior staff and our mentors as our parents, our fellow colleagues as our siblings and our patients as our children.

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However, the vastness of space had its benefits for both patients and doctors. “The therapy treatment at the time was mostly outdoor therapy,” Mdm Chua explained. “Patients enjoyed the freedom of space, and therapies included farming on the land. Patients would sell their produce to the staff and be able to spend the money they received at the canteen – a welcome break from the daily hospital food.” The space also proved a challenge for the few staff on duty, and Mdm Chua was grateful to the able patients who would help staff out in daily chores for a small monthly fee. “It gave these patients a sense of achievement and certainly helped in their rehabilitation,” she added.

Therapy also came in the form of craft work. Workshops were held on the grounds to teach patients carpentry and basketry skills. “The commodes and chairs they made were sold to local hospitals,” recalled Dr Leong, “and other products they made were bought by expatriate housewives at their functions.”

A Sense of Family

The football fields on the grounds also helped staff to form close bonds. “We used to play volleyball and football matches representing the hospital in competitions,” explained A/Prof Chee. “When I first joined Woodbridge back in 1967, there were only 15 doctors – ten medical officers and five specialists. This meant we had to work closely as a cohesive team. We all enjoyed each other’s support and companionship. There was a real sense of family at that time. We considered senior staff and our mentors as our parents, our fellow colleagues as our siblings and our patients as our children.”

Dr Cai recalled the closeness with fondness, “The staff at Woodbridge were generally a calmer lot. It was an atmosphere where you could unload your stresses and talk openly and honestly with fellow colleagues knowing they would understand.”


Dr Cai also remembers working with Dr Ang Ah Ling, the Medical Director of IMH/WH from 1996 to 2000. Dr Ang passed away in December 2007. He recalled, “Dr Ang gave his all. We could always count on him to support the institution and cluster’s initiatives and directions. Approachable, humble, kind, responsible and pragmatic, he will be missed by many and remembered for his many contributions.”

A New Home

WH was relocated to its new home at the IMH/WH building at BGMP in 1993 and the transition was a massive change for both staff and patients. Mdm Chua remembered the time of moving, “Many patients had developed a strong attachment to the old building. It had been their home for so long and had become a sort of security blanket for some of them. So it took some time to prepare the

patients for the move. One patient was so adamant about not going that she went into hiding. After some searching we found her behind a cupboard!”

Despite the traumatic move for some patients, Mdm Chua added that patient care improved at the new facility. “Patients received even better care now because of the centralised facilities and improved security. We are better able to administer crisis management immediately when there is a need, and patients get to participate in so many more organised activities thanks to our many volunteer programmes,” she attested.

Dr Cai remains impressed with the changes. He declared, “The new multi-storey complex was purpose built to meet the needs of IMH/WH. Facilities have greatly improved to the extent that for the patients, it is like living in a condominium or even a resort!”

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Evolving Psychiatric Care

Along with the new facilities came a fresh approach to managing mental healthcare. Care became less custodial with an emphasis placed on the rehabilitation of patients with a view to their eventual reintegration into society. IMH/WH is now dedicated to the care of long-term chronic patients who face difficulties reintegrating into the community, and specialised programmes have been developed to aid reintegration through outpatient clinics and schemes aimed to place clients in supportive work environments through collaboration with participating companies. Dr Leong explained, “Psychiatry has become much more advanced with specialised departments set up and divided into specific sub-specialities. This not only improves patient care, it also attracts doctors into the profession. Things were very different in my time when psychiatry was considered a general service.”

Advances in the global understanding of psychiatry and the working of the human mind have gradually changed the way doctors are trained in psychiatry at IMH/WH. A/Prof Chee recollected, “In the

early days, we learned from senior doctors, our mentors and from our patients. Each patient gave us a chance to learn. There wasn’t the wealth of books that student doctors have access to today. We got most of our information from pharmaceutical journals.” Training at the time was more hands-on. A/Prof Chee added, “We were taught a procedure one day and were left to do it unsupervised the next. Today, training is more structured, and since 1985, we have our own degree programme in Psychiatry in Singapore. Students no longer have to study abroad.”

A/Prof Chee also considered the commercial aspect of developments that are changing the manner in which mental healthcare is delivered. “Branding has become a societal trend we can’t ignore,” commented A/Prof Chee. IMH/WH has achieved ISO certification and received People Developer awards along with the prestigious Joint Commission International Accreditation (JCI) certification in 2005, a globally recognised endorsement of the high standards of care found at IMH/WH today. Affirmed A/Prof Chee, “In an age of expanding medical tourism, patients know that they can come to IMH/WH and receive the best care available.”


A/Prof Chee Kuan Tsee

In an age of expanding medical tourism, patients know that they can come to IMH/WH and receive the best care available.

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Rising Above the Challenges

Undoubtedly the greatest challenge faced by the psychiatric profession throughout the world is the ongoing stigma attached to mental health. It is encouraging to note that through the consistent work of IMH/WH and its allied healthcare providers, IMH/WH has succeeded in reducing stigma in Singapore.

When A/Prof Chee joined WH back in 1967, stigma even among doctors was high. Now, A/Prof Chee is heartened by today’s graduates who make psychiatry their first choice in specialist training.

IMH/WH has made great inroads into decreasing the stigma in the community at large and is encouraged by the depth of support it sees today from different sectors of the community. According to Dr Leong, it is important to change public perception for two reasons. Firstly, for existing patients to be reintegrated into society, they need the ongoing support of the community. Secondly, it is also important to treat patients early as the earlier they are treated, the better their prognosis for recovery.

Dr Leong elaborated, “We are tackling stigma today through public education. Programmes include creating awareness in schools, teaching students about mental health and giving them the facts that debunk myths. There are also programmes for the public, volunteer groups and organisations. In this way, the correct information permeates through society at large and support for the rehabilitated increases.”

While educating the public is an ongoing process, IMH/WH has not forgotten the undiagnosed patients that remain victims of the stigma still attached to mental illness. Mdm Chua highlighted her involvement in the Psychological Outreach Programme (POP). “We send our volunteer psychiatric nurses out into the community to identify and treat those members of the community that need help,” she explained. “We work with the support of grassroots leaders who help us identify the needy during house visits.”

The Drive to Continue Giving

Despite the years these four remarkable characters have given to IMH/WH, the passion for what they do is as strong as ever. For each, this stems from the miracles they have witnessed time and again – the recovery of patients that society had given up on.

“It’s good to know we have made a difference and that society has benefited from the patients’ rehabilitation,” Dr Leong commented. For A/Prof Chee the drive to understand the mysteries behind the working of the brain are a driving force that keeps him glued to his post way beyond his retirement, while Dr Cai is inspired by his patients’ recovery and the effect on their families. Perhaps Mdm Chua expressed it best: “These are the patients above all that really need our help – our raison d’etre.”

chapter 02:

friends and familiars

36 heartening minds chapter 02: friends and familiars

In Appreciation

Beacons of Hope

There is no greater testament to the success of the work done by the Institute of Mental Health/Woodbridge Hospital (IMH/WH) and its allied healthcare providers than the successful rehabilitation of former patients. Where mental illness used to be seen as an unmanageable and incurable affliction with sufferers doomed to life-long incarceration in the dark vaults of a secure mental asylum, former patients of IMH/WH now rehabilitated and integrated into the community are shining beacons of hope for people with mental health problems throughout Singapore and the region.

Here, we meet four courageous individuals or their family members who have struggled through various forms of mental health problems and who, through the support of IMH/WH and its allied healthcare providers, have become active members of the community once again.

Harris Ng

Harris Ng had symptoms of schizophrenia in the early 1970s while he was studying at university abroad. He came back to Singapore to seek treatment and begin his long road to recovery.

The Struggle Within

Harris had three relapses before he began to progress through his recovery. His third admittance to WH as an inpatient was at the hands of the police after he was arrested for creating a public disturbance while distributing religious pamphlets. At this stage, Harris was at his lowest point. His words were disconnected, he was crying uncontrollably and was refusing to eat.

Harris attributes his struggles towards recovery to his unwillingness to accept or fully understand his disease. Each time he stopped

taking his medications, he suffered a relapse. “My first relapses were due to my refusal to take the medication because of the side effects. The meds slowed my speech, which made it difficult for me to get a job,” explained Harris. Other side effects included tremors, body stiffness, and an upward-rolling motion in his eyes.

“When I started to do well and my medication was controlling my symptoms to the extent where my family doctor and all my friends thought I had made a full recovery, I stopped taking my medication again,” Harris recalled. “Needless to say I ended up back in the hospital. By this time, treatment had advanced. The drugs did not have so many undesirable side effects. Under the care of Dr Eu Pui Wai, my recovery started its upward momentum.”

A New Direction in Treatment

Eventually, Harris was transferred to outpatient treatment and Dr Eu suggested he should go for counselling to help keep his recovery on track. “I didn’t think I had anything to lose, so I gave it a go,” he said. “It made a real difference as finally I was talking to people like myself, people who had been through what I was going through and had come out the other end for the better. These people inspired me towards my own recovery and at last I understood that I was not alone.”

The counselling gave Harris mental and spiritual strength and he has remained on his medication ever since. “I now understand and accept that schizophrenia is a life-long condition. It is not something I can be cured of, but it can be controlled with the right medication,” Harris explained. Over the years Harris has worked with his doctors to manage the medication and reduce its side effects. His counsellor has helped him with his basic daily needs and also with finding jobs.

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An Inspirational Role Model

Harris now only returns to his doctor every six weeks for a single injection, and his dosage has been reduced to an appropriate level so that he no longer experiences the debilitating side effects that caused him to abandon his medication at the beginning.

Today Harris gives hope to others with mental illness. Through the right treatment, collaboration with medical practitioners and counsellors and support from the family, his is an example which shows that managing and coping with the illness is truly possible.

