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JULY - SEPTEMBER 2013AN IMH QUARTERLY PUBLICATION
MICA (P) 162/07/2011
IMHLINK
WHAT’S INSIDE
CLINICAL
RESEARCH
EDUCATION
AWARDS
GIVING
WHAT’S ON
SPECIAL EDITION: FY2012 IN REVIEW
Message from the CEOYear in Review 2012
I am pleased to provide a review of the Institute of Mental Health’s key initiatives in FY2012.
Our efforts to develop specialised services to better help our patients have seen good progress in the past year. We initiated two new services for patients—the Mood Disorder Unit to treat depression, anxiety, and bipolar disorder, and the Adult Neurodevelopmental Service for patients with intellectual disabilities and autism spectrum disorders who present with mental health problems. The multidisciplinary model of care employed by these two services ensures that our patients’ needs are addressed holistically and treatment regimens made more seamless.
Our Forensic Psychiatry team has collaborated with the Singapore Prison Service (SPS) to run a psychosocial rehabilitative treatment unit within the prison for inmates with mental disorders, with good results. The contract with SPS has been renewed and includes a wider scope of work, covering both male and female offenders with mental health disorders. The multidisciplinary team plans to develop a structured assessment to identify inmates with mental health problems. New programmes, such as treatment addressing offenders’ behaviour issues, substance misuse counselling, and modified illness management will be conducted to address the different needs of inmates.
Our National Mental Health Blueprint programmes continue to make an impact in the community. REACH rolled out its support to 11 Special Education Schools in FY2012, and also won the NHG Excellence In Action Awards (Team Category).
The Community Mental Health Team introduced the Pilot Supervision Programme, a new clinical service focusing on the rehabilitation of patients with moderate to severe mental illness and history of involuntary admissions. Intensive weekly psychosocial rehabilitation, including medication counselling and compliance monitoring, is provided for patients at their homes, to help them cope with independent living in the community.
We recognise that caregivers play an integral role in the recovery of our patients, and have introduced several services and resources to help them better perform this role.
In the area of research, the WiSE study was officially launched in October 2012 and household interviews are currently being conducted. We are on track to complete the survey within 2013. New research initiated in IMH during the period cut across a range of disciplines, including child and adolescent psychiatry, addictions, nursing, and general psychiatry, with IMH securing S$2.56 million in grants. Two of our staff also received the NMRC Research Training Fellowship.
Our work in training healthcare professionals continues to make good progress. The NHG-AHPL National Psychiatry Residency Programme received reaccreditation for a four-year period (2012–2016) by the Accreditation Council for Graduate Medical Education International. Nine IMH psychiatrists are on its core faculty. IMH also played a key role in developing the curriculum for psychiatry with the faculty from Imperial College London for the newly-opened Lee Kong Chian School of Medicine.
Further afield, IMH signed collaborative agreements with Galya Rajanagarindra Institute in Thailand; West China Hospital, Sichuan University in China and Rumah Sakit Dr. Cipto Mangunkusumo in Indonesia, to provide training to build capability in mental health support for their communities in times of disaster. This programme is supported with a grant from the Temasek Foundation.
We have achieved much in FY2012 because our partners have worked alongside us to help us achieve seamless services and care to meet the needs of our patients. I take this opportunity to sincerely thank everyone for your contribution.
A/Prof Chua Hong Choon, Chief Executive Officer, IMH
On the cover: A/Prof Chua Hong Choon, Chief Executive Officer, IMH (extreme right) networking with community partners (from left to right) Ms Rajeswari K, Executive Director, Singapore Association for Mental Health (SAMH); Mr Choo Jin Kiat, Executive Director, O’Joy Care Services; and Dr Tan Weng Mooi, Chief, Community Mental Health Division, Agency for Integrated Care (AIC).
A/Prof Chua Hong Choon, CEO of IMH, with a selection of art and craft by talented IMH patients.
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Dialectical Behavioural Therapy (DBT) has been introduced at the Mood and Anxiety Clinic (MAC) at the Child Guidance Clinic, HPB to help adolescents who have difficulties regulating their emotions. Four adolescents, who were concurrently seeing a therapist as part of their outpatient treatment, participated in the DBT Skills Training Group and preliminary evidence indicated that DBT skills can reduce mood disturbances and improve stress tolerance.
As IMH strives towards its vision of being a tertiary centre of excellence and global leader in mental healthcare, we have looked at ways to enhance our clinical services to better meet specific needs of the mentally-ill.
Read on to understand how our new sub-specialty services bring together teams with particular areas of expertise that work together to optimise care for our patients.
Clinical Care
New Sub-Specialty Services
Tackling Co-morbid Mental Health Problems with Intellectual Disability
Intensive Rehabilitation through Pilot Supervision Programme
Boosting Mood Disorders Treatment
Help for Children with Mood and Anxiety Issues
The clinical presentation and treatment needs of mental health problems in adults with intellectual disability may be different from the general population due to the impairment in their cognitive abilities and social skills, and communication deficits.
In view of this, in February 2013, IMH started the Adult Neurodevelopmental Service (ANDS), an integrated multidisciplinary service for adult patients withneurodevelopmental disorders (e.g. intellectual disability or autism spectrum disorder) and psychiatric co-morbidity behaviours. ANDS is offered at Clinic B in IMH and at the Community Wellness Centre, Queenstown. Patients referred are reviewed by a specialist multidisciplinary team of medical and allied health staff, who will work together to optimise care for this group of patients, including implementing care plans that will better address their mental health, behavioural and habilitation needs.
Besides direct clinical care, the team will also support the patients, their caregivers and other community agencies involved in their care through case management, outreach and training.
The Pilot Supervision Programme is a new clinical service which provides support for the rehabilitation of psychiatric patients with moderate to severe mental conditions and a history of involuntary admissions.
Started in October 2012, the programme encompasses weekly psychosocial rehabilitation sessions at patients’ homes, including medical counselling, compliance monitoring and life skills training. These are aimed at helping patients develop their self-confidence and take ownership of their condition, so that they can effectively integrate with their families and neighbours, and live independently within the community. Their assimilation into the community helps to reduce emergency room attendances, hospital admissions and length of stay in the hospital, if they are admitted.
As a form of encouragement and motivation to remain committed to their recovery efforts, patients are provided with incentives when they meet milestones in their treatment plan.
