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新加坡卫生部:六年后,全国32所综合诊所都有心理健康问诊

2024/05/01
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3月6日,新加坡卫生部兼通讯及新闻部高级政务部长普杰立医生在国会拨款委员会辩论卫生部开支预算时说到了心理健康咨询辅助和诊治服务。

以下内容为新加坡眼根据国会英文资料翻译整理:

除了关注身体健康之外,我们还需要关注心理健康。在上个月的国会讨论了关于促进心理健康的议会动议,这个议会认识到心理健康对于健康、社会和经济问题的重要性,并确认了建立健全的国家心理健康生态系统,对增强心理健康和幸福感都十分重要。

蔡长春先生询问全国心理健康办公室重点关注的主要领域。该办公室预计将在2025年成立,由卫生部、社会和家庭发展部以及教育部的工作人员组成。监督全国心理健康战略的执行工作,以及规划心理健康护理的未来发展,如全国心理健康蓝图和社区心理健康总蓝图。

在这个办公室的领导下,我们将扩大初级卫生保健服务机构的心理健康服务,并加强社区服务。具体而言,最初的计划包括提升专业人员和一线人员的能力,包括宗教组织的工作人员,以支援有心理健康需求的人,以回应文礼佳博士关于让宗教组织参与社区心理健康支持的问题。其他计划包括:通过设立精神健康第一站接触点,尽早介入早期护理,并通过制定实践指南,确保服务提供者之间有更好的护理协调。该办公室还将追踪指标,以监测这些计划的进展和成果,反映在全国心理健康策略报告中。

有严重心理健康问题的人可能会在医院寻求精神医疗,但那些患有轻度到中度心理健康症状的人,与其接受专业治疗或被剥夺日常生活和社交,不如在社区接受护理更为有益。

赛义德哈伦医生询问健康SG计划计划是否把心理健康作为重点。让我详细说明一下我们如何在初级卫生保健中扩大心理健康服务。

今天,现有的25个综合诊疗所中有19个提供心理健康服务。此外,超过450名家庭医生已接受了心理健康全科医生合作伙伴计划(MHGPP)的培训,以支援有心理健康需求的人。为了让心理健康服务更普及,到2030年,本地所有32间综合诊疗所和1350家健康SG全科诊所也将提供心理健康服务。卫生部还将制定心理健康协议,并将心理健康护理和支持纳入到健康SG计划诊所家庭医生的工作范围中。

我们还将加强社区中的心理健康外展和干预工作。目前,我们有73个邻里咨询小组(CREST),邻里咨询小组旨在提供基本的情感支持和筛检,以便及早识别和转介可能出现心理健康问题的人,接受进一步评估和介入。到2030年,我们将邻里咨询小组的数量扩大到90个。

对于那些需要更加密集的心理健康支持的人,他们可以被转介到我们的29个社区辅助小组(COMIT)之一,到2030年将扩展至50个团队。这些小组辅助家庭医生在社区为有心理健康需求的人提供心理干预。这也回应了文礼佳博士提出的关于如何增强社区内心理健康服务的可及性和整合性的问题。

我们有关键的结构和政策来确保预防护理的有效实施。我们需要适当规模且具备正确技能的初级护理团队。这些团队需要得到充分的支持,以提供基于团队和整合的护理,通过初级护理网络(PCNs)、与专家的会诊以及利用技术。这有助于确保患者获得高质量的预防保健服务。

以下是英文质询内容:

In addition to physical health, we also need to look after our mental health. At the Parliament Motion on advancing mental health last month, this House recognised the importance of mental health as a health, social and economic issue, and affirmed the importance of a robust national mental health ecosystem to enhance mental health and well-being.

Mr Keith Chua asked about key areas that the National Mental Health Office (NMHO) will be focusing on. The Office is expected to be fully established by 2025, comprising officers from MOH, MSF and the MOE. It will oversee the implementation of various plans under the National Mental Health and Well-Being Strategy and shape the development of future mental health initiatives, building upon previous efforts such as the National Mental Health Blueprint and the Community Mental Health Masterplan.

Under the Office, we will scale up mental health services in the primary and community care settings and strengthen access to community-based care. Specifically, initial plans include building the competencies of professionals and frontline personnel. We will include staff in religious organisations to support persons with mental health needs, to address Dr Wan Rizal's question about involving religious organisations in community mental health support. Other plans include promoting early care access through publicising key mental health first-stop touchpoints and ensuring better care coordination among service providers through the development of a practice guide. The Office will also track indicators to monitor the progress and outcomes of these plans, as reflected in the National Mental Health and Well-being Strategy Report.

While persons with severe mental health conditions may seek psychiatric care at hospitals, those with mild to moderate mental health symptoms would benefit more from care delivered in the community, as compared to being institutionalised for treatment or being removed from their daily routines and social networks.

Dr Syed Harun asked if mental health will be a focus of Healthier SG implementation plans. Let me elaborate on how we are scaling up mental health services in the primary and community care settings.

Today, 19 out of the existing 25 polyclinics provide mental health services. In addition, over 450 GPs have been trained to support persons with mental health needs under the Mental Health General Practitioner Partnership (MHGPP). To bring mental health services closer to where individuals live, we will expand mental health support in all polyclinics and Healthier SG clinics by 2030. MOH will also be developing mental health protocols and incorporating mental health care and support, as part of the scope of practice for GPs in Healthier SG clinics.

We will also be strengthening mental health outreach and intervention in the community. Today, we have 73 Community Outreach Teams (CREST) that detect and help individuals with mental health needs. By 2030, we will expand the number of outreach teams to 90.

For those who require more intensive mental health support, they can be referred to any of our 29 Community Intervention Teams (COMIT), which will be expanded to 50 teams by 2030. These teams support GPs in the provision of psychosocial interventions for persons with mental health needs in the community. This also addresses Dr Wan Rizal's question on what is being done to enhance the accessibility and integration of mental health services within the community.

Sir, there are critical structures and policies to support the effective delivery of preventive healthcare. Our primary care teams need to be suitably sized and equipped with the right skills. They also need to be adequately supported to provide team-based and integrated care, through Primary Care Networks (PCNs) and consultations with specialists and by leveraging on technology.

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