Harris has come a long way in his own personal journey of recovery. He is married to a very supportive wife, and works full-time as a private tutor so that he maintains control over his time. This

enables him to give voluntary support to other sufferers. He runs support groups for his peers offering advice such as how to get back to work. His involvement in the IMH/WH-run Early Psychosis Intervention Programme (EPIP) gives patients the invaluable experience of seeing someone like them leading a normal life. He also gives talks on schizophrenia to tertiary institutions such as the Nanyang Technological University (NTU), the National University of Singapore (NUS), as well as community centres and other public forums.

Harris is encouraged by the direction IMH/WH has taken with its approach to the treatment of mental health. “Centres like the Sayang Wellness Centre, run by IMH/WH, provide innovative treatment focussed on wellness not illness. This is a huge step forward, and one of the reasons I am better today,” enthused Harris.

Harris’ journey to recovery is chronicled in his book, Recovered Grace: Schizophrenia, which has since been translated into Mandarin and Bahasa Indonesia.


Rita Goh

When Rita became delusional and started imagining that her family was trying to kill her, something was desperately wrong. Although she received treatment in the early stages, Rita suffered four relapses because she stopped taking her medication each time. On her final relapse, she was referred to IMH/WH shouting and crying.

Medication Makes a Difference

Rita has been diagnosed at different times with schizophrenia, depression, mood disorders and bipolar disorder. Her current diagnosis is anxiety disorder and her medications are working to control her symptoms. Rita explained, “The changing labels of what was wrong bothered me at first, but since the medications seemed to work, that’s all that really matters.

“When I started taking the medications, I noticed an immediate difference. Something about the way I was treated by one of the nurses at IMH/WH really got through to me that last time. Now I accept that just because the symptoms are gone, this doesn’t mean I can stop taking the medications.” Rita is now on a low dosage and is fully supported by her family and friends.

Giving Back

Today Rita gives back to help others recover as she has done. She runs her own business co-ordinating counselling and conducting talks within the community to raise awareness of mental illness, reduce its stigma, and aid the recovery of sufferers.

“IMH/WH is working in the right direction, investing in educating the public so disorders can be identified and treated early. Early intervention helps shorten the recovery period,” explained Rita. She

also works through the Silver Ribbon programme to conduct talks on mental illness at tertiary institutions, community centres, and public forums.

An Example to Follow

Rita’s motivation stems from her desire to help others because she feels that she, as a recovering patient, is the best example. “If people see me now and learn what I have been through, there is no better encouragement for them to continue with their recovery programme,” she explained. “It’s also good for my self-esteem and continued good mental health.”

Rita’s advice to people going through mental illness? “Don’t give up. Keep taking your medication and go for all your follow-up appointments. Be active and deal with your recovery one stage at a time. Don’t be tempted to take on more than you can handle or you risk a relapse.”

B C Tey

Mr Tey hit rock bottom when he faced his desperate state of addiction to gambling and wanted to end his own life. “Over the years of gambling, I lost hundreds of thousands of dollars betting on horseracing, 4D, TOTO and football matches. My addiction and denial of my problem caused me to blame everyone but myself,” he explained of his former self.

A Master of Manipulation

His salvation came late as he became very skilled at hiding his addiction and no one in his family knew that he had this condition. “They suspected, but I hid it well. I would also borrow, cheat or spin whatever web of lies necessary to gain their trust and sympathy. My

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Ms Rita Goh

If people see me now and learn what I have been through, there is no better encouragement for them

to continue with their recovery programme.


Prof Hartanto

We experienced such a depth of care during our visits. The staff delivered care with such compassion that my son trusted them, and was able to open up and discuss his feelings as he never had done before.

41

wife and mother were usually the ones to bail me out of financial difficulties to save the family name. My family also suffered under my neglect. My time spent gambling meant that I spent little time and attention on my wife and our three kids. This is time I can never get back,” commented Mr Tey with regret.

The Road to Acceptance

Finally tired of the deception, Mr Tey bravely came clean with his family in January 2007 after accepting care at IMH/WH’s Community Addiction Management Programme (CAMP). However, the struggle was only beginning for Mr Tey. Although he had admitted his problem, he could not fully accept its implications and he continued to manipulate his recovery, blaming moral deficiencies and self-inflicted problems. He finally succumbed to chronic depression.

“Realising the shock, disgust and disappointment of my loved ones was devastating. I had lost absolutely everything and just wanted to end it all. It all seemed so hopeless,” recalled Mr Tey ruefully.

Invaluable Support

Mr Tey found the doctors and counsellors at CAMP very encouraging and supportive through his painful process of change. “I have been attending weekly counselling sessions at IMH/WH to get me out of my depression and to help me understand the illness. My counsellor has even gone beyond the call of duty to deal with my issues at work and my dysfunctional family life,” he explained gratefully.

Mr Tey also attends rehabilitation and aftercare sessions, frequently accompanied by his supportive wife and children. “We play games there as part of the programme to mend the breaks in our

relationship, and at weekends we enjoy simple activities together like picnics or going to the playground – things I never used to do when I was obsessed with gambling.”

Help is Out There

Mr Tey is grateful for the treatment, help, hope and love he has received through the period of his recovery and has one simple message to deliver to addicts: “There is help available to stop this addiction. Don’t wait till you lose everything.”

Son of Prof Hartanto

Prof Hartanto’s son was diagnosed with narcolepsy – a medical condition that makes the person go to sleep unexpectedly – while he was still in high school in the United States. Although he had to live with this handicap, he was still able to finish his architectural studies in Indonesia.

A Life on Hold

“My son would fall asleep during the day and suffer from hallucinations. This was extremely destructive to his daily life and studies, and severely damaged his confidence,” recounted Prof Hartanto.

“He shut himself off from his friends and became quite depressed as he could see them progressing in life while he was being left behind because of his debilitating condition. I was desperate to find help for him and am so grateful we found IMH/WH and Dr Chua Hong Choon,” Prof Hartanto explained. “To complicate matters, he also suffered from sleep apnoea and needed medication for that too.”


Care with a Human Touch

The road to recovery for Prof Hartanto’s son began with a visit to the Singapore General Hospital (SGH), where they were referred to IMH/WH and the start of invaluable care that has made an amazing difference in the young man’s life.

Prof Hartanto explained, “We experienced such depth of care during our visits. The staff delivered care with such compassion that my son trusted them, and was able to open up and discuss his feelings as he never had done before. He realised the condition is not his fault and his confidence increased as a result.” Prof Hartanto remains grateful that their search for answers had finally ended.

A New Hope

Today his son is greatly improved and his condition is managed through adjusted expectations and a different approach to activities. “Narcolepsy is a vicious cycle,” Prof Hartanto explained. “Patients fall asleep because they are not occupied. Then they feel idle because they sleep, so they want to sleep again. Now my son keeps active by working with models he builds. This occupies his mind so he doesn’t fall asleep while he is busy.” His son has also been back in touch with his friends and no longer feels embarrassed when he falls asleep in front of them.

“Educating his friends about the disease has led to him gaining their understanding and support,” explained Prof Hartanto. “This wouldn’t have been possible before his treatment at IMH/WH. We have much to thank IMH/WH for.”

Community Insight and Initiatives

Branching Into Community-based Mental Healthcare

The roots of IMH/WH may be found in its custodial function of looking after the severely mentally ill, which include keeping them in wards, apart from the rest of society. However, just like an evergreen tree, IMH/WH has grown much and is still growing as a tertiary institution with branches that reach into community-based mental healthcare.

IMH/WH has certainly come a long way – to fully appreciate this journey, one has to reach back to the past, where IMH/WH worked in near total isolation, to its present network of partners that work at the community level.

Community Impressions of Old

Minister for Health, Mr Khaw Boon Wan, first visited WH in the late ’70s, accompanying then Health Minister, Dr Toh Chin Chye. He remembered the rural setting and WH’s low-rise buildings with large open wards. “It was quite charming in its own way, with a landscape that was very different from the rest of Singapore,” recalled Minister Khaw.

Sharing his impressions of the old WH, Mr Lam Pin Woon, Chief Executive Officer (CEO), Health Promotion Board (HPB), commented, “At that time, the word ‘Woodbridge’ was synonymous with mental illness. People largely associated it as an isolated place where people with mental illnesses were locked up. It was a place that people avoided going to.”

Ms Kala Karkal, Director, Dignity Links Ltd concurred, “The old Woodbridge was more institution-based – essentially a treatment hospital. Compared to now, IMH/WH is very different. They are looking at more community-based intervention and prevention initiatives, and rehabilitation. They are trying to cut down on the hospitalisation aspect and exploring whether prevention, treatment and rehabilitation can be done within the community.”

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Minister Khaw Boon Wan

The key challenge for mental healthcare stakeholders remains the stigma associated

with mental illness and we should go all out to combat it.


Indeed, the old hospital’s custodial nature captured the imagination of the Singapore public. It was a place that everyone seemed to perceive as an institution that locked up the insane and was the source of many off-colour jokes. The stigma surrounding the institution was so strong that some doctors who were posted to WH resigned and many staff declined to reveal to others that they worked at WH.

“Stigma prevents patients from coming forward to treatment. Stigma prevents patients from being able to benefit from rehabilitation at the community level. Stigma prevents patients who have recovered from being able to work and earn a living. The key challenge for mental healthcare stakeholders remains the stigma associated with mental illness and we should go all out to combat it,” emphasised Minister Khaw.

From Reactive to Proactive

The stigmatisation of people with mental illnesses is no longer as strong as it was before during WH days. Many people actively pursue mental healthcare professions and IMH/WH staff are certainly proud to be associated with the institution.

