iCommunity@ East: an integrated community mental health and dementia support network in Singapore

Abstract

Aim: This paper describes the establishment of iCommunity@East: An Integrated Community Mental Health (CMH) and Dementia Support Network in Singapore. Background: Mental wellness is an emerging area of need, given our fast ageing population. . The current prevalence rate for dementia is 6%(1) and 5.7%(2) for depression amongst seniors in the community. Coupled with our growing number of seniors and shrinking old-age support ratio, there will be a growing number of seniors (and their caregivers) who will require support to enable them to age in place. Therefore, we need a more extensive, community-based and preventive approach to better support the mental health (MH) of the community. A population survey which interviewed 2,558 elderly living in East region was conducted in 2011. The outcome showed that 1 out of 10 elderly is not able to live independently and about 14.6% show signs of depression or dementia. This survey also projected that almost 30% of elderly will require health or social services. Current gaps: The gaps of the existing MH system are: i) services are overly driven by the acute care sector where the expertise reside, ii) limited number of community MH service providers who lack support and development and iii) insufficient integration across sectors. Good CMH care is associated with higher self-reported quality of life and service satisfaction ratings among service users. Meeting the needs The iCommunity@East is a pilot project to address these gaps in the Eastern region, Singapore. It is a community based MH care network that integrates MH with social services and medical system so that elderly with/at risk of dementia or mental illness are supported to continue staying at home. Community Resources and Support Engagement Team (CREST) are located in the community and staffed by social service staff. The teams provide a vital link between residents and MH support networks. Their roles are outreach and MH education, recognising seniors with dementia and MH conditions to link them with the right service for diagnosis and treatment, providing basic emotional support to these seniors and their families. Two CREST teams managed by Marine Parade Goodlife and Thye Hua Kwan Moral Charities have rolled-out their services since Oct' 12 and Jul' 13, respectively. To date, a total of 229 clients and their families have benefitted from their services. 70% of the clients expressed their satisfaction with the services received. 3,828 people in the community have been reached out with basic dementia and MH information. The multi-disciplinary Community Psychogeriatric Programme team of Changi General Hospital provides resource expertise and builds the capability of CREST teams through training, regular case discussions and conferences. Regular communication platforms were established to allow timely escalation to addressing care issues, and knowledge sharing between the partners. Conclusion: The preliminary result of iCommunity@East is encouraging and addresses the needs of elderly with dementia and depression, and their caregivers - realizing the vision of integrated community living and aging in place. [ABSTRACT FROM AUTHOR]