The Mood Disorders Unit (MDU) was started in April 2012 as a pilot, providing specialised inpatient treatment for patients suffering from affective (mood) disorders like depression and bipolar disorder, and anxiety disorders (such as obsessive-compulsive disorder). Previously, patients with mood disorders were treated with patients suffering from other mental disorders. The ward environment could be disruptive and was not optimal for the treatment of the patients with mood disorders.
A multidisciplinary team comprising clinicians, case managers, psychologists, medical social workers, pharmacists, occupational therapists and art therapists now works together to provide a more customised treatment intervention that these particular groups of patients require.
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Improved Infrastructure
“Needling” Addictions in the Bud with Acupuncture
One-stop Occupational Therapy Rehabilitation Services at OcTAVE@IMH
The National Addictions Management Service (NAMS) has introduced acupuncture as an adjunct treatment to complement its existing treatment programmes for addictions. This pilot service is helmed by Adj Asst Prof Guo Song, Head of Research and Consultant Psychiatrist at NAMS, who is also a registered acupuncturist. Catering to patients with a primary diagnosis of an addiction disorder, it aims to promote recovery by reducing the severity of withdrawal symptoms, pain and cravings, as well as the symptoms of some co-morbid disorders, such as mood disorder and anxiety.
The service will accept referrals from polyclinics, restructured hospitals and private specialist clinics, where cases of addiction disorders may be picked up. The patient will be assessed for addiction disorders at NAMS and advised if acupuncture treatment is suitable.
The Occupational Therapy: Activities, Vocation and Empowerment day centre at IMH (OcTAVE @ IMH) underwent a revamp in July 2012, integrating all outpatient rehabilitation services under one roof. The one-stop service now brings together clinical rehabilitation programmes such as cognitive remediation, Personal Effectiveness for Successful Living (PESL), sensory modulation, Mindfulness-Based Stress Reduction (MBSR), Illness Self Management and Recovery (ISMR) and health management. Also, Craft Creates, vocational training and job preparation services through Job Club are incorporated into this one-stop service. Amidst the plethora of interventions available, patients work out their rehabilitation goals with their occupational therapists (OTs), and jointly decide on the range of interventions needed to achieve these goals. The OTs will also case-manage their patients and refer them to appropriate community resources, if they require further support upon completion of the year-long OcTAVE programme. The OcTAVE team works synergistically, meeting weekly and working in tandem with a rehabilitation psychiatrist to achieve the best outcomes for patients. FY12 saw the major upgrading of two IMH outpatient clinics.
The renovations were not merely cosmetic, but patient-centric to offer greater convenience and comfort to patients.
Clinic B at IMH now boasts an advanced queue system, additional consultation rooms that are spacious and conducive for doctor-to-patient interactions, individual rooms for financial counselling and admissions that enhance patients’ privacy, a spacious waiting area for easy wheelchair maneuverability, and a handicapped toilet. The expanded clinic also facilitates operational synergy, as it now houses the Mandatory Treatment Order Clinic and the Residency Outpatient Continuity Clinic as well.
Over at our Community Wellness Clinic (CWC), Geylang (formerly known as Geylang Behavioural Medicine Clinic), a warmer and brighter ambience with natural lighting now greets patients, who get to benefit from a self-registration kiosk to shorten registration wait time for those with appointments, an activity room for rehabilitation, and a more conducive treatment room.
A Facelift for IMH Outpatient Clinics
Dr Amy Khor, Senior Minister of State, Ministry of Health and Ministry of Manpower (extreme left) visiting the new Community Wellness Clinic, Geylang during the reopening of the upgraded Geylang Polyclinic. Dr Lee Cheng, Vice Chairman Medical Board (Clinical), IMH (in red tie) shows her around.
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Supporting Families Affected by Gambling Addiction
Empowering Caregivers of Persons with Dementia
Problem gambling not only hurts the gambler but also his loved ones. The stress of handling a family member’s compulsive gambling can lead to physical and psychological abuse, not to mention the stress from mounting debts, harassment and threats from bill collectors and creditors. As such, a support programme known as Gambling Addiction Management through Education (GAME)-Family was launched in September 2012 for family members of patients undergoing treatment for gambling addiction at NAMS. Over eight sessions, GAME-Family aims to help family members make sense of their situation, and receive professional help and support for their loved ones’ recovery. Family members can also pick up tips and strategies on dealing with the consequences of problem gambling along with emotional support from each other. More than 300 attendees benefitted from the programme in the past year.
Also, 80 people attended the psychoeducational group Families in Recovery through Education and Empowerment on Problem Gambling (FREE-PG), which helped them better understand gambling addiction and how to help a loved one who has refused treatment.
IMH started dementia training and workshops for caregivers in 2012 and there have been two runs of these workshops thus far in April and November 2012, with about 20 participants for each run. These workshops provide psychoeducation and create awareness of dementia-related caregiving issues for direct caregivers of persons with dementia.
Services for Caregivers
Caregivers and Patients Provide Peer Support
A Resource for Parents of Children with Learning Disorders
In 2012, our Early Psychosis Intervention Programme (EPIP) rebranded its Peer Support Specialists initiative, renaming it Peers 4Rs (Remembering, Resilience, Respect and Recover). This new name represents the principles and values of the peer support provided by patients and caregivers to others who are going through the same journey.
The PSSs provide support through groupwork sessions or one-on-one support via telephone or face-to-face meetings. They also share their experiences in workshops and forums and instill hope through encouragement and sharing of their own experience.
A total of 11 PSSs (nine patients and two caregivers) were recruited in 2012. Sixty-five patients and 72 caregivers have benefited during this period. Mrs Ting, our PSS for caregivers, emerged a winner in the Individual category of the Silver Ribbon Champion of Mental Health Award 2012.
Internationally, peer work has garnered interest as a promising psychosocial intervention in the mental health field. EPIP has presented its work in peer support over three separate conferences in India, the USA and Singapore.
A multidisciplinary team from IMH, comprising a child psychiatrist, an educational psychologist, an occupational therapist and specialist teachers published “Minding the Gaps” in August 2013, to help parents whose children have beendiagnosed with a learning disorder. The book offers practical recommendations and approaches that parents may find helpful, and also hopes to inspire and empower parents
to be more active and creative in supporting their children’s psychological, emotional, educational and social well-being.
The workshops feature talks by psychiatrists, occupational therapists or medical social workers for a multidisciplinary perspective. Participants also get the opportunity to share the experiences and challenges that they face in caregiving, hence creating a supportive network for one another in the community as they exchange useful tips in providing better care for their loved ones. Currently, the training is conducted in English and Mandarin.