In 2007, the Ministry of Health (MOH) and HPB ensured that mental wellness received centre stage attention during the National Healthy Lifestyle Campaign. Launched by Prime Minister (PM) Lee Hsien Loong, the campaign’s theme, Healthy Mind, Happy Life, effectively focussed on physical and mental health for the first time in the campaign’s 16-year run.

As part of the National Healthy Lifestyle Campaign, IMH/WH organised a mental health carnival at the shopping centre, Vivocity,

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thus bringing mental well-being and education out of the hospital setting and into the public.

HPB and IMH/WH have also collaborated on the Mind Your Mind programme which has been running since 2001 and has educated the public on issues such as clinical depression.

Mr Lam elaborated, “IMH/WH is an extremely important partner for us to educate the public, to de-stigmatise any type of mental or emotional problems. It is very important that HPB in collaboration with IMH/WH conduct public education to help people understand that there is nothing wrong with seeking help if they are undergoing some mental or emotional problems.”

Another active outreach effort that brings mental well-being to the community is the Treasure Your Mind programme that was

launched in October 2007. Developed and managed by HPB, this workplace-based initiative reaches out to employers and employees at their workplace.

Different workshop modules have been designed: basic well-being workshops that emphasise the importance of mental health and the coping of workplace stress are open for all employees, while supervisors may arrange for a workshop that teaches them the signs of anyone undergoing mental stress to identify employees who may need help. IMH/WH provides support for the Treasure Your Mind programme.

“Over the years, we have been trying to remove stigma, to get people to realise that coping with a mental or emotional problem is nothing to be ashamed about. If one has a mental problem, he or she should seek help early and not wait till the problem worsens.

From left to right: A/Prof Wong Kim Eng, CMB, IMH/WH; Mr Leong Yew Meng, CEO, IMH/WH; Ms Yong Ying-I, Permanent Secretary, MOH; Dr Lim Suet Wun, CEO, NHG; and Mr Lam Pin Woon, CEO, HPB at the World Mental Health Day 2007.


Also, the general public must be more enlightened and supportive of people who are coping with mental or emotional problems,” affirmed Mr Lam.

Rehabilitation Initiatives within the Community

The Singapore Association of Mental Health (SAMH) was established in December 1968 by the late Dr Koh Eng Kheng, a General Practitioner, and Dr Paul Ngui, then a Consultant at WH. The association aims to empower people with mental illness to rebuild their lives and to promote mental wellness.

Like IMH, SAMH runs community-based rehabilitation initiatives such as a day centre, counselling services and support programmes for patients and their families. In addition, SAMH manages a YouthReach Centre for children and youths with mental health concerns.

A/Prof Leslie Lim, President, SAMH, explained, “We have community level facilities and services. Most of the referrals are from IMH/WH, with a lesser extent from general hospitals and private psychiatrists. For example, if the clients have a job but no place to stay, they may be referred to one of our group homes. IMH/WH’s Child Guidance Clinic (CGC) refers those with stabilised psychiatric illnesses to our YouthReach Centre, which helps through counselling, psychosocial rehabilitation programmes and planned, structured activities.

“Our partnership with IMH is a close, dexterous one. In fact, a number of IMH/WH psychiatrists serve on SAMH’s management committee. We consult and support each other’s efforts in client care, public exhibitions and public talks on mental wellness.”

A/Prof Lim was a Medical Officer at Woodbridge Hospital in 1982. He chose psychiatry as his field of practice because he felt that compared to other medical specialities where patients were

47

relatively well taken care of, psychiatric patients appeared to have been forgotten by society in general.

“Mental patients did not seem to have a place in society in those days. This situation appealed to me because these are the people who really need our help and support,” explained A/Prof Lim.

More than 25 years later, it is clearly evident that A/Prof Lim is still assisting people – the ones who need that extra bit of support in rebuilding their lives.

Towards Greater Collaboration for Community Care

Currently, IMH/WH serves the community as an all-encompassing centre for psychiatric help. However, it is working towards becoming a tertiary mental healthcare institution, where resources and efforts would be devoted towards more severe and complex cases, as well as research and advancements in the field of psychiatry. This would mean that frontline healthcare providers such as General Practitioners (GPs), must be better equipped to handle the early

detection and treatment of less severe mental illnesses, and to assist in the rehabilitation of patients who have undergone a period of inpatient care.

For Dr Nelson Lee, Deputy Chief of General Psychiatry, bold moves can deliver the best impact. He directs the IMH-GP Partnership Programme, an initiative that aims to break down barriers of unfamiliarity that GPs face. Partner GPs attend training courses where they acquire knowledge and techniques to identify the physical symptoms of psychiatric illnesses and to provide treatment. The programme also equips GPs with the know-how and confidence to manage patients referred to them by IMH/WH.

The IMH-GP Partnership Programme has gained ground since its inception in 2005. Today, IMH/WH has managed to partner more than 30 GPs to engage in follow-up care for stabilised patients. “That’s actually quite amazing because, just a few years ago, I would think that no GP would want to see this group of clients,” Dr Lee related. With MOH formally backing the effort, IMH/WH’s pioneering initiative is now known as the Mental Health GP


Ms Kala Karkal

Every individual has something to contribute to society. It is the right of an individual to contribute. We, as a society, should not deny, at whatever level of disability, each person’s right and dignity to play a contributing role.

49

Partnership Programme and will be expanded to other hospitals in Singapore over the next few years.

Dr Lee cited his people-oriented personality as an integral part in his career choice, “I guess I like to talk and listen to people and, from there, make a change by improving the quality of their lives.” With his work as a consultant and the IMH-GP Partnership Programme under his charge, he has certainly made worthy inroads in his quest.

Social Enterprise

For Ms Karkal, her not-for-profit social enterprise, Dignity Links Ltd, runs Barista Express, a snacks and beverage outlet, in collaboration with IMH/WH. Located in the heart of the business district at Raffles Place, Barista Express is the first of its kind in Singapore, where

training for persons with psychiatric illness is provided in a real-life setting within a public space.

Ms Karkal explained, “Barista Express not only trains the recovering patients, it also creates awareness about mental illness and its acceptance. We have signs that inform the public about the patients and our regular customers know about the social cause.

“All our patients have made excellent progress in their recovery and have been certified by IMH/WH psychiatrists as fit for work trial at Barista Express. They then work for three to six months and once they feel they are ready, we place them with empathetic employers on a one-month probation. During this entire time, we provide support groups, cognitive therapy and wellness enhancement programmes for the clients. IMH/WH occupational therapists also guide them throughout this period.”


Mr Lam Pin Woon

It is very important that HPB in collaboration with IMH/WH conduct public education to help people understand that there is nothing wrong with seeking help if they are undergoing some mental or emotional problems.

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While those recovering may rely on long-term medication, they are certainly intellectually and physically fit for work. However, after a treatment period at IMH/WH, the transition may be too disruptive and they need psychosocial support to help them re-familiarise themselves with social skills at the workplace and to work with their colleagues.

Ms Karkal works with empathetic employers who are willing to extend a much needed chance to those with mental disorders. She commented, “Prospective employers visit Barista Express and observe how our recovering patients work. We educate them on the potential areas in which these unique individuals may need more employer support. To widen the network of employers, the next project that IMH/WH and Dignity Links are considering may be retail business.”

Uplifting Lives in the Community

“Mental health services will continue to shift from hospital-based to community-based care. IMH/WH has pioneered several community-based mental health services by themselves and with their partners, with good results. But there will always be scope for more innovations and we should also learn from others and adapt their solutions here,” affirmed Minister Khaw.

Indeed, IMH/WH’s role in developing more community-based care programmes has grown and will continue to grow over the years. Correspondingly, the people’s perception of mental and emotional illnesses, and IMH/WH itself will change, and hopefully, stigmatisation will be replaced by the spirit of understanding, empathy and support.

“The role and function of IMH/WH have really evolved over time. IMH/WH continues to be strongly relevant to the changing needs and potential ills of society. They have come a long way in terms of the quality of care and in terms of engaging the public to be appreciative and supportive of mental healthcare. Their slogan, Loving Hearts, Beautiful Minds, says it all. It demonstrates the spirit and mission of IMH/WH as a very caring organisation that puts patients and mental healthcare above everything else,” praised Mr Lam.

Even though the quest is never-ending, a listening ear, encouraging words and an uplifting hand have always helped those in need at some point in time. For the community at large, this can only mean goodness and inclusiveness.

Ms Karkal certainly captured the spirit of all stakeholders concerned when she affirmed, “Every individual has something to contribute to society. It is the right of an individual to contribute. We, as a society, should not deny, at whatever level of disability, each person’s right and dignity to play a contributing role.”


Partners In Prime

The Captain and Its Team Partners

Synergistic collaboration and co-operation in a team approach – this is the way in which breakthroughs and improvements are invariably achieved in Singapore’s mental healthcare landscape. By virtue of its unique position as Singapore’s leading mental health centre, IMH/WH is entrusted with a central and leading role, a captain so to speak, of a team of local and international partners in training and in furthering mental healthcare knowledge.

In this section, a selection of partners in the training of mental health professionals and in research are featured.

Teaching and Training Medical Students

With IMH/WH’s rich and extensive experience in caring for the mentally ill in Singapore, the degree of organisational capabilities and staff knowledge is truly an important resource in clinical health care education and research.

“IMH/WH is a truly unique resource. They provide a full set of services and they’re very organised, unlike many other countries. This gives mental health stakeholders the opportunity to realise it as a platform for teaching, training and research in partnership,” commented Prof K Ranga Rama Krishnan, Executive Vice Dean, Duke-NUS Graduate Medical School Singapore (Duke-NUS GMS).

IMH/WH staff teach first year Duke-NUS GMS students on psychosis and schizophrenia as part of their Doctor of Medicine (MD) degree training. In their second year, they are attached to IMH/WH as part of their clinical rotation programme.

