Institute of Mental Health

The Institute of Mental Health (Abbreviation: IMH; Chinese: 心理卫生学院) has a long tradition of care for psychiatric patients. In 2006, the Woodbridge Hospital compound, part of IMH, was marked as Singapore's 83rd historic site by the National Heritage Board due to its history as Singapore's first mental institution.

Present-day IMH is located on a 25-hectare campus at Buangkok Green Medical Park in the north-east of Singapore. It is Singapore’s only tertiary psychiatric hospital and offers psychiatric, rehabilitative and counselling services to children, youth, adults and the elderly. IMH is a modern hospital, with 50 wards and 2010 beds for inpatients and seven specialist clinics for outpatients. It provides hospital-based services, runs satellite clinics at different locations in Singapore, and spearheads mental healthcare programmes in the community.

History
“To appreciate Woodbridge [Hospital] and its work, one must have a historical sense of development and movement. It has been a long battle from custodial care which provides simple refuge and security to community psychiatry that enables people to return to a normal life.” (Dr Chee Kuan Tsee, Emeritus Consultant, Woodbridge Hospital/Institute of Mental Health, 1990)

The Institute of Mental Health (Abbreviation: IMH; Chinese: 心理卫生学院) has a long tradition of care for psychiatric patients. In 2006, the Woodbridge Hospital compound, part of IMH, was marked as Singapore's 83rd historic site by the National Heritage Board due to its history as Singapore's first mental institution.

The earliest psychiatric facility began as a 30-bed building at the corner of Bras Basah Road and Bencoolen Street in 1841. It was then known as ‘The Insane Hospital.’ It was renamed the ‘Lunatic Asylum’ in 1861, and moved to a site near the old Kandang Kerbau Maternity Hospital. In 1887, this hospital was moved to the ‘New Lunatic Asylum’, with a capacity for 300 patients, built at College Road (Sepoy Lines) to check an outbreak of cholera. In 1928, a 24-ward ‘The Mental Hospital’ was built along Yio Chu Kang Road. The ‘New Lunatic Asylum’ at Sepoy Lines and the ward at Pasir Panjang were closed down and 1030 patients were transferred to ‘The Mental Hospital’.

Spread out over 80 hectares of land, The Mental Hospital was then the largest medical facility in Singapore providing custodial care for the mentally ill, with a capacity for 1,400 patients. In the 1920s, caring for the mentally ill was mainly custodial in nature. Patients were segregated from the community and were cared for by a handful of expatriate nurses with the help of health attendants who were not trained in nursing.

After Singapore surrendered to the Japanese in 1942, about 700-800 seriously wounded civilian casualties were transferred from the General Hospital to The Mental Hospital, which was transformed into the Japanese Civilian and Military Hospital. The Japanese transferred about 500 ‘quieter’ mental patients to St John’s Island, where many starved to death. The remaining 1,000 were locked up and neglected, of which about 600 were transferred in 1944 to the Central Mental Hospital, Tanjong Rambutan, in Perak, Malaysia. Of these 600, after the war, only 329 returned.

For a brief period from 1945 to 1947, the British Royal Air Force from the nearby Seletar Airfield requisitioned the hospital for use to treat the sick and wounded of Allied servicemen and Japanese POWs after the end of hostilities of World War II. Thus, the female section was converted into the RAF Hospital while the male section was allocated for use as the Japanese Prisoners of War Hospital. It was known as the 81 Mobile Field Hospital until its return to normal civilian usage in 1947, this hospital was the first Royal Air Force hospital established after the Japanese surrender. In 1946, the Mental Hospital was returned to its original function, housing some 440 mental patients. In 1951, to shake off some of the stigma associated with mental illness, the hospital was renamed Woodbridge Hospital (WH). This name was derived from the local Chinese name for the hospital area—‘Pang Kio’ (‘Wooden Bridge’) as there was a wooden bridge in the hospital vicinity in Yio Chu Kang.

By 1958, Woodbridge had accommodation for 2,000 patients. The Psychiatric School of Nursing was set up in 1954. In 1955, a social work department was formed as well as an improved occupational therapy service. Psychological services were started in 1956 and V.W. Wilson, the first clinically trained psychologist in Singapore, was contracted from the United Kingdom by the Colonial Medical Service to incorporate a psychological service within the mental health programme.

A Child Guidance Clinic was opened in 1970. This grew to become the Child Psychiatry Clinic and family therapy soon became used to treat the whole family and not just the child.

Community Psychiatric Nursing was set up in 1988 and psychiatric nurses conducted home visits to provide care, support and follow-up for patients within the community.

Up to 1981, psychiatry trainees were sent to the UK to train for the MRCPsychiatry (Member of the Royal College of Psychiatrists) qualification. From 1983 onwards, WH, in conjunction with the National University of Singapore Graduate School of Medical Studies, trains its own psychiatrists. The first locally-trained Master of Medicine trainee in Psychiatry graduated in 1985.

In 1984 the Ministry of Health mooted the idea of a new psychiatric hospital to evolve from a largely custodial care model to one of community care for the benefit of the people. The prevention, early treatment and rehabilitation of clients with mental conditions would actively operate within the community as opposed to late treatment within an institution that would isolate them from everyday life and make it much harder for them to reintegrate into the community.

Plans were put in place for a very different hospital that would revolutionise mental healthcare in Singapore with further emphasis on training and new initiatives in mental health promotion and clinical research.

WH moved to its present 25-hectare premises in Hougang in 1993. With the move, WH was reorganised and renamed the Institute of Mental Health/Woodbridge Hospital to reflect its added commitment to research and training.

The Institute of Mental Health Today
Present-day IMH is located on a 25-hectare campus at Buangkok Green Medical Park in the north-east of Singapore. It is Singapore’s only tertiary psychiatric hospital and offers psychiatric, rehabilitative and counselling services to children, youth, adults and the elderly. IMH is a modern hospital, with 50 wards and 2010 beds for inpatients and seven specialist clinics for outpatients. It provides hospital-based services, runs satellite clinics at different locations in Singapore, and spearheads mental healthcare programmes in the community.

IMH is the only tertiary psychiatric hospital in Singapore and offers a multidisciplinary and comprehensive range of psychiatric, rehabilitative and counselling services. The 2010-bedded hospital serves the needs of three groups of patients—children and adolescents, adults, and the elderly.

It became the first mental health institution in Asia to receive Joint Commission International Accreditation in 2005, a highly reputable international accreditation of healthcare organisations. Besides providing clinical services, IMH coordinates and oversees education of clinicians, nurses and allied health professionals in psychiatry and conducts research related to mental health.

It also plays a key role in developing capability in community agencies, such as family service centres, to enable their staff to provide support to persons with mental health problems in the community.

Clinical Departments
•	General Psychiatry •	Geriatric Psychiatry •	Child & Adolescent Psychiatry •	Community Psychiatry •	Forensic