This book retails at S$19.26 (inclusive of GST) and can be found at all leading bookstores and at the IMH eShop at www.imh.com.sg.
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IMH has been spearheading the National Mental Health Blueprint (NMHB) programmes for children and adolescents, adults and the elderly since 2007. The key programmes – Response, Early intervention and Assessment in Community mental Health (REACH), Community Health Assessment Team (CHAT), Community Mental Health Team (CMHT), Aged Psychiatry Community Assessment & Treatment Service (APCATS) Clinical Service, Regional Eldercare Agencies Partnership (REAP) – have reached their five-year milestone and the teams have seen their efforts bear fruit, in terms of seeing early detection and intervention for the population.
As the NMHB programmes continue with their good work, more remains to be done to extend mental healthcare services in the community. IMH has stepped up our efforts in capability-building within the community through programmes like ASCAT and GP-COMIT. Besides that, we are working closely with community agencies to cultivate dynamic partnerships which we hope will usher in a new era of collaboration for mental healthcare in Singapore.
Community Partnerships
Assessment Shared Care Team (ASCAT)
IMH has taken on important roles in the new Community Mental Health Master Plan, including supporting the National Healthcare Group in providing mental health services in the community for the central region. Since October 2012, IMH has started working with NHG Polyclinics to run the Assessment Shared Care Team (ASCAT) at Ang Mo Kio Polyclinic. ASCAT is a physician-led, multidisciplinary teamwhich manages patients with mild to moderate mental health conditions such as depression, anxiety disorder and sleep symptoms. The team comprises family physicians, care managers, psychologists and medical social workers at the polyclinic. ASCAT is trained and supported by specialists
from IMH through co-consultations and case discussions so that they are better equipped to care for such patients.
With ASCAT, patients are now able to access mental healthcare services at the Ang Mo Kio Polyclinic without the need to go directly to the specialist outpatient clinics (SOCs) at hospitals. The patients’ health (e.g. chronic conditions and mental health) can be managed holistically within the polyclinic instead of in different care settings. This gives patients the advantage of being treated in a place close to where they live, and also helps the polyclinic doctors to identify any mental health condition early.
Dr Winnie Soon, Family Physician-Consultant at NHGP Ang Mo Kio Polyclinic, seeing a patient in an ASCAT co-consultation session with Dr Wei Ker-Chiah, Deputy Chief and Consultant from the Department of Community Psychiatry, IMH (extreme left).
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General Practitioner-Community Mental Health Intervention Teams (GP-COMIT)
IMH has also identified GPs with whom IMH psychiatrists will perform case conferences, to support them in the management of patients with mild to moderate mental health conditions who walk-in to their practice. The skills of the GPs will be further enhanced through training and specialised courses such as the Graduate Diploma in Mental Health (GDMH).
To complement the solo GPs in managing new mental health patients, IMH will link the GPs up with a Community Mental Health Intervention Team (COMIT) run by voluntary welfare
Help is Just a Phone Call Away
Detecting Addictions Early
Community agencies have often encountered situations where the persons seeking their help were mentally unwell and challenging to engage. With this in mind, IMH and the Agency for Integrated Care (AIC) jointly introduced the Mental Health Helpline (MHH) in August 2012. The 24-hour MHH is part of the Mobile Crisis Service and is manned by qualified counsellors providing information and advice to callers or caregivers facing a crisis. They also render help to partner agencies, giving them an avenue to seek advice and discuss challenging clients who have mental illness.
MHH services were first piloted at Covenant Family Service Centre (FSC) from December 2011 and subsequently extended to all the other FSCs and Senior Activities Centres (SACs). Staff from the various FSCs and SACs were also provided mental health training in 2012 and 2013 to equip their counsellors with skills and knowledge to better identify and manage persons with mental illness.
The MHH is part of the existing Mobile Crisis Service which also includes an intervention team. If necessary, the intervention team will visit the person who may be suffering from mental illness and de-escalate the stressful situation. It aims to reduce the impact of mental health emergencies through immediate response to crisis at the community level.
Moving forward, plans are underway to work with Community Development Councils (CDCs) to streamline avenues of support and intervention for people with mental illness. The MHH strives to ensure that care and support is promptly rendered to those who need help through the coordinated efforts and networking with partner agencies.
In September 2012, the National Addictions Management Service (NAMS) at IMH rolled out two initiatives to equip primary care physicians (PCPs) in the community to identify people with addiction problems, and refer them for further help where needed.
Firstly, NAMS produced a toolkit for PCPs which outlined a three-step approach to help them identify and provide advice to patients who show symptoms of alcohol abuse or gambling addiction.
Secondly, IMH conducted addictions-related training for PCPs and community partners. The sessions equipped them with the knowledge on how to identify and manage various addictions, and also refer those affected for help.
organisations (VWOs). While the GPs will provide psychiatric assessment and medication, mental health counselling, psychoeducation, therapy, intervention and case management will be provided by the VWOs.
The IMH team will train COMIT partners in specific mental health skills set to build up their capability and confidence to see stabilised patients with mental health issues independently. Currently, one COMIT partner, O’Joy Care Services, has come on board to support the Central region.
IMH nurse clinician, Leow Me Lye from the Community Mental Health Team (CMHT) conducting a mental health training session.
Also, with effect from July 2013, NAMS extended its treatment services for addictions to IMH’s Community Wellness Clinic (CWC) in Geylang, on top of the clinic it was already running at the CWC at Queenstown. This makes it more accessible for patients, who do not need to travel to IMH to seek help for their addictions.
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In FY2012, IMH continued to make steady strides in research efforts as evidenced by collaborations across different departments, a myriad of research themes and many external collaborators coming on board.
Amidst our increasingly vibrant research culture, we have published 51 articles in peer-reviewed journals and also seen a number of our research studies highlighted in media reports.
“A Population-based Survey of Mental Disorders in Singapore,” one of the first publications derived from the Singapore Mental Health Study (SMHS) spearheaded by Assoc Prof Chong Siow Ann, Vice Chairman Medical Board (Research), Research Division and Adj Asst Prof Mythily Subramaniam, Director, Research Division from IMH, was honoured with the Best Publication Award 2012 (Silver) by the Editorial Board of the Annals, Academy of Medicine, Singapore (AAMS) medical journal. This Award is a nod to the paper’s clinical impact, study design, research methodology, data analysis, quality of data interpretation and balanced discussion.