“IMH/WH’s strengths lie in its patient population and excellent clinical care. With Duke-NUS GMS, the intent is to train medical students with a focus on research, where neuroscience and mental health problems form one of the chosen areas. For us, IMH/WH is

a strong, key partner and our relationship continues to flourish in teaching, training and research,” Prof Ranga declared.

IMH/WH’s Partners at the Research Frontier

At the forefront of research, IMH/WH is collaborating with Duke-NUS GMS staff and other institutions, such as the Genome Institute of Singapore (GIS), the National Neuroscience Institute (NNI), the Singapore Biomedical Imaging Consortium (SBIC), and international specialists.

But why did Duke-NUS GMS choose neuroscience and mental health problems as one of their main research areas? Studies have indicated that schizophrenia affects approximately 1% of the population. The National Mental Health Survey conducted in Singapore in 2004 suggested a lifetime prevalence (the proportion of persons who have ever suffered from the condition) of depression in adults at 5.6%.

“There are various anxiety disorders, addictive behaviour and pathological behaviour. International studies show that when you add all these together, even if they are not mutually exclusive in nature, up to 40% of the population may be affected. The burden on families and society is huge. We should be asking ourselves, who is not going to need help at some point in time?” expressed Prof Ranga.

“Mental dysfunctions and psychiatric disorders are all part of a mental health continuum that we have to deal with as a society. You can’t wish mental illness away,” commented Prof Edison Liu, Executive Director, GIS. “There are many treatments that are extremely effective these days and they were all achieved through research,” emphasised Prof Liu on the necessity and value of research.

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Prof K Ranga Rama Krishnan

For us, IMH/WH is a strong, key partner and our relationship continues to

flourish in teaching, training and research.


Prof Edison Liu

One of my goals in research is to see how we can make research sing for society. Can we make people healthier and happier, reduce the burden of disease on society, and at the same time, advance Science? I think we can do it.

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Besides the treatment of mental illnesses, a key potential rests in finding ways to prevent them. Prof Liu elaborated, “It is well known that schizophrenia has a distinct genetic component. But what are the genes that are involved? Once we have identified them and with early diagnosis, are there ways for us to intervene and prevent the onset of serious disorders? When a bone breaks, it takes a lot longer to heal than a bruise. In general, can we diagnose mental disorders before they arise and spare individuals the break?

“One of my goals in research is to see how we can make research sing for society. Can we make people healthier and happier, reduce the burden of disease on society, and at the same time, advance Science? I think we can do it. Today’s technologies are so powerful that we have been able to uncover a large number of genes causative for common disorders. We’re hopeful that with the patient resources at IMH/WH and the continued co-operation between GIS and IMH/WH, we will be able to make significant contributions in this area.”

With mental disorders’ rising contribution to the burden of disease in Asian countries and globally, research is needed to achieve significant breakthroughs in the treatment and the prevention of mental illnesses. Concerted effort is needed to direct limited resources to achieve focus and develop the desired research output before research can have an impact on society, as mentioned by Prof Liu.

Current projects include research into the genetic factors of depression, schizophrenia and tardive dyskinesia (involuntary movement caused by anti-psychotic drugs which may continue for a period of time even after the drugs are no longer taken), and the effects of schizophrenia on cognition.

Furthermore, from April 2008, together with international and local experts, IMH/WH will develop a comprehensive and extensive world-class national epidemiological benchmark study to assess the prevalence of mental disorders as well as the social, cultural and economic factors associated with these disorders in Singapore. This study, termed the National Mental Health Evaluation Programme (NMHEP), will provide invaluable data on treatment gaps, the utilisation of mental health services as well as the barriers to accessing mental healthcare. As part of the interest in mental well-being, there are also plans to develop a tool to assess it. This tool would be the first validated and culturally sensitive tool of its kind developed in Asia.

Indeed, many partners are involved at these research frontiers – and IMH is honoured to be at the centre of these concerted efforts with its captaincy to collaborate with outstanding scientists and professionals to broaden the horizons of many.

chapter 03:

the next stage

58 heartening minds chapter 03: the next stage

To be the Leading Mental Health Centre in Asia

Vision 2012

The Institute of Mental Health/Woodbridge Hospital (IMH/WH) is moving forward with the next stage of its development and has established its Vision: to be the leading mental health centre in Asia by 2012.

Spearheading changes to streamline mental healthcare through the next five years, the master plan to achieve this vision encompasses the promotion of mental health; improvements to facilities; integrating procedures to deliver holistic healthcare with the support of an enhanced IT infrastructure; a stronger focus on continuous learning and research; and comprehensive training programmes to train staff in skills necessary to deliver the standards of service that will push IMH/WH to the forefront of mental healthcare in the Asia Pacific region.

With an eagle’s eye view of such organisation-wide changes, Dr Tan Weng Mooi, Chief Operating Officer (COO), IMH/WH is leading the award-winning organisation to achieve further excellence and innovations in mental healthcare. “We are bringing the accessibility and effectiveness of mental healthcare to totally new heights at the cluster, intra-organisational, inter-organisational with our partners and community levels. Throughout IMH/WH, new initiatives and enhancements in infrastructure, practice and systems processes, research and training have been set in motion to make our Vision 2012 a reality,” declared Dr Tan. It would not be an exaggeration to say that it will take a whole new book to detail the multitude of initiatives and programmes that are, and will be, implemented by IMH/WH. Undaunted by the sheer amount of work and co-ordination that has to be done, Dr Tan expressed, “As IMH/WH develops its own competencies in the many professions within the institution, ultimately, the patients and their families, and the community are the ones who benefit. Personally, this gives me tremendous drive and satisfaction in overseeing and managing such constructive change.”

In this section, a handful of these efforts and the people behind them are presented to provide a glimpse of IMH/WH’s work scope.

A Thriving Hub for Wellness within the Community

Over the next five to seven years, IMH/WH is set to transform its sprawling 25-hectare campus now renamed Buangkok Green Medical Park (BGMP), into a bustling medical park offering a variety of medical services complemented by retail, F&B and recreational facilities for the community.

“We are seeking to establish BGMP as an iconic landmark – a thriving hub integrating medical, wellness, retail and F&B (food and beverage) aspects,” explained Mr Lim Chee Ming, Director, Facilities Planning & Development, IMH/WH. “It is our goal to make the stigma attached to mental illness history when we successfully integrate BGMP into the surrounding community. We have built a 1.6 km jogging track and a children’s playground, and are planning further social activities for the park.”

BGMP plans to set up a medical centre where General Practitioners (GPs) and physicians in any discipline can practise alongside various community services in a bid to break down existing barriers. Mr Lim described how this will be achieved, “7-Eleven and a Traditional Chinese Medicine (TCM) centre are already on board and we are in dialogue with commercial outlets to bring them onto the grounds to build a thriving and diverse community of services for the general public. We want people to use the grounds and to facilitate this, we are looking at ways to increase accessibility. A shuttle bus service is already running from Hougang MRT station and a covered walkway will soon link IMH/WH to the public bus stop nearby.”

Mr Lim remains undaunted by the many upcoming changes. He revealed his motivation, “Our goal is to be a referral centre for the region within a decade. We have great pride in the work we do here. We want to transform BGMP into a bustling medical park.”

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Dr Tan Weng Mooi

Throughout IMH/WH, new initiatives and enhancements in infrastructure, practice and systems

processes, research and training have been set in motion to make our Vision 2012 a reality.


Mr Lim Chee Ming

Our goal is to be a referral centre for the region within a decade. We have great pride in the work we do here. We want to transform BGMP into a bustling medical park.

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Stepping Up the Care

Spearheaded by the Ministry of Health (MOH), the National Mental Health Blueprint (NMHB) has been devised to change the way mental healthcare is managed and to enhance the mental healthcare services for the nation.

Dr Chua Hong Choon, Chief of General Psychiatry and Deputy Head of Mental Health Promotion, IMH/WH, is tasked under MOH to oversee and to assist in the implementation of many of the programmes under the NMHB. These programmes create many opportunities for IMH/WH to work with other ministries and organisations across the full spectrum of services.

“We have the knowledge to implement the changes. We have close collaborations with key local and international industry players and

we have the funding necessary to embark on the initial stages of the blueprint,” Dr Chua explained.

While IMH/WH is a key driver of NMHB and currently provides the full range of primary, secondary, and tertiary care, the focus for the future is really on tertiary initiatives. Becoming a predominantly tertiary mental health centre allows IMH/WH to step up its expertise on research and training in order to lead the Asia Pacific region in the provision of advanced mental healthcare. “The NMHB is like a foundation that will support us in moving to our next stage of growth, not just directly but indirectly, because other agencies and healthcare providers are involved as well,” asserted Dr Chua.

He elaborated, “We hope that in the future, IMH/WH will concentrate on inpatient care of the most serious cases and community-level healthcare providers will manage the milder, less severe cases. Our


Dr Chua Hong Choon

I want to contribute by changing the system to help many more people, and to make a lasting difference to the landscape of mental health.

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community mental health teams will work closely with GPs and community services to encourage the early detection and treatment of mental health problems.”

Dr Lee Cheng, Chief of the Department of Community Psychiatry, concurred, “In addition, the move towards community-based services for persons with mental illness is also for rehabilitation and societal reintegration, so that they may contribute as much as they are able, and lead fulfilling and productive lives. There is evidence that the assertive community management of persons with mental illness can result in improvements in the quality of life and greater acceptance of treatment.”

