Singapore GPs step up to support those with mental health problems
Over 520 GPs had joined the Mental Health General Practitioner Partnership as at December 2024. ILLUSTRATION: LIM KAILI, ADOBE STOCK
No health without mental health Singapore GPs step up to support those with mental health problems
SINGAPORE - From excelling in a management position in a multinational corporation to bringing up two teenagers, Ms Lee has done it all.
But after clinching her hard-won successes, the high-flier found herself in a deep state of emotional and physical exhaustion amid a hectic work period in 2022.
Sleep and rest did not help.
'Everything started to feel heavy and I lost interest in things I used to love.
'I was like a functional wreck, still showing up, smiling and delivering results. But inside, I just constantly felt very disconnected and my mind was very foggy,' said Ms Lee, who declined to use her full name, nor provide her age .
Overwhelmed, she decided to turn to family physician Lim Hong Shen at Bridgepoint Health, who had treated her and her family for minor illnesses over the years.
'I've developed that trust with him, and he was the first person who came to mind when I decided to seek help,' said Ms Lee, adding that she had never thought of going to a psychologist or counsellor because she was unfamiliar with mental health issues.
She was grateful that Adjunct Assistant Professor Lim took a slow and tactful approach in assessing her over a few consultations.
'He did not even mention a word about mental health, and I think that was helpful for me because the moment he did, I would have been taken aback,' said Ms Lee.
It was only on her third visit that Prof Lim gently broached the topic and referred her to a private therapist to manage her anxiety symptoms.
He continued to stay in touch with Ms Lee through her therapy, even helping her find another therapist when she felt she could not click with the first.
In 2023, Ms Lee was discharged by Prof Lim after mastering coping strategies and feeling energised by a new zest for life.
Her experience inspired her to set up a women's help group in her company.
Her recovery would not have been possible without Prof Lim, she said.
'He didn't just send me to a therapist, he was there throughout the entire journey,' said Ms Lee.
While the treatment of mental conditions has always been part of what general practitioners (GPs) can do, they are now being asked to play a greater role in the national effort to have patients diagnosed early and treated in the community, rather than mainly in hospitals and specialist centres.
According to latest figures from the Ministry of Health (MOH), more than 520 GPs had joined the Mental Health General Practitioner Partnership (MHGPP) as at December 2024. The initiative supports doctors in identifying, diagnosing and managing patients with mild to moderate mental health conditions.
GPs on the MHGPP programme, which began in 2012, benefit from access to lower-cost psychiatric medicine and support from hospital-based psychiatrist-led teams. About 450 joined in March 2024.
Prof Lim, who has been on the programme since 2018, said the clinic's Everton Park branch sees about 30 patients a month who need help with mental health.
Most are regular patients of the clinic while others were previously seen at hospitals or by private specialists.
The patients come from different walks of life, from students facing school stress to young adults who have relationship or work struggles and elderly folks who face isolation.
Prof Lim believes that mental health conditions should, by and large, be treated in the community as the first line of defence. This is especially if the GP has had a long relationship with the patient.
'That trust component is huge… and that gives us an advantage over the touch-and-go or one-time encounter that a specialist may have with a patient,' said Prof Lim, adding that patients in such circumstances are more forthcoming about their struggles and receptive to treatment options.
The common conditions seen at the clinic include depression and anxiety, and most are mild cases.
GPs may also choose to refer patients who need more community support to social service agencies, and those with more severe and urgent mental health needs to specialists. The latter could be a patient who is suicidal, or has multiple mental health issues, said Prof Lim.
'We are like the master navigator for our patients,' he added.
Dr Daryl Yeo, a GP and deputy primary care network clinical lead at Parkway Shenton, said family doctors can offer more integrated and holistic care for their patients. Dr Yeo has been on the MHGPP programme since 2022 and sees about one to two new mental health patients a week.
He pointed out that many mental health patients, such as new mothers, have other health concerns. They can develop post-partum depression if they struggle with experiences like breastfeeding.
'As family doctors, what we can do is offer care on issues with breastfeeding and post-partum care, and at the same time manage their mental health conditions, which may actually go hand in hand with their breastfeeding issues,' said Dr Yeo.
GPs can also notice red flags earlier. 'Patients who come in every month saying that they have headaches could trigger us to consider if there's an underlying issue of burnout, anxiety or depression,' said Dr Yeo.
While the MHGPP programme allows GPs to prescribe lower-cost psychiatric medication to patients, sometimes the prescription is non-medical.
Dr Yeo cited the example of a man who started suffering panic attacks because his wife feared he would cheat on her after witnessing infidelity in her friend's marriage.
In cases like this, the social issues also need to be addressed.
'As primary care doctors, we are relatively familiar with community services. If there are couple or family issues that need resolution, we would try to get them to visit a family service centre,' said Dr Yeo.
An MOH spokesperson said the ministry will continue to work with the Agency for Integrated Care, polyclinics, GPs and community mental health partners to expand and enhance mental health services in the community.
With the launch of Healthier SG, which pairs those above 40 with a family doctor, MOH is developing care protocols for major depressive disorder and general anxiety disorder to be rolled out in 2026.
These protocols will help more GPs integrate mental healthcare with chronic disease management. As more Healthier SG GPs become equipped to handle these conditions, MOH will be reviewing the MHGPP programme, with details to be shared in due course.
Helplines Mental well-being Institute of Mental Health's Mental Health Helpline: 6389-2222 (24 hours)
Samaritans of Singapore: 1-767 (24 hours) / 9151-1767 (24-hour CareText via WhatsApp)
Singapore Association for Mental Health: 1800-283-7019
Silver Ribbon Singapore: 6386-1928
Tinkle Friend: 1800-274-4788
Chat, Centre of Excellence for Youth Mental Health: 6493-6500/1
Women's Helpline (Aware): 1800-777-5555 (weekdays, 10am to 6pm) Counselling Touchline (Counselling): 1800-377-2252
Touch Care Line (for caregivers): 6804-6555
Care Corner Counselling Centre: 6353-1180
Counselling and Care Centre: 6536-6366
We Care Community Services: 3165-8017
Clarity Singapore: 67577990 Online resources mindline.sg
eC2.sg
www.tinklefriend.sg
www.chat.mentalhealth.sg
carey.carecorner.org.sg (for those aged 13 to 25)
limitless.sg/talk (for those aged 12 to 25)
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