Indeed, the SMHS continues to impact the formulation of mental health policies and development of programmes and services. Likewise, we are confident that our relentless pursuit of research in different areas of mental health will bear fruit, as we seek to advance our borders of knowledge and translate our understanding into clinical practice.
Tracking the Well-being of the Singapore Elderly (WiSE)
Research on Children and Adolescents
The Well-being of the Singapore Elderly (WiSE) study launched in October 2012 and led by Adj Asst Prof Mythily Subramaniam is well underway. The study aims to establish high-quality data on the burden of dementia and depression among the elderly in Singapore and to bridge the knowledge gap on the associated risk factors, healthcare use and economic impact. WiSE will also study the burden and needs of caregivers of the elderly who have dementia. The study is expected to be completed within this year.
The Supplements and Social Skills Intervention Study (SASSI), fronted by IMH Chairman Medical Board, A/Prof Daniel Fung investigates the effects of Omega-3 supplementation on children with conduct disorder and hyperactivity has been completed and the data analysis results are expected in end-2013. Moving forward, the Research Unit of IMH’s Department of Child and Adolescent Psychiatry (DCAP) will further its research efforts on Omega-3 supplementation in various child and adolescent clinical populations, and novel technology-based interventions such as gaming and robotics (please see page 13 for more info on one such initiative, Regna Tales).
Dr Lim Choon Guan, Deputy Chief of DCAP is leading a study to see if a brain-computer interface-based training programme can reduce symptoms of attention deficit hyperactivity disorder (ADHD) in a randomised controlled trial. The team will also study brain structure and activity using functional imaging to elucidate the effectiveness of this treatment for ADHD symptoms.
Research
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Advancing Knowledge of Addictions
Biomarkers for Psychosis
Integrating Research into an Early Psychosis Intervention Clinical Service
How Schizophrenia and Bipolar Disorder Change Brain White Matter
Having completed two years of treatment outcome monitoring, the National Addictions Management Service (NAMS) Research Unit published several papers and abstracts in 2012, reporting findings which identified the predictors of clinically meaningful change among patients with alcohol, opiate and gambling disorders. In 2013, the team commenced two new studies – an evaluation of the Montreal Cognitive Assessment (MoCA) tool to detect cognitive impairment among substance misusers and a randomised control trial examining the safety and efficacy of lofexidine versus diazepam for the management of opioid withdrawal syndrome.
Consultant psychiatrist, Dr Jimmy Lee’s earlier work demonstrated the potential of blood-based biological markers (biomarkers) in identifying individuals with psychosis. A follow-up study is in progress to reproduce the same results in a larger sample, as well as evaluate other potential molecules. In addition, Dr Lee is looking to evaluate the ability of these biomarkers to predict clinical outcomes, especially with regard to the selection of suitable therapies or vulnerability of individuals to developing side effects.
Our Early Psychosis Intervention Programme (EPIP) has made much headway in integrating research into clinical service. The team has started studies to examine the profiles and outcomes (quality of life, medication adherence, etc) of first-episode psychosis patients. Other qualitative studies looked at the peer support programme and patient experience. The team has also embarked on studies on the effectiveness of psychosocial interventions in patients’ weight management, the efficacy of cognitive remediation for schizophrenia, use of clozapine in first-episode
Imaging studies of subjects with psychotic spectrum conditions (including bipolar disorder and schizophrenia) led by Assoc Prof Sim Kang, Deputy Director, Research Division & Deputy Chief and Senior Consultant, Department of General Psychiatry earlier suggested white matter changes involving brain cortical and subcortical regions in these patients. These will now be further investigated
psychosis and predictors of conversion in patients who are at risk of psychosis.
Two multi-site collaborations are also nearing completion. One is an international study looking at the use of Omega-3 fatty acids and cognitive-behavioural management in patients at risk of psychosis, while the other is a local study in collaboration with Tan Tock Seng Hospital and the National Neuroscience Institute to examine the links between antibodies in the blood and spinal fluid of individuals with acute psychosis and changes in the brain.
through longitudinal neuroimaging studies, which seek to chart the progressive brain changes present in patients with bipolar disorder and schizophrenia, and correlate the brain white matter changes with clinical outcome measures.This area of research has been awarded a new grant under the FY2013 NHG-KTPH Small Innovative Grant I (SIG I).
Koh Puay Kee, Research Officer from NAMS, collecting baseline data from a patient for treatment outcome monitoring.
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Understanding Obesity in Patients with Schizophrenia
IMH Nurses in the Research Scene
A Site for Clinical Trials @ IMH
Metabolic abnormalities such as obesity, diabetes, hyperlipidemia and metabolic syndrome are common in patients with schizophrenia. In collaboration with the Saw Swee Hock School of Public Health (SSHSPH) at NUS and the nutrition division at Temasek Polytechnic, our research team is currently studying the burden and risk factors of obesity in patients with schizophrenia. The findings will identify other risk factors for obesity in the local patient population, and guide future interventions. This study is led by Dr Jimmy Lee and supported by senior research officer, Milawaty Nurjono.
Our nurses have participated in various research opportunities in 2012. Two research projects done by IMH nurses clinched Gold and Bronze awards at the Singapore Health and Biomedical Congress 2012, namely a research project demonstrating the clinical effectiveness of the Brøset Violence Checklist in predicting inpatient violence, and one on how an Illness Self-Management and Recovery (ISMR) programme reduced symptoms and increased social functioning in adults dwelling in the community respectively.
Four research studies by our nurses were also published in scientific journals and in the Joanna Briggs Institute (JBI) – Library of Systematic Reviews. Notably, an Evidence-Based Utilisation Workgroup under the JBI International Evidence-Based Utilisation Network was set up in April 2013 to advance mental health evidence-based practices and research in the region by implementing research findings in nursing practice while benchmarking outcomes with other workgroups.
The Clinical Trial Unit (CTU) at IMH not only provides administrative and clinical support, but currently serves as a point of contact for all industry-sponsored clinical trials in IMH.
The CTU had completed a Phase II investigator-initiated trial in patients with schizophrenia. This was a single-site double-blind, randomised, placebo-controlled study, and one of the largest single-site trial on a neurocognitive-enhancing agent globally. The success of this trial enhanced IMH’s reputation as a trial site for cognition. This has led to several industry contacts and two ongoing clinical trials in cognition. In the years ahead, the CTU hopes to facilitate more intervention studies, both pharmacological and non-pharmacological, so as to bring newer therapies to our patients.
IMH was awarded a S$10 million Centre Grant (CG) from the National Medical Research Council (NMRC) over the next four years (FY2013 to FY2016). The programme for the IMH CG comprises the two main research themes of Health Services Research and Translation and Clinical Research.