Since the formation of the Department of Community Psychiatry, many IMH/WH patients have been treated or have received medical support in their homes or living quarters through community-based programmes such as the Assertive Community Treatment

(ACT) programme, the Mobile Crisis Team (MCT) programme, and the Community Psychiatric Nurse (CPN) service. Through these services, patients are effectively managed in the community. Adjunct services such as helplines, counselling, job placements and psycho-education for caregivers are also provided by the family service centres, Medical Social Work (MSW) department at IMH/WH and Voluntary Welfare Organisations (VWOs).

Dr Chua is highly motivated by the changes he has seen in mental healthcare over the years and the obvious benefits they bring to the patients. “It is rewarding when people thank you, especially when their recovery is a result of them seeking early intervention because they have been educated about mental health,” Dr Chua affirmed. “When we accept the status quo, we stop progressing. I want to contribute by changing the system to help many more people, and to make a lasting difference to the landscape of mental health.”


With a similar view to patients’ welfare in mind, Dr Lee elaborated, “Over the next few years for community psychiatry, we aim to maximise our networking and collaborations with community service providers to improve service delivery, so that patients can experience co-ordinated and seamless care.”

Collaborating on Research, Sharing Our Knowledge

Research at IMH/WH is spearheaded by A/Prof Chong Siow Ann, Vice-Chairman of the Medical Board of Research. A/Prof Chong has drawn up the roadmap that will enhance the reputation of IMH/WH to that of a world-class research centre.

A/Prof Chong’s vision is to create and maintain a vibrant culture at IMH/WH for clinically and scientifically significant research. He has implemented an in-house funding mechanism to help the staff in IMH/WH get started in research, as well as a training programme in research and a Visiting Scientist Scheme which brings other researchers to IMH/WH.

The research protocol that has been established at IMH/WH is strictly adhered to because the protection of the welfare and confidentiality of the research subjects are paramount. “The mentally ill are a vulnerable population, and we have strict guidelines to ensure that we obtain informed consent before enrolling them in our research programmes. We have a committee overseeing the welfare of the subjects, as well as the reputation of IMH/WH,” explained A/Prof Chong.

“Biomedical research is highly complex and involves collaborations with local and international partners. These partners include the Nanyang Technological University (NTU), Duke-NUS Graduate Medical School Singapore (Duke-NUS GMS), National University of Singapore (NUS), the Genome Institute of Singapore (GIS) and Singapore Biomedical Imaging Consortium (SBIC) on a local level, and internationally with Melbourne University, Duke University and Harvard University,” explained A/Prof Chong.

Consultant Psychiatrist, Dr Sim Kang, who is also the Deputy Director of Research at IMH/WH, explained how research impacts the treatment of mentally ill patients, “There’s a lot to be understood from the basic science to the clinical symptomatology and treatment. In one regard, the study of beneficial effects of drugs on mood or behaviour, conducted through clinical trials, may result in newer treatments for patients.

“We also try to understand what are some of the biological underpinnings in mental illnesses. That understanding will hopefully throw light on how the progression of these illnesses takes place. Thereupon, in time to come, we can refine or come up with novel treatment strategies, which will also lead us to develop methods for earlier intervention.”

The Research Division of IMH/WH has made a number of significant breakthroughs in several different ways. A/Prof Chong highlighted, “Our research has contributed to the understanding of the mechanisms underlying some of the most severe mental disorders, provided information which helped us develop better programmes for our patients, as well as generated vital data which have been important in the formulation of policies.”

What has kept A/Prof Chong and Dr Sim going all these years? “A famous scientist once said that people do science from ambition, altruism and curiosity, and that is true for me as well,” revealed A/Prof Chong. “Through research we can change the way we think about mental illnesses and change the way we treat them and make people’s lives better. It is also intellectually exciting and fulfilling, and I’m also happy if I can help young talented researchers realise their potential.”

Dr Sim paid tribute to his mentors: “People like A/Prof Chee Kuan Tsee and A/Prof Teo Seng Hock have been pillars of inspiration, teaching me to understand the patient as a whole, not in part. They taught me to be constantly curious about the individual

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A/Prof Chong Siow Ann

Through research we can change the way we think about mental illnesses and change the way

we treat them and make people’s lives better. It is also intellectually exciting and fulfilling,

and I’m also happy if I can help young talented researchers realise their potential.


A/Prof Chong receiving the WHO State of Kuwait prize for EPIP in 2006.

and to continue the quest for understanding and knowledge so as to be able to take care of our patients in a better and more meaningful way.”

Early Intervention for Early Recovery

A/Prof Chong also pioneered the Early Psychosis Intervention Programme (EPIP), which is now run by Dr Swapna Verma, Chief of Department of Early Psychosis Intervention. Research in this field is geared towards putting systems in place to facilitate the early detection of psychosis as it has been proven that the earlier the intervention, the better the recovery prognosis.

EPIP is a landmark initiative that reaches out to people who are at the early stages of psychosis. EPIP strives to get them to seek help early and thus minimise the disruption psychosis could cause to their lives. For its outstanding contribution to research in health promotion, EPIP was awarded the inaugural and prestigious State of Kuwait Prize by the World Health Organisation (WHO) in 2006. More recently, EPIP received one of the inaugural National Medical Excellence Awards in 2008 conferred by the Ministry of Health (MOH).

Dr Swapna explained, “Our programme has managed to reduce the gap between the onset of symptoms and intervention down to a five-month median from the original median of 12 months. We attribute this to the better education of the public as they are seeking treatment at IMH/WH rather than relying on alternative therapies. Favourable reporting by the mass media, support by celebrity figures, and innovative publicity drives have helped to de-stigmatise mental illness and we find that more patients are now turning to us first at the initial onset of symptoms. This makes treatment so much easier on an outpatient basis.”

To deliver the supportive care necessary to get these patients quickly back into society, the programme relies heavily on community teamwork from doctors, case managers, psychologists and occupational therapists. Dr Swapna commented, “Psychosis usually presents itself in teen years or early adulthood. Hence, there is scope for delivering education and wellness enhancement programmes through tertiary institutions such as the polytechnics. It is also vital, then, that we get GPs, schools and youth counsellors on board to refer patients to us as soon as problems arise.”

Nurturing and cultivating healthy young minds.

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Dr Jimmy Lee, a Registrar with EPIP, emphasised, “Psychosis can be a chronic disabling disorder. The longer a person remains untreated, the worse his condition will be. Through EPIP, we have managed to reduce the duration of untreated psychosis from years to months, giving people a second chance at a fulfilling life. This is the main reason that made me want to be a part of EPIP.”

The young registrar, who won the Clinician Leader in Research Award in 2007, is enthusiastic about research and his field of work. He elaborated, “I believe that the brain is the last frontier of medical science. It’s so incredibly complex and that’s why nobody really knows much about it yet. It is an opportunity to discover and contribute new knowledge in psychiatry. For people with mental illnesses, beneath the eccentricity of their behaviour, there is a very human side to the person. As doctors, we see beyond their behaviour and illness, and really want to help the patient as a human being.”

For Dr Daniel Fung, Chief of the Department of Child and Adolescent Psychiatry, it is essential to be there for the youths of today. He pointed out that “children and adolescents up to 19 years of age constitute about a quarter of our nation’s population, thus there is a need to address their psychological and emotional issues and dedicate adequate efforts and resources to the provision of medical services for them.”

The department boasts comprehensive inpatient services, specialised outpatient services in learning disabilities and autism, and is also engaged in research and community child mental health services.

“Healthy young minds and bodies form the cornerstone of a healthy nation. One of the ways in which we are proactively involved is our REACH (Response Early Intervention and Assessment in Community Mental Health) programme for students. Our mobile

From left to right: The EPIP team comprising A/Prof Chong Siow Ann, Ms Poon Lye Yin, Ms Helen Lee, and Dr Swapna Verma with the other winners.


Dr Swapna Verma

I have seen how beneficial preventive and early detection work is in the prognosis of patients, and it is so rewarding to see patients being rehabilitated.

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multidisciplinary mental health team provides assessment and treatment for children and adolescents between six and 18-years old within the school clusters with an aim to improve their mental health early, and train school personnel like full-time school counsellors to form and manage community networks to support youths,” commented Dr Fung.

Early Prevention

The focus on penetrating into the community is a theme that reverberates for the work done in and for the younger generation. For an example of IMH/WH’s focus on mental wellness rather than mental illness, look no further than one of the projects that Dr Swapna has implemented.

Dr Swapna detailed, “We have just set up a programme for individuals at risk of developing psychosis called SWAP (Support for Wellness Achievement Programme). It is well known that there are early symptoms before the actual onset of psychotic symptoms characteristic of schizophrenia and related disorders. Research has shown that if the early symptoms can be recognised and treatment

provided at this stage, then disability may be minimised, and it may be possible to prevent or delay the onset of a psychotic disorder.”

“Current mental health clinics tend to focus their resources on assisting those who already have psychosis and unfortunately, are often viewed in an extremely negative light, particularly by young people and their families. In the light of these considerations, we have located SWAP out of IMH/WH. In addition, we are collaborating with our community partners through education, outreach and care management to ensure a seamless flow of appropriate referrals and continuity of care for our clients.”

Since March 2008, SWAP has been running in the Community Wellness Centre, located within the new premises of the Queenstown Polyclinic. IMH/WH looks forward to its success and further developments, with continuous support from its community partners.

When asked why she continues to give so much through her work, Dr Swapna revealed, “It’s knowing that our patients can get better that spurs me on. We have made so much progress in mental

Sunrise Wing, Child Guidance Clinic , IMH/WH. Community Wellness Centre, Queenstown.


The Atrium, IMH/WH.

healthcare and great things are possible today through our work. I have seen how beneficial preventive and early detection work is in the prognosis of patients, and it is so rewarding to see patients being rehabilitated.” Dr Swapna added, “Curiosity also drives me. I simply want to know what makes my patients tick.”

