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Community psychiatry in Singapore: a pilot assertive community treatment (ACT) programme
1Department of Psychiatric Rehabilitation, Institute of Mental Health, Singapore. c_g_lim@yahoo.com
Annals of the Academy of Medicine, Singapore
|February 24, 2005
Summary
Community psychiatric care, like the Assertive Community Treatment (ACT) program, offers a cost-effective alternative to hospitalization for severe mental illnesses. This approach aims to improve patient functioning and self-care within the community.
Area of Science:
- Psychiatry
- Public Health
- Mental Health Services Research
Background:
- Severe mental illnesses, such as schizophrenia, significantly impair patient functioning and contribute heavily to global disability.
- Hospitalization for severe mental illnesses is prolonged and resource-intensive, with 90% of Class-C beds at Singapore's Institute of Mental Health (IMH) occupied by such patients for an average of 300 days.
- De-institutionalization efforts have had limited success, highlighting the need for effective community-based psychiatric care.
Purpose of the Study:
- To detail the aims, setup, and services of a pilot Assertive Community Treatment (ACT) Programme launched by IMH in Singapore.
- To evaluate the effectiveness of community-based care in assisting patients with severe mental illnesses to live and function within the community.
- To explore the cost-effectiveness of community psychiatric services compared to traditional hospital-based inpatient care.
Main Methods:
- A pilot Assertive Community Treatment (ACT) Programme was implemented by IMH in November 2003.
- The program was funded by the Health Service Development Programme (HSDP) for three years.
- Referrals to the ACT team were received from IMH psychiatrists, and services included psychosocial rehabilitation.
Main Results:
- The pilot ACT Programme aimed to provide continuous psychiatric care and maintain self-care and independent living skills for patients.
- The program focused on psychosocial rehabilitation to support community integration.
- While specific quantitative results are not detailed in the abstract, the program's design suggests a focus on improving patient outcomes in a community setting.
Conclusions:
- Community-based psychiatric care, exemplified by the ACT Programme, is crucial for managing severe mental illnesses.
- Assertive Community Treatment (ACT) offers a viable and potentially more cost-effective model than inpatient hospitalization.
- Continued emphasis on community psychiatric services is necessary to support patients' long-term functioning and independent living.
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