A Funding Boost for Research at IMH
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Beyond delivering comprehensive clinical services and pursuing cutting-edge research, we see IMH’s role very much as an educator – sharing our expertise with community partners, and training the next generation of mental health professionals.
In the academic year from July 2012 to June 2013, IMH trained 327 medical undergraduates. We also trained 86 allied health professionals in our financial year which ended 31 March 2013, and in calendar year 2012, 1,738 nursing undergraduates underwent training with us as well.
IMH’s forays into the region in the past year have also seen us expand our teaching and training influence, and such collaborations truly shape us more and more into the global leader in mental healthcare that we have articulated in our vision.
Building a Strong Foundation for Community Mental Health in Asian Communities Affected by Disasters
IMH’s medical and allied health professionals have been engaged to provide consultancy services as well as share their skills in the Temasek Foundation – Institute of Mental Health, Singapore: ‘Disaster Mental Health Programme for Communities in Asia.’ Under this Programme, in FY12, IMH signed collaborative agreements with the Galya Rajanagarindra Institute (GRI), Thailand, West China Hospital, Sichuan University, China, and Rumah Sakit Dr Cipto Mangunkusumo (RSCM), Indonesia, to boost recovery and preparedness of local communities affected by disasters. The total cost of the programme for these three countries is S$2.38 million, largely enabled by a grant of S$1.96 million from Temasek Foundation. The Programme is based on a three-level training model targeting various groups ranging from policy and healthcare leaders, mental healthcare professionals and community-based workers.
From 2012 to 2015, IMH will be involved in this capacity-building programme through mental health education and training, which effectively positions IMH well as a regional leader in mental health education and training.
The first milestone under the IMH-GRI collaboration was marked with the emergence of the Programme’s first group of master trainers, when 40 healthcare professionals from Thailand participated in and completed an intensive “Training-of-Trainers” (TOT) course between June to July 2013. The course was conducted in Bangkok and Singapore. These healthcare professionals will in turn train community-based helpers who work directly with individuals affected by crises in Thailand.
Marking a milestone: The Programme’s first group of master trainers from Thailand, together with some members of IMH senior management.
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Equipping Corporates with Crisis Management Skills
Second Cohort of GPs Complete Graduate Diploma in Mental Health
A World-Class Psychiatry Residency Programme
In the past financial year, IMH clinical and allied health professionals have conducted a total of 10 basic crisis management courses and two leaders’ courses for organisations in industries like aviation and tourism, as well as government agencies. A total of about 220 staff and 40 leaders were trained.
As part of our continuous effort to build community capability in times of crisis, IMH has also partnered with organisations in the aviation and technology industries to provide training on psychological first aid.
Twenty-four general practitioners (GPs) graduated from the Graduate Diploma in Mental Health (GDMH) programme in March 2013. This was the second graduating batch and since the inception of the GDMH in 2010, 43 GPs have successfully completed the programme. The third and current cohort of 26 GPs is expected to complete the programme by November 2013. We are heartened to see GPs taking a steady interest in mental health.
In October 2012, the National Healthcare Group–Alexandra Health Private Limited (NHG-APHL) Psychiatry Residency Programme, under the leadership of its Programme Director, A/Prof Chiam Peak Chiang from IMH, successfully received reaccreditation for a four-year period (2012 – 2016) by the Accreditation Council for Graduate Medical Education International (ACGME-I) in the United States of America.
This reaccreditation is of great significance to IMH as it is the primary site for the programme. It allows IMH to further its training initiatives to equip psychiatrists to manage the wide
range of psychiatric conditions to meet local mental health needs. As of September 2013, 49 residents are undergoing training through this five-year programme, in which they get to work in a variety of mental health settings. Currently, there are 22 core faculties in the NHG-AHPL Psychiatry Residency Programme, out of which nine are from IMH. We are confident that the improved training curriculum and robust learning culture will produce more well-rounded psychiatrists who are adept at delivering even better medical care and treatment to patients with mental illness.
Our residents enjoying a teaching session under the NHG-AHPL Residency Programme.
Dr Low Kee Hwa, a GDMH graduate, sharing his experience going through the course and how he has applied the knowledge gained to his work.
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IMH Makes Progress in Medical Education Research
IMH Nurses Broaden Educational Horizons with Alice Lee Nurses’ Development Fund
Regna Tales
The National Healthcare Group’s (NHG) Health Outcomes & Medical Education Research (HOMER) Grant is a short-term grant designed to encourage doctors, nurses, allied health professionals, and medical researchers from NHG institutions to embark on medical education research. Regular HOMER webcast-style meetings are held for these researchers to share their results and findings with the cluster, and to also encourage others to undertake medical education research as part of their training and development.
A generous donation from the Lee Foundation has allowed IMH to establish the Alice Lee Nurses’ Development Fund in 2012 to support the professional development of nurses in IMH. The fund seeks to enhance professional education and development via two-week overseas clinical attachment and education trips for IMH senior nurses.
Traditionally, psychologists have conducted skill-based, manualised interventions in clinic settings. With funding from the National Research Foundation in April 2011, the clinical team from IMH’s Department of Child & Adolescent Psychiatry set out to challenge this tradition with an infusion of modern technology. They partnered with Immersive Play Spaces, a local gaming company to develop a web-based game entitled “Regna Tales”, which incorporates social problem-solving skills training (SPSST) modules.
“Regna Tales” (where “Regna” is “Anger” spelled backwards)is tailored to help the player learn and execute social responsibility by picking up skills related to anger management and social communication in a fun and engaging environment. Through playing the game, the child picks up skills in identifying emotions and feelings, perspective-taking, coping skills, empathy, pro-social skills and problem solving.
The game is peppered with audio and visual animations to engage the player. Challenges and missions also abound which test the player’s patience, emotion regulation and self-control. Positive or negative game consequences are awarded when the player fulfills tasks or fails tasks. A soft launch of the game was done in May 2013 via Facebook, to gather feedback from players and to allow the team to further finetune the games before the official launch, which took place during the Youth Counsellor’s Conference in August 2013. The clinical team has also secured a 10-year licensing agreement for IP Spaces to have exclusive rights to commercialise the games locally and worldwide eventually.
Four IMH projects received S$10,766.20 in grants, with research topics spanning interprofessional collaboration (GP partnership), nursing, autism, and intellectual disability.
IMH nurses have plenty to smile about, with the new boost for their professional development.
