Official Opening Of Early Psychosis Intervention Programme (Epip) Art Exhibition

25 Feb 2004

By Dr Balaji Sadasivan

Venue: The Alliance Francaise Gallery

Introduction

It gives me great pleasure to be here today at the opening of 'Early Psychosis Intervention Programme' (EPIP) Art Exhibition.

Background

2 Psychosis is a disorder of the brain, which gives rise to symptoms like hallucinations, delusions, and disorganization in thinking and behaviour. Amongst the various psychosis disorders, the most common and severe is schizophrenia. The World Health Organisation lists schizophrenia as one of the top 5 most disabling disorders that have a profound impact on patients, their caregivers and society.

3 It is estimated that there are about 25,000 people with schizophrenia in Singapore. As many as 600 people develop this disease every year. A significant proportion of those affected are less than 20 years of age. The disease seems to typically strike at the late adolescence stage, at a time when an individual is just stepping out in the world to undertake the tasks of adulthood.

4 The nature of this illness is such that there are initial difficulties in making a definite diagnosis by the doctors and it is also difficult for the family and friends to understand what the person is going through. The situation is further complicated by the societal stigma that still exists in Asian societies. All these factors result in unfortunate delays in seeking and initiating treatment. A study by Institute of Mental Health found that there was an average lag time of more than one and a half years between the time of first episode and the time of seeking treatment for psychosis.

Early Psychosis: a critical therapeutic approach

5 A growing body of evidence suggests that delays in providing effective treatment for patients with psychosis results in more frequent relapses leading to recurrent and longer hospitalizations, slower and inadequate recovery, and increased risk of episodes of violence, drug abuse and suicide. Research has also demonstrated that the first episode of schizophrenia is a critical therapeutic opportunity.

EPIP

6 My Ministry had initiated the Early Psychosis Intervention Programme (EPIP) in April 2001 with the Institute of Mental Health. The aim of the programme is to ensure early detection and timely medical and psychosocial treatment for people who develop psychosis. The programme follows a three-pronged approach. First, at the societal level, the programme is aimed to increase the awareness of the early signs and symptoms of psychosis and reduce stigma associated with psychosis. As most patients would initially seek treatment from their general practitioners and sinsehs, the second step is to establish strong links to primary health care providers to work with them as ?partners? in the detection and referral of potential EPIP clients. Thirdly, once the diagnosis is confirmed, the programme aims to improve the outcome and quality of life through effective and structured treatment and rehabilitation.

Results

7 To date, EPIP has received referrals for around nine hundred individuals and accepted more than five hundred of them into the programme, after due evaluation. The average number of hospitalizations, length of stay and percentage of unplanned readmission for the clients within the programme has been significantly lower compared to the average for IMH patients with schizophrenia who are not enrolled in the programme. There has also been no untimely mortality or chronic debilitation in any of these patients.

8 On the awareness front, over the past year, a series of public forums have been organised in an effort to raise awareness about psychosis. A docu-drama on Psychosis called Mind Matters was produced which achieved good viewership and encouraging feedback.

9 Another major milestone was the publication of EPIP team's first book: Delusions, Possession or Imagination? Experiencing and Recovering from Psychosis. This first easy-to-read and practical book on psychosis in Singapore is an invaluable resource for patients, and their families, friends and care providers.

EPIP and Art

10 Besides medical treatment, psychosocial rehabilitation is an integral part of psychosis management. The Early Psychosis Intervention Programme facilitates re-integration

of its clients into the community by providing emotional, vocational and social support in a supervised and structured environment. The focus is on imparting skills needed for renewed confidence in daily living, stress management and interpersonal interaction.

11 What we will see today is the remarkable work produced by some of the EPIP clients.

12 On this note, I am pleased to open the 'Early Psychosis Intervention Programme' (EPIP) Art Exhibition. Hope you will thoroughly enjoy the splendid work of art that surrounds us this evening.

Thank you.