Another pivotal thrust that IMH/WH is involved with is making mental well-being more accessible to the greater community. A common public perception of mental healthcare is that it is only reserved for the mentally ill. However, it is a misconception that is slowly but steadily fading.

Ms Clare Yeo, Head of the Department of Psychology at the hospital explained, “With a faster pace of life and multiple stressors, the help we give has never been more relevant. That’s where positive psychology comes in. It’s like life coaching.”

Besides fulfilling the demands on her department within IMH/WH, her team of psychologists has been stepping up their efforts in the Workplace Emotional Health Programme under the hospital’s Corporate Consulting Services. When a company engages the service, expert counselling on emotional health is offered to employees on a one-to-one basis with utmost confidentiality, with no repercussions from their employer.

Another development consists of mobile teams of multi-disciplinary members to offer on-site assistance. These teams reach people by way of partnerships with organisations at the community level such as Community Development Councils (CDCs), grassroots leaders, schools and social services, which are more intimately engaged with different communities.

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Ms Clare Yeo

I think what’s more important than treating people with medication and psychotherapy

is imbuing in them the capacity and power to take care of themselves, so that they can have a place in society.


To Ms Yeo, this idea makes perfect sense. She enthused, “Instead of sitting here and waiting for people to come and consult us, we go to them and engage people at the community level. We have child and adult mobile teams, and soon, geriatric mobile teams to help old people who face difficulties in leaving their homes.

“I am very big on empowering people. I think what’s more important than treating people with medication and psychotherapy is imbuing in them the capacity and power to take care of themselves, so that they can have a place in society.”

And that captures the essence and grander goal that IMH/WH is endeavouring towards in the coming years to establish more community-level mental healthcare.

Improving the Level of Care through Training

IMH/WH continues to expand its level of service within the community to encompass preventive, rehabilitative and inpatient care. As such, training and development for healthcare providers and community volunteers have been enhanced to address the changing needs. Dr Chiam Peak Chiang is Chief of Department of Geriatric Psychiatry and Training Director of IMH/WH. She is in charge of training programmes for psychiatric trainees and the provision of weekly sessions of psychiatric education for graduates. Dr Chiam also holds the portfolio as Education Director, IMH/WH and is in charge of the teaching programme for medical students posted to the institute.

In the past, the training IMH/WH provided for doctors taking the Master of Medicine (MMed) (Psychiatry) examination focussed on clinical training and was not formalised. The National Training Programme for the Basic Specialist Trainees (BSTs) and formalised training for the Advanced Specialist Trainees (ASTs) started only in

2001. Specialist training in psychiatry used to last six years (three years for BST and three years for AST). However, with Dr Chiam’s effective planning, the training period has been reduced to five years for the entire curriculum since May 2007.

As the provision of mental healthcare extends into the community, Dr Chiam also oversees the training of healthcare providers within the community. One target group for training is GPs, as they have the potential to identify psychiatric cases early on and refer them to IMH/WH for care. GPs will also be at the forefront of care for rehabilitated patients. They will play a key role in mental healthcare in the near future, so Dr Chiam will be introducing a two-year Diploma in Psychiatry, especially for GPs.

Dr Chiam also oversees the training of care providers in nursing homes. “We train them to be alert to symptoms of mental illness so that early treatment therapies can be applied.”

Working with Dr Chiam is Dr Joshua Kua, Deputy Chief of Department of Geriatric Psychiatry, IMH/WH. Dr Kua is the Programme Director of the Aged Psychiatry Community Assessment and Treatment Service (APCATS), the first community psycho-geriatric service in Singapore that provides psychiatric assessment and treatment for frail elderly in their own home. Initiated by Dr Kua, and supported by Dr Chiam, the programme, now called APCATS-Clinical Service, aims to allow the elderly to remain in their home longer and prevent premature institutionalisation or unnecessary hospitalisation. In addition, APCATS provides education and support for patients and caregivers, and establishes a link to other service providers to co-ordinate patients’ care.

Dr Kua will certainly be busy in 2008, following the launch of the APCATS-Regional Eldercare Agencies Partnership Programme (APCATS-REAP). His team will engage various community eldercare agencies in the Central Community Development Council (CDC)

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region by providing training, education, consultation and support so as to strengthen their capability in the early detection and management of psycho-geriatric problems in the community. They will also assist in the co-ordination of services for the elderly to improve the continuity of care for the elderly with mental illnesses.

What drives Dr Kua in his work? “These patients need our help,” he explained, “and it is heartening to be able to alleviate the suffering of the elderly and their caregivers, and to bring hope into people’s lives.”

Innovating to Improve Emergency Care

Consultant Psychiatrist, Dr Alex Su, heads the Emergency Services Unit. The unit serves as the first point-of-contact for all mental crisis cases that land at the doorstep of IMH/WH, receiving

patients suffering from a full spectrum of mental illnesses ranging from minor reactionary attacks to the most severe cases of schizophrenia and psychosis.

The unit is tasked with critically balancing the flow of incoming patients needing immediate attention with being able to allot enough time and care to each patient. Therefore, to boost efficiency, Dr Su and his team pioneered the creation of a 23-hour Observation Ward where selected patients are treated under close observation for less than a day, without the need for admission to IMH/WH.

The Emergency Services Unit also serves as an excellent ground for psychiatric training. Groups of staff doctors and nurses are attached to the unit to hone their skills in assessing and managing crisis situations. Recently, their training sessions have also attracted participation from overseas medical students and practising doctors.


Dr Alex Su

For a lot of psychiatrists and nurses here, their personality probably gravitates them towards this line. They don’t really care too much about money or glamour in their work. They just have this compassion to take care of people.

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The soothing surroundings at IMH/WH’s Emergency Department.

What unites and drives Dr Su and others like him in this field is a passion to help a group of people that is, in his words, forgotten by society. Dr Su explained, “For many psychiatrists and nurses here, their personality probably gravitates them towards this line. They don’t really care too much about money or glamour in their work. They just have this compassion to take care of people.

“It’s a great feeling to be able to really care for these people and do something to change their lives for the better. It’s like a beacon of light, where people who are really lost in their lives can approach for help.”

For his efforts and care towards his patients, Dr Su won the Healthcare Humanity Award in 2005, and was also one of those singled out for the Distinguished Award honour among the 80 recipients of the PS21 Star Service Award in 2007. The PS21 Awards are presented to public officers — across positions of all levels — who have consistently provided excellent service within the civil service.

The Focus on Rehabilitation and Reintegration

Equipping and Empowering

As IMH/WH moves its focus to the rehabilitation of recovering patients, outpatient care and eventual reintegration into society, Occupational Therapy (OT) has become a cornerstone of mental healthcare. IMH/WH’s goal is to benchmark psychiatric care in the region and OT will help in reintegrating patients back into the community.

Through volunteer groups within the community, IMH/WH runs a number of vocational training programmes geared to developing patients’ work skills and work behaviour to help them integrate into the workplace. Programmes include training in F&B social enterprises like Barista Express (sheltered employment operated by Dignity Links Ltd in partnership with IMH/WH) at Raffles Place and Juiceworks (operated by IMH/WH) at BGMP. In addition, ISS Facility Services and IMH/WH run cleaning services training with

Occupational Therapy.


Juiceworks - a rehabilitation initiative of IMH/WH. Salvation Army Thrift Store, “Pick and Choose”.

a view to job placement. Other training programmes include retail service at the Salvation Army Thrift Stores, car wash and library administrative duties. Upon the completion of such programmes, patients are assisted in job placements and given follow-up support at the job sites.

“Apart from reintegration into the community through occupational therapy, we also wish to tap on available recognised and certified vocational courses, so that our patients can be equipped with the skills and confidence to be involved in competitive employment,” explained Ms Tan Bhing Leet, Head, OT, IMH/WH. The OT Department is currently working with NTUC Learning Hub to provide patients with nationally recognised vocational courses. One factor that is always considered in OT is adapting the training to suit the patient. Ms Tan explained, “We work closely with employers, voluntary welfare organisations, government agencies and volunteers to help patients progress towards full reintegration into society. Our services cater to patients across a range of capabilities,

harnessing their individual strengths and potential to move them from a sheltered setting within the hospital to a supportive setting within the community. Eventually, they learn to function within the community with minimal support.”

The OT Department also looks to developing staff’s skill sets through training and research. “We strive to increase our training opportunities, and we give those who are passionate about research a chance to develop their interests,” Ms Tan explained. “There is also a need to benchmark ourselves by evaluating the effectiveness of our programmes and by investigating the efficacy of new treatments.”

Ms Tan is encouraged by the positive feedback she receives from patients and family members. “When I see success cases, it gives me great motivation to keep going because it shows that the treatment our patients receive does work. For some, it may take longer than others and there are setbacks, but we don’t give up because we believe and know it can happen.”

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Getting a Grip on Life

There are many aspects to consider in the successful reintegration of patients. They need the support of family and community, and the role of the medical social worker is to co-ordinate this support for the best interests of the patient.

“We work as part of a multi-disciplinary team of doctors, nurses and medical social workers to co-ordinate discharge plans, deal with practical needs including financial assistance, information or referrals for required services, as well as counselling and therapy for those with emotional difficulties. All these aim to assist patients and their family members to manage and sustain the care required as functional statuses may have declined as a result of the illness,” explained Ms Lilian Mark, Head, Medical Social Work, IMH/WH.

However, Ms Mark has seen her role expand as services become more holistic with new emphasis on preventive care. She emphasised, “There is little point in rehabilitating patients only to release them back into the same environment that triggered the illness in the first place. While our core work in casework and counselling remains, we now also collaborate with the government and voluntary agencies to advocate services that are lacking and to close service gaps that hinder patients’ efforts to return to live in the society.” An example of this is the setting up of the Home Improvement Fund (from the Woodbridge Hospital Endowment Fund) which provides funding for minor purchases and repairs in patients’ homes to ensure a basic decent environment upon discharge.