A HOMER teleconference in progress.
Innovation
“Regna Tales” seeks to engage players through a colourful interface.
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Excellence in Public Service Awards
Mental healthcare is a very people-oriented profession that is founded on compassion, empathy and selflessness, beyond the necessary medical and practical know-how. As such, people – staff – are considered the greatest asset to IMH. In FY2012, many of them have received recognition for giving their best to their work. They have indeed done IMH proud.
The PS21 Star Service Award recognises and rewards public officers who have consistently demonstrated high standards of service excellence. They have shown immense dedication and commitment to the Public Service values of Integrity, Service and Excellence.
In May 2013, Dr Leong Jern-yi, Consultant, Department of Community Psychiatry and Deputy Programme Director, Community Mental Health Team received the PS21 Distinguished Star Service Award for his tireless efforts in driving rehabilitation psychiatry initiatives, amongst others. He launched the Psycho-Rehabilitation Clinic in IMH, which helps to coordinate continuity of care with specialist input to help patients on their recovery journey. He also pioneered the
Personal Effectiveness for Successful Living (PESL) programme in Singapore to help patients rebuild their lives through social and problem-solving skills training. His compassion and caring bedside manners have also won him compliments from many of his patients. In addition, IMH had a PS21 Star Service Award winner in Mdm Ng Chui Eng, Covering Nurse Manager. Not only is Mdm Ng devoted to caring for patients and caregivers and going the extra mile for them, she is a highly respected mentor among her colleagues. As a strong proponent of quality nursing care for patients, Mdm Ng has also contributed actively to various quality improvement projects to improve the welfare of patients.
Dr Leong Jern-yi receiving the PS21 Distinguished Star Service Award from Mr Teo Chee Hean, Deputy Prime Minister, Coordinating Minister for National Security, Minister for Home Affairs and Minister-in-Charge of the Civil Service.
Mdm Ng Chui Eng receiving the PS21 Star Service Award from Mr Peter Ong, Head of Civil Service and Permanent Secretary, Ministry of Finance.
MOH Nurses’ Merit Award 2012
Five of our nurses received the MOH Nurses’ Merit Award for their exceptional performance and devotion to the nursing profession:
Tan Hoi HwangNurse Manager
Yeoh Ai LeanSenior Nurse Manager
Paramesvari JayaramanNurse Clinician
Wong Chui PingNurse Clinician and Advanced Practice Nurse
Frieda Tan Peck LanSenior Staff Nurse
Thumbs up: Our jubilant award recipients Tan Hoi Hwang (third from left), Yeoh Ai Lean (fourth from left), Paramesvari Jayaraman (fifth from left) and Frieda Tan (third from right) with Dr Amy Khor, Senior Minister of State, Ministry of Health and Ministry of Manpower (fifth from right) and senior management from IMH Nursing Administration. Fifth winner, Wong Chui Ping is not pictured.
Awards & Achievements
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National Day Awards 2013 The Singapore National Day Awards are a means of recognising various forms of merit and service to Singapore.
Efficiency Medal
Samat Bin MahmoodNurse Manager
Gurbak Singh s/o Inder Singh BhagatNurse Manager
Abdul Rahman Bin Sukiman Nurse Manager
Long Service Medal (25 years of service and above)
A S Kurunian s/o Murthu SubramanianHealth Attendant
Lim Yang ChueSenior Staff Nurse
Arumugum GovindasamyAssistant Director of Nursing
Ong Lay KhengSenior Assistant Nurse
A/Prof Chiam Peak ChiangVice Chairman (Education)
Dr Parvathy d/o PathySenior Consultant
Dr Eu Pui WaiSenior Consultant
Romaino Bin MisraHealth Attendant
Hardev KaurPrincipal Assistant Nurse
Sazali Bin HusinHealth Attendant
Jamalia Binte AhmadNurse Clinician
Tan Chong EngSenior Staff Nurse
Krishnan s/o SivadasSenior Staff Nurse
Tien Mui ChaiSenior Administrative Assistant
Poh Chee Lien, Assistant Director of Nursing (Education) at IMH was conferred the President’s Award for Nurses 2012. At that point, she became the youngest-ever award recipient at age 37.
An excellent role model for lifelong learning, Chee Lien is a firm believer in continuing education and is pursuing her PhD currently. Many nurses of all ages see her as a mentor who has spurred them on to realise their aspirations. As a nursing educator, Chee Lien develops strategic plans for Nursing Education at IMH and improves processes to standardise the development of curriculum and training materials. She contributes actively to mental health nursing through her publications and presentations locally and internationally. Chee Lien has also introduced many learning initiatives including a Problem-Based Learning Process to guide nurses in case study discussions and develop their critical thinking skills.
President’s Award for Nurses 2012
Ms Poh Chee Lien (left) receiving the Award and certificate from President Tony Tan at the Istana.
Healthcare Humanity Award 2013The Healthcare Humanity Award recognises and honours healthcare workers who have been inspirational role models exemplifying the values of courage, extraordinary dedication, steadfastness in ethics, compassion and humanity. These values underscore healthcare as a noble profession.
IMH recipients of the HHA 2013:
Dr Wei Ker-ChiahHead, Adult Neurodevelopmental Service; Deputy Chief and Consultant, Department of Community Psychiatry
Ms Wendy ChuaDeputy Head and Principal Occupational Therapist, Occupational Therapy Department
Singaravelan s/o PavadaiClinical Instructor, Nursing Training
Our 2013 HHA winners (from left to right): Dr Wei Ker-Chiah, Wendy Chua, and Singaravelan s/o Pavadai.
(from left)
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NHG Excellence in Action Awards 2013
NHG Teaching Excellence Awards 2012
IMH Wins Asian Hospital Management Award 2012
The NHG Excellence in Action (EIA) awards are given out to staff and teams who have consistently demonstrated the NHG Care Values (Confidence, Attentiveness, Respect and Empathy), provided exceptional service to both internal and external customers, and also contributed to significant changes in work practices that have improved customer service or patient safety.
The annual Asian Hospital Management Awards (AHMA) recognises and honours hospitals in Asia that implement best hospital practices.
In 2012, it received a total of 363 entries from 89 hospitals across 12 countries for its 10 award categories. IMH’s Case Management Unit team received the Excellence Award (Runner-up) in the Service Improvement for Internal Customers category for its project, “Promote Improved Integrated Care through the Reduction of Patient Rejection Referrals to the Community Mental Health Services”.
