Making a Positive Impact

Early detection and intervention of persons with psychosis and at high risk
Providing a personalised, caring and accessible service, using a multi-disciplinary team approach
Innovative approaches leading in the field of early psychosis
Pursuing continuous learning and research

Public Awareness and Networking
We embarked on an ongoing public education campaign, which comprised a multi-pronged approach with different modes of communication and education (e.g. public forums, radio talks, television documentary drama, a book written on psychosis by the EPIP team, posters displayed at MRT stations, art exhibition, our website and hotline telephone service). The aim of providing the public with information on the manifestation of psychosis and the importance of early treatment is to encourage help-seeking behaviour.

Networking and Improving Accessibility
Initiatives were launched with the aim of educating, networking and collaborating with primary health care providers (private and polyclinic general practitioners (GPs), counsellors from the various tertiary institutions, social and welfare services, and traditional healers).
We decentralized our services to make it more accessible to our patients by involving General Practitioners (GPs) in the care of stable patients and right-site the care within the community. setting up clinics in the community, and an assessment centre in one of the local universities.

Integrated, Multidisciplinary Care (Case management)
Case Management is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s health needs through communication and available resources to promote quality cost effective outcomes (Case Management Society of Australia). In EPIP, Case Managers work in a multidisciplinary team, as well as establish links and work collaboratively with community resources, to engage patients in a collaborative, therapeutic relationship. Through assessment of patient and family's needs, a comprehensive care plan is developed, and continuity of holistic care is ensured.

Research and Training
Research which is a core component of EPIP allows us to continually evaluate and improve our services. In addition, staff training which includes consultations with a number of visiting experts from established overseas programmes, ensures that EPIP remains innovative and current.

We have seen a steady increase in new referrals to the programme, we have screened close to 1500 individuals and accepted 1112 into EPIP as of end of 2006. The number of attendees at our outreach events has also been on the increase.

The median duration of untreated psychosis - defined as the time between the onset of the first psychotic symptoms and the first adequate treatment - was 12 months before the programme and this fell to 4 months in the 2 years following the start of the programme. 95.5% of our patients rated our service (at the end of 2 years) as “Good” or “Excellent”. Compared to the baseline where only 24.8% of the patients were employed, we increased the employment rate to 48% by the end of the 2 years.

Only 0.72% of all episodes of hospitalizations had exceeded 90 days (our a priori definition of long-stay) and none of the patients to date has subsequently been transferred to the chronic wards of Woodbridge Hospital. Our analysis showed that with time and experience, we have become more cost-effective: there was an increase of 10.7% in average improvement index from the first year cohort of patients to a cohort the following year. The average treatment cost per improvement index for the second cohort was 16.3% lower.

In 2006, EPIP received the inaugural State of Kuwait Prize in Health Promotion awarded by the World Health Organization (WHO). This was in recognition for our outstanding contribution to research in health promotion.

• Singaporean / Permanent Resident
• 18 – 40 years old
• First episode psychosis
• Not induced by organic, drug or alcohol factors
• No forensic complications

In-patient and outpatient services
Individuals who are referred into EPIP are holistically treated through our multidisciplinary team. The emphasis of our services is on accessibility and continuity of care. Through a case-management approach, each individual is assigned a case manager who will assist in managing that person’s overall needs. This includes medication as well as any other psychological or psychosocial interventions required.

Club EPIP
Club EPIP is designed as a clubhouse as well as a place for social interaction for patients recovering from early or first episode psychosis and their families. It serves as a warm and comfortable place where they can share their experiences, engage in social interaction and support one another in groups.

Family Care Group
The Family Care Group seeks to equip family members of patients with knowledge and skills in understanding and caring for the patient.

Support for Wellness Achievement Programme (SWAP)
With the advantages of early detection and intervention, EPIP has established SWAP for individuals, between the ages of 16 to 30, with an at-risk mental state (at ultra high-risk for the development of psychosis or other mental disorders). SWAP is located in a non-traditional mental health setting to improve accessibility of the service. Psychological and social interventions form the foundation of treatment.

Dr Swapna Verma - Chief & Consultant Psychiatrist
A/Prof Chong Siow Ann - Senior Consultant Psychiatrist
Dr Theresa Lee - Consultant Psychiatrist
Dr Sujatha Rao - Associate Consultant Psychiatrist
Ms Helen Lee - Senior Case Manager & Team Leader
Ms Caroline Lim - Senior Case Manager & Deputy Team Leader
Ms K Pushpa - Case Manager & Club EPIP In-charge
Ms Sarah Ann Tay - Case Manager
Mr Christopher Loh - Case Manager
Ms Lee Yi Ping - Case Manager
Ms Ang Suying - Case Manager
Mr Spencer Yuen - Case Manager
Mr Raymond Chong - Case Manager
Ms Yong Yee Huei - Case Manager
Ms Bhavaani Ambrose - Case Manager
Ms Joycelyn Ling - Senior Psychologist
Mr Eunice Wong - Occupational Therapist
Mr Eugene Tay - Senior Counsellor
Ms Poon Lye Yin - Assistant Manager
Ms Selvarani Murugesan - Executive
Mr Simon Tey - Administrative Assistant