As far as reintegration goes, Ms Mark and her team get involved in all aspects as long as it helps to get patients back into the community in resuming employment or in functioning independently. Measures include finding accommodation and jobs for them, liaising with employers to educate them on the specific requirements of the clients, and caregiver support through the counselling of patients and their families. “The challenge is to match the right person with

the right job or social skill. We work very closely with our colleagues from the Occupational Therapy Department to ensure a high success rate,” Ms Mark pointed out.

All the long hours and hard work medical social workers put in stem from one fundamental belief that patients are capable of change. Ms Mark concluded, “We do all that we can to help patients, because our role goes beyond simply discharging them. It is our aim to see them return to and stay in the community for as long as possible, leading successful and fulfilling lives.”

Harnessing Technology to Deliver Holistic Healthcare

As IMH/WH embarks on its Vision 2012 and NMHB to provide holistic healthcare encompassing preventive, rehabilitative and inpatient healthcare – supported by research and training programmes that will place IMH/WH as a leading mental healthcare centre for the region – there is a need to improve the management of data and records through digitisation to support the comprehensive delivery of healthcare for every patient.

Digital Psychiatry is the next step in the enhancement of psychiatric care for both patient and doctor. The system’s data mining capabilities will allow IMH/WH to track patterns, monitor standards and make continual improvements.

“We already have the electronic prescribing of medication and ordering of laboratory tests, referrals and services on the iPharm system,” said Dr Eu Pui Wai, Director, Rehabilitation Psychiatry. Information flow from prescribing doctor to pharmacy and laboratory is taken care of electronically, thus removing transcribing errors and improving efficiency. In addition, there are built-in safeguards to ensure that doctors cannot order medication that the patient is allergic to, or drugs that conflict with the patient’s existing prescription.


“We are now working on the electronic medical records system which will streamline mental healthcare to a whole new level. It will result in an integrated paperless medical records system whereby the doctors, nurses and allied health staff will be able to document their clinical notes systematically and retrieve needed information instantaneously. The system is designed to be user-friendly and needed information is displayed for the user to plan and track the care that the particular staff is providing. The electronic medical records system will facilitate IMH/WH’s goal to be a regional centre of excellence in mental health care,” clarified Dr Eu.

So what motivates Dr Eu to develop the system to the best of his capabilities? He explained, “There is a real need for caregivers to have instant accessibility to patient information to facilitate the continuity of care for the patients. We believe there is so much more that we can do for our patients, and I firmly believe that with Digital Psychiatry in place, care can only be further enhanced. It’s a right step and I am motivated to see that change happen.”

Recruiting and Inspiring a New Generation of Psychiatrists

Competent and inspired, the assembly of new leaders of IMH/WH are paving the way towards improved services and more community-based healthcare. However, one of the foremost matters at hand is the need to fuel the next generation of mental healthcare professionals.

To keep the momentum that IMH/WH has gained going, pro-active recruitment initiatives are needed to meet the demand for more staff. With support from MOH, measures are already being meted out to increase the number of training positions in psychiatry for medical officers.

As Vice-Chairman of the Medical Board, filling the ranks of prospective staff is one of Senior Consultant Psychiatrist, A/Prof Rathi Mahendran’s major undertakings. She elaborated, “Currently, we do not have enough trained professionals in the

Through the Commcare initiative, patient records are now accessible on the go with the use of mobile handheld devices.IMH/WH staff facilitate reintegration through conscientious efforts and care.

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Dr Eu Pui Wai

We believe there is so much more that we can do for our patients, and I firmly believe that with

Digital Psychiatry in place, care can only be further enhanced. It’s a right step and

I am motivated to see that change happen.


field. We require a higher flow of incoming personnel to execute all the action plans as our services are expanding at a tremendous rate. With support from MOH, we are now able to do year-round recruitment of trainees in psychiatry which used to take place only once a year. That should help to alleviate the dearth of talent.”

This initiative has certainly borne fruit as the total number of medical and allied health staff employed increased by 59% from 2002 to 2005.

In a sense, the higher requirement for new professionals reflects the vast progress that IMH/WH has made. It is hoped that through the efforts of the current leaders, more and more people will be inspired to take on a career where the greater goal is to touch and improve the quality of life for many people, their family members and society.

A/Prof Rathi affirmed, “The interest in psychiatry and mental healthcare is really a personal choice that can lead to a very emotional and stressful kind of career. But it’s in coming to work and seeing how patients recover and return to the community, where they’re able to look after and support themselves, that makes it meaningful.”

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The Constant That Drives the Changes

Above All, Always with Heart

IMH/WH staff are always mindful that first and foremost, they are responsible to the patients and their families, and the general public when it comes to mental well-being. It is this core quality of concern, commitment, care and compassion for fellow human beings, and the belief in the resilience of people to remain or become well – qualities that should never be taken for granted – that drive the staff’s endless efforts in the many ongoing projects.

Just how special are these qualities? There was a long-term stay patient who was about to reach her one hundredth birthday and IMH/WH staff decided to celebrate this special occasion. They tracked down her relatives who had not visited her for years. It was only then that the relatives turned up.

The difference is stark: it is an abyss that gaspingly separates a shocking divide between those who work relentlessly to improve mental health services, and those who have given up and turned away.

IMH/WH staff hope, and give hope to people.

And IMH/WH staff will carry on doing the best that they can – in heartening minds – well into the future.

82 heartening minds milestones

Milestones

1928 A new mental hospital was constructed and 1,030 patients were transferred to the ‘Mental Hospital’.

Dr E R Stone, Medical Superintendent from 1928 to 1934, introduced farm work in 1928.

1931 Malaria treatment was used to treat General Paralysis of the Insane (GPI).

1935 Doctors were given the power to admit patients and voluntary treatment was allowed.

1942 About 500 mental patients were transferred to St John’s Island before Singapore surrendered to the Japanese forces. After Singapore’s surrender, 800 civilian casualties were transferred to the Mental Hospital, which was transformed into the Japanese Civilian and Military Hospital.

1946 The Mental Hospital returned to its original function to house 440 mental patients.

1947 Dr B F Home introduced electroconvulsive therapy (ECT).

1951 The Mental Hospital was renamed Woodbridge Hospital (WH).

1953 WH was recognised for the Conjoint Diploma in Psychological Medicine.

1954 Psychiatric School of Nursing set up.

Penicillin used to treat neurosyphilis.

Construction of four new blocks of two-storey buildings (which later became the Chronic Sick Unit) and one new block (Green Groves).

1956 Psychological services started.

A new three-storey Nurse Hostel was built.

1957 Outpatient clinics started at Bukit Timah, Paya Lebar and Kallang Dispensaries.

1958 Dr E C Winslow was Medical Superintendent (Acting) and Dr Burton Bradley was Medical Superintendent (on contract).

The antidepressants isocarboxazide and imipramine were introduced.

1965 A rehabilitation committee was formed.

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1972 The Child Psychiatric Clinic became a full-time department.

The first psychiatric day centre in Singapore was opened.

1973 The drug lithium was first used to treat manic-depressive illness.

Modecate, a long acting neuroleptic, was used to treat schizophrenia.

1978 WH celebrated its 50th anniversary.

1979 Inauguration of the psychiatric nurse practitioners scheme to help with the increasing attendance at the outpatient clinics.

1982 WH started to provide specialist training which leads to a Master of Medicine (Psychiatry) degree from the National University of Singapore.

1988 A Community Psychiatric Nursing (CPN) service was established.

An evening clinic was started at Woodbridge Hospital.

1990 The first Cognitive Behavioural Therapy Clinic was started at Tampines Clinic.

The Alcohol Dependency Clinic and Alcohol Treatment Programme commenced at Alexandra and Mandalay Day Centres respectively.

1993 WH shifted from its Yio Chu Kang premises to the new building at Hougang, thus ushering a new era in psychiatric care. The hospital occupies 45 hectares of land of which 30 hectares have been developed. To facilitate the efficient operation and implementation of the National Mental Health Programme, Woodbridge Hospital was re-organised and the Institute of Mental Health/Woodbridge Hospital (IMH/WH) established.

1994 IMH/WH organised the first Emergency Behaviour Officers (EBO) course in Singapore in conjunction with the Ministry of Home Affairs to train officers from the public sector and uniformed organisations in rendering psychological support and assistance in disaster situations.

1995 IMH/WH started Emergency Psychiatry services to cater to those facing crises.

1998 IMH/WH prepared for the implementation of a new computerised Patient Administration System for outpatient and inpatient services, and the certification of the hospital for ISO 9002 Quality Management System in the provision of mental health care.

The Child Guidance Clinic (formerly known as the Child Psychiatric Clinic at Outram Road) moved to its new premises at the Institute of Health in March 1998. Two new clinics for Attention Deficit Hyperactivity Disorder and Child Abuse were introduced.

84 heartening minds milestones

2000 The satellite Behavioural Medicine Clinic was started at the Health Promotion Board (HPB) Building in Outram to provide administrative support for Stress and Anxiety Disorders Clinic, Mood Disorders Clinic, Sleep Clinic, Psychotherapy Clinic and Weight Management Clinic.

IMH/WH celebrated its new beginning as a restructured organisation under the National Healthcare Group.

The Early Psychosis Intervention Programme (EPIP) was started to reduce deterioration after the initial psychotic symptoms have manifested.

The Living Room, a cafeteria, was created by the Occupational Therapy Department to facilitate rehabilitative activities for IMH/WH patients in a socially pleasant and friendly environment.

2001 IMH/WH collaborated with HPB to initiate the Mind Your Mind programme, a five-year public education programme with the focus on stress management.