The NHG Teaching Excellence Awards promote and recognise teaching excellence, and are awarded to deserving doctors and allied health professionals in the teaching of medical students and their juniors.
The award-winning recipients from IMH were:
Individual
Ashley JayapaulSenior Occupational Therapist
Sharon Tan Chay HuangNurse Clinician
Mavis SeowSenior Clinical Psychologist
Team
• Neurobehavioural Clinic, Department of Child & Adolescent Psychiatry, IMH
• Occupational Therapy: Activities, Vocation and Empowerment day centre at IMH (OcTAVE @ IMH)
IMH’s EIA winners for 2013 with Prof Chee Yam Cheng, Group Chief Executive Officer, NHG (extreme left) and Adj A/Prof Nellie Yeo, Group Chief Quality Officer, NHG (extreme right).
NHG Education Leaders AwardA/Prof Swapna VermaSenior Consultant/Chief, EPIP
NHG Outstanding Education Partners AwardProf Kok Lee PengVisiting Consultant, General Psychiatry
NHG Teaching Award for Junior CliniciansDr Sutapa BasuAssociate Consultant, Early Psychosis Intervention Programme (EPIP)
NHG Teaching Award for Non-PhysiciansMr Lawrence Tan Kok KahSenior Psychologist, National Addictions Management Service (NAMS)
Mr Lawrence Tan (right), Senior Psychologist from the National Addictions Management Service (NAMS) receiving his award from Prof Chee Yam Cheng, Group Chief Executive Officer, National Healthcare Group.
The project aimed to discover why a large number of patients in an acute psychiatric ward who were referred to the Community Mental Health Team (CMHT) were rejecting the team’s services, and to bring down this rejection rate so that patients could receive the help they required. The practical solution — which comprised a refinement of the patient selection process and more patient education — successfully reduced the rejection rate to 22% from 45% before project implementation.
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Mindset Gym
Outdoor Garden for Long-Stay Patients
The Mindset Gym will be set up at the end of 2013 to allow patients to cultivate a healthy lifestyle through physical exercise. The gym will have exercise equipment such as treadmills, stationary bicycles and muscle training machines to allow patients to be engaged in a variety of aerobic and anaerobic exercises. A Group Therapy-cum-Sensory Treatment Room is alsoincorporated within the gym for group intervention programmes. Evidence-based group intervention programmes such as Mindfulness-Based Stress Reduction and Personal Effectiveness for Successful Living (PESL) will be run. For psychiatric patients who have co-morbid intellectual disabilities and who often suffer from sensory processing problems, the room will boast equipment that will allow our occupational therapists to carry out sensory modulation work with them, aimed at minimising their emotional problems and improving their functioning.
MINDSET Care, a registered charity set up by the Jardine Matheson Group, will be organising the Mindset Challenge 2013, a vertical marathon, to raise funds for this project.
IMH has over 1,000 long-stay patients who have “lived” in the hospital for many years. Due to the high-rise nature of the hospital, they do not have much opportunity to venture out of their secured wards to relax in an open space, taking in fresh air and sunlight. This is set to change with the development of a safe outdoor garden for our long stay patients. With funding from MINDSET Care, a landscaped garden with exercise
Gift of Mobility The SMRT Gift of Mobility Programme, a key Corporate Social Responsibility initiative under SMRT Cares, is a financial assistance scheme that allows IMH to reimburse needy patients their taxi fares when they seek treatment at IMH. These patients are unable to take public transport due to their physical or medical problems, and include patients who are elderly, wheelchair-bound, less mobile, or recently discharged and do not have the mental capacity to take a bus or MRT home on their own. SMRT’s Gift of Mobility has enabled 124 patients to benefit from point-to-point travel services for their medical treatment or social-related needs at IMH.
In our mission to make a difference in the lives of patients with mental illness, IMH is fortunate to have donors who have come alongside us, believing in the importance of what we do. This generous support from corporates and individuals over the years has enabled us to sustain many programmes and kick-start new initiatives that benefit our patients.
Several initiatives that have been made possible by generous donations to our Woodbridge Hospital Charity Fund (WHCF) in FY2012 include the Mindset Gym, an outdoor garden for long-stay patients and free taxi rides for patients with mobility problems.
Making a Difference - TogetherBy Vera Soo, Corporate Communications
The Woodbridge Hospital Charity Fund (WHCF) was established in 2001 by the Institute of Mental Health to raise and receive funds for programmes over and above the basic medical services that benefit our patients. These programmes provide rehabilitation, welfare, as well as caregiver and family support to needy patients and their families. The WHCF also provides grants for research that may lead to better services and treatments for those with mental health problems. About S$300,000 is needed a year to support ongoing programmes that benefit some 1,200 long-stay patients, as well as outpatients and caregivers. To find out more about donating to WHCF, visit www.imh.com.sg.
Transforming Lives with Beautiful Hearts – About the Woodbridge Hospital Charity Fund
equipment, water features and garden benches will be ready early next year for patients to enjoy outdoor recreational activities and exercise.
An artist’s impression of the Mindset Gym.
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Your Story, Our JourneyOne of the challenges of working in mental healthcare is that every patient is different and has different life circumstances. As such, there is no one-size-fits-all treatment approach. Often, our mental healthcare professionals have to think out of the box and collaborate with other agencies as they work hard to connect with patients, to help them take baby steps in their recovery from mental illness. Furthermore, the work frequently extends beyond the patient to his/her family members, who may be in need of help too.
Read on for more on how things have turned around for these patients.
With a Little Help from a Furry Pal
Lending an Ear, and a Hand
Annie (pseudonym), 15, was referred to REACH by her school for behavioural and emotional problems. When the REACH (North) team first met Annie, she was defensive and simply refused to open up. Over the next six months, Annie also did not respond much to the team’s efforts to engage with her.
During an inter-agency case conference later which involved the multidisciplinary team from IMH’s Department of Child and Adolescent Psychiatry and Annie’s school counsellor, a psychiatrist noted that Annie was fond of animals and suggested that the team try to connect with her through that.
Hence, Ong Kim Siew, Nurse Clinician from the team brought her cocker spaniel, Angel, to Annie’s school. The effect was miraculous as Annie warmed up in no time to the dog, and opened up to the team. Having a greater rapport with the team now, Annie talked freely and started sharing her issues. Subsequently, the team had fruitful sessions with Annie even when Angel did not go along.
Kim Siew reflected, “Truly, there is never a dull day in our profession, which does call for creativity. I am so glad that we managed to reach out to Annie thanks to my faithful dog.”
Wei Ting (pseudonym), 37, first sought treatment at IMH in 2001. She was diagnosed with schizophrenia and mild intellectual disability. After her discharge, she was followed up by Nurse Clinician Lee Choon Mui from our Community Mental Health Team (CMHT; for adults).
Recalled Choon Mui, “When I first visited Wei Ting at home in December 2008, she did not welcome me. She even scolded me because of her paranoia.” Despite Wei Ting’s hostility, Choon Mui did not take offence. She persisted in showing her genuine care and concern, and in trying to see things from Wei Ting’s perspective. Gradually, over the course of a year, Wei Ting began to accept Choon Mui, even as she began to accept her mental health condition.
However, there were further issues to be addressed. Choon Mui revealed, “I found out that Wei Ting is the main caregiver for her family, despite her own mental health concerns. Her elderly father has Parkinson’s
Ong Kim Siew, Nurse Clinician and her friendly dog, Angel.
A helping hand: IMH Nurse Clinician, Lee Choon Mui (right) with Wei Ting (pseudonym).
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A Tale of Two Brothers
IMH got to know of Ah Seng (pseudonym), 78, in March 2011 through the Police when he allegedly threatened his neighbour with a knife. Although a team from the Aged Psychiatry Community Assessment and Treatment Service (APCATS) was sent to Ah Seng’s flat to assess him, Ah Seng refused to let them in because of his paranoia.
Seeing this roadblock, APCATS’ Principal Medical Social Worker (MSW) Kong Lai Yee turned to various community agencies to understand the situation better. She found out that Ah Seng had similarly declined assistance from them, and that they in turn feared visiting him alone because of his paranoia. Furthermore, Ah Seng’s younger brother Ah Tiong (pseudonym), whom he lived with, had dementia.
Lai Yee persuaded one of the community agencies to visit Ah Seng and introduce the members of APCATS’ multidisciplinary team (MDT) as their friends. This helped pave the way for the MDT – consisting of a doctor, clinical manager, case managers, and an MSW – to connect with the two brothers.
As the MDT interacted with Ah Seng and Ah Tiong, they managed to coax Ah Seng to board the ambulance which was arranged to bring Ah Tiong to a general hospital for treatment of a swollen leg.
The ambulance first dropped Ah Seng off to IMH for admission, and then Ah Tiong. Ah Seng was cared for at IMH, stabilised with anti-psychotic injections and discharged after two weeks. However, because of the lack of insight into his illness, a lot of follow-up care was needed.
The APCATS home visit team visited him monthly to assess his mental state, risk of harm to his neighbours and to administer anti-psychotic injections. The team, especially case manager David Ng, established a therapeutic alliance with both brothers. Ah Seng grew to trust the team and became compliant with treatment.
The brothers managed to live independently in the community until Ah Seng fell into problem drinking, affecting his ability to care for himself and his brother. In the interest of their safety, MSW Lai Yee sought placement in a nursing home for them, working at length with numerous daycare centres and MSWs from the general hospitals. With the close inter-agency collaboration, the brothers were placed in a nursing home after a short wait, with beds side by side.
Lai Yee shared: “I had to consciously pace with Ah Seng’s level of comfort and trust for receiving help, and this required a lot of patience, effort and perseverance. The inter-agency collaboration was also indispensable in maintaining complex cases such as this in the community.” David concluded in agreement, “Ah Seng has a much improved quality of life and is no longer displaying aggressive behaviour. I find it very rewarding to see how things have worked out well for these brothers.”
disease, depression and heart problems. I noticed that her mother, who has diabetes, displayed some psychotic symptoms and so I recommended that she seek treatment too. Also, Wei Ting’s brother, who suffers from epilepsy and depression is the sole breadwinner, but wanted to quit his job due to job stress. I encouraged him to persevere in his work for the sake of his family.”
A multi-pronged approach is necessary to enable a family like Wei Ting’s to live independently in the community. For example, from our CMHT, medical social worker Loh Yiang Theng helped Wei Ting apply for financial assistance from their Community Development Council (CDC). Other healthcare institutions and community partners, such as a religious association and a medical outreach team from a general hospital, were also roped in to support the family.
Choon Mui shared, “What I learnt from caring for Wei Ting and her family was to exercise patience with our patients. We should always try to see their perspective given their life circumstances. We should also not belittle them, but recognise their strengths and weaknesses and help to boost their confidence so that they can go through life with its up and downs. I have found it very rewarding helping this family.”
Expressing her gratitude, Wei Ting declared: “Nurse Lee has been supporting me for many years, and is a very important person in my life. I want people to know that persons with mental illnesses are able to lead a meaningful life, and that a helping hand lent to us goes a long way.”
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Inaugural IMH Play: 8 – 5
National Addictions Awareness Day
Buy your tickets online at www.imh.com.sg/eshop or contact Ms Ng Sijia at 6389-2827 or [email protected].
Find out more about addictions and its treatment at the inaugural National Addictions Awareness Day, organised by the National Addictions Management Service (NAMS) as part of its national public outreach programme. Visitors will be treated to a variety of performances and educational activities put up by community partners. The event will also be graced by Dr Amy Khor, Senior Minister of State, Ministry of Health (MOH) and Mayor of Southwest CDC.
8 – 5 is a play about everyday people trying their best to cope with mental health issues. Dawn is a “superwoman” granddaughter, who dotes on her grandfather who has dementia and is guilt-stricken when she contemplates nursing home care for him. Steph is an attractive lady struggling to shut out voices in her head; Naz is a girl-next-door whose life is disrupted by obsessive-compulsive disorder. Their lives cross paths through Arief, a kind-hearted “expert” in mental health who saves the day and even finds love where he least expects it.
We invite you to be challenged to see mental illness in a new light and to discover that persons with mental illness are not so different from anyone else!
Date:
Time:
Venue:
Date:
Time:
Venue:
Tickets:
Saturday, 23 November 2013
8.30am - 4.00pm
Yew Tee Square Plaza(open space outside Yew Tee MRT & Yew Tee Point Mall)
Saturday, 14 December 2013
3.00pm - 8.00pm
NAFA Lee Foundation Theatre 151 Bencoolen Street Singapore 189656
S$10
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EDITORIAL TEAM
Advisor Ting Mei See
Editor Vera Soo
Circulation Coordinator Chris Ngiam
Committee MembersJamilah BeeviFiona FooPenny Chua
Cheong Yaun MarnHan Bing LingNg Si Jia
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