IMH/WH embarked on the Stress Management Programme (ISMP) to serve the interests of our corporate clients.

Community Addiction Management Programme (CAMP) was launched to provide treatment for various addictions, including substance and non-substance addictions.

The Department of Academic Psychiatry was established.

Early Psychosis Intervention Programme (EPIP) commenced to offer holistic comprehensive and accessible service for those with early psychosis.

2002 A new specialist outpatient clinic was started to provide psychiatry services to non-subsidised patients in a private and conducive environment.

The Woodbridge Hospital Endowment Fund was set up to provide financial assistance to needy patients.

2003 The Department of Community Psychiatry was established with community based treatment provided by a multidisciplinary team of clinical staff.

2004 A Mobile Crisis Team was introduced by the Department of Community Psychiatry.

2005 The Aged Psychiatry Community Assessment and Treatment Service (APCATS) was launched where a medical team conducts home visits for elderly patients who have difficulties commuting to IMH/WH for follow-up psychiatric treatment.

Milieu Therapy was introduced to all acute wards to help change the patient’s role from that of a passive recipient of care to that of an active participant.

IMH-GP Partnership Programme was initiated to support our strategic initiative for the right siting of care. This aims to provide affordable, convenient mental healthcare for stable patients with chronic mental illness with community-level General Practitioners.

Fund-2-Work Scheme was launched to train recovered patients with appropriate skills that will help to integrate them back to society.

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IMH/WH became the first mental health institution in Asia to receive the Joint Commission International accreditation which benchmarks standards of care at IMH/WH with international standards.

2006 Launch of Buangkok Green Medical Park by Minister for Health Mr Khaw Boon Wan to revamp the existing campus into a bustling medical hub.

IMH/WH’s EPIP won the WHO State of Kuwait Health Promotion 2006 Award in recognition of its outstanding contribution to research in health promotion.

Dignity Links Ltd – a social enterprise partner set up Barista Express, an upmarket first-of-its-kind café in Singapore where people with psychiatric illnesses are provided transitional supportive employment in a business enterprise, operating in a commercial district.

Together with the Ministry of Health (MOH), IMH/WH implemented the Subutex Voluntary Rehabilitation Programme (SVRP) to help patients on Subutex wean off their dependence.

Digital Psychiatry 2009 vision was launched to transform the delivery of psychiatry services for excellent patient care through the use of information technology.

2007 23-hour observation ward introduced at IMH/WH’s revamped emergency services provides timely interventions in a safe environment and reduces unnecessary inpatient admissions.

A new Autism Clinic was established to treat children above five years of age suspected or diagnosed with autism.

Multi-sensory therapy was introduced for elderly patients with dementia.

IMH/WH won the most outstanding project award in the customer service category of the Asian Hospital Management Awards.

IMH/ WH successfully trained recovering patients who bagged the silver and bronze medals in the 7th International Abilympics, Japan.

2008 Community Wellness Centre (CWC) opened to provide a one-stop venue focussing on the continuum of care from prevention, to treatment and finally to rehabilitation.

The Early Psychosis Intervention and Prevention (EPIP) programme received one of the inaugural National Medical Excellence Awards 2008, conferred by MOH.

SWAP (Support for Wellness Achievement Programme) was launched at the CWC for individuals at risk of developing psychosis.

86 heartening minds

Chiefs – Through the Years

CEOs1993 – 1997 : Dr Luisa Lee1997 – 2000 : Dr Daniel Leong2000 – 2002 : Prof Kua Ee Heok2002 – Present : Mr Leong Yew Meng

Medical Superintendents/Medical Directors1928 – 1934 : Dr E R Stone1935 – 1950 : Dr B F Home1950 – 1958 : Dr James Browne1958 – 1959 : Dr Edward Charles Winslow (Acting) 1958 – 1959 : Dr Burton Bradley 1960 – 1971 : Dr Yap Meow Foo1971 – 1979 : Dr Tsoi Wing Foo1979 – 1996 : Dr Teo Seng Hock1996 – 2000 : Dr Ang Ah Ling2000 – 2002 : Prof Kua Ee Heok2002 - Present : A/Prof Wong Kim Eng

CLINICAL DEPARTMENTS – HEADSHIP

Department of General PsychiatryDr Wong Yip ChongDr Tsoi Wing Foo Dr Paul NguiDr Teo Seng HockDr Chew Seck KeeDr NagulendranDr Chee Kuan TseeDr Ang Ah LingDr Leong Oil KenA/Prof Wong Kim EngA/Prof Rathi MahendranDr Eu Pui WaiDr Adrian WangDr Chua Hong Choon

chiefs – through the years

Department of Forensic PsychiatryDr G Sathyadevan

Department of Community PsychiatryA/Prof Leslie LimDr Lee Cheng

Department of Early Psychosis InterventionA/P Chong Siow AnnDr Swapna Verma

Department of Geriatric PsychiatryA/P Teo Seng Hock Dr Ng Li LingDr Chiam Peak Chiang

Department of Child & Adolescent PsychiatryDr Ho Eng SiongDr Wong Sze TaiDr Cai YimingDr Daniel Fung

Department of Addiction MedicineDr Winslow Rasaiah Munidasa

CLINICAL PROGRAMMES/SERVICES – HEADSHIP

Emergency Services Dr George FernandezDr Samuel ChengDr Alex Su

Psychotherapy Services Dr George FernandezDr Gwee Kok PengDr Samuel Cheng

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Rehabilitation PsychiatryDr Eu Pui Wai

ALLIED HEALTH SERVICES – HEADSHIP

PsychologyMr Long Foo YeeMs Lyn ChuaMs Clare Yeo

Medical Social WorkMrs Choo Soon PingMr Peter Lee Lian HengDr Seng Boon KhengMs Lilian Mark

Occupational TherapyMr Bernard Wadham-Eyre & Ms Phyllis Ong Fook NgohMr Ho Meng Jang & Mrs Yin Kwai LanMrs Queenie SivagnanagnamMrs Sylvia NgMs Lilian LeongMr Kamaldin IbrahimMs Sheila ThamodharanMs Tan Bhing Leet

PharmacyMrs Lim Yok KuaMs Teo Lee KhengMr Velmurugan VaiyapuriMs Soh Lay Beng

PhysiotherapyMrs Chua Soon ChooMrs Lim Chai MingMr Venigalla Sumanth Kumar

NURSING ADMINISTRATION – HEADSHIP

Ms McMunnMs Winnifred D’CruzMdm M T RajahMr Santa MariaMr Tan Eng HongMs Lim Suat HongMs Patricia NorrisMdm Yeo Soo HarMdm Lucy ChengMdm Han Guek ChooMrs Rosie PereiraMdm Mary Yeo Kim LuangMs Pauline Tan Cheng JeeDr Premarani K (Acting)

88 heartening minds

Translating Hope into Reality

translating hope into reality

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IMH/WH Senior Management 2007

1. Dr Eu Pui Wai, Director, Rehabilitation Psychiatry2. A/Prof Chong Siow Ann, Vice Chairman (Research)3. Mr Lim Chee Ming, Director, Facilities Planning & Development 4. Dr Alex Su, Head, Emergency Services5. Dr Samuel Cheng, Head, Psychotherapy Services 6. Mr Venigalla Sumanth Kumar, Head, Physiotherapy7. Dr Daniel Fung, Chief, Department of Child & Adolescent Psychiatry8. Mr Leong Yew Meng, Chief Executive Officer9. A/Prof Rathi Mahendran, Vice Chairman (Training)10. Dr Swapna Verma, Chief, Department of Early Psychosis Intervention11. Ms Tan Bhing Leet, Head, Occupational Therapy12. Ms Clare Yeo, Head, Psychology13. Ms Fiona Soh, Deputy Director, Corporate Communications

14. Dr Chiam Peak Chiang, Chief, Department of Geriatric Psychiatry15. Dr R M Winslow, Chief, Addiction Medicine Department16. Dr Chua Hong Choon, Chief, General Psychiatry17. Ms Lim Soh Har, Deputy Director, Medical Affairs18. Ms Lilian Mark, Head, Medical Social Work19. A/Prof Wong Kim Eng, Chairman, Medical Board20. Ms Pauline Tan, Director, Nursing21. Dr Tan Weng Mooi, Chief Operating Officer22. Ms Helena Tan, Director, Support Services23. Dr Lee Cheng, Chief, Department of Community Psychiatry24. Dr G S Devan, Chief, Department of General & Forensic Psychiatry25. Ms Lok Yoke Har, Deputy Director, Information Management26. Ms Peggy Ong, Head, Deputy Director, Human Resource27. Ms Irene Png, Director, Finance

90 heartening minds

Acknowledgements

This book is dedicated to all our staff, past and present, for their contributions in running, shaping and innovating mental healthcare as part of IMH/WH. For ideas remain as they are – just ideas – until we give them potency by actualising them in action. Without the dedication of our staff, there would have been no progress in IMH/WH for the benefit of people.

We would also like to express our thanks and appreciation to all of IMH/WH’s Medical Directors for their leadership and inspiration, and take a moment to remember Dr Ang Ah Ling, our Medical Director from 1996 to 2000, who passed away peacefully in December 2007.

PublisherInstitute of Mental Health/Woodbridge Hospital

Editors-in-ChiefMr Leong Yew Meng A/Prof Wong Kim Eng

EditorsMs Fiona SohMs Vera Soo

SponsorISS Facility Services Private Limited

Copyright © 2008 Institute of Mental Health/Woodbridge Hospital

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publisher.

acknowledgements

www.imh.com.sg

Institute of Mental Health/Woodbridge Hospital

Buangkok Green Medical Park10 Buangkok ViewSingapore 539747

T 6389 2000F 6389 2986E [email protected]

ISBN 978-981-08-0441-1

Documents

80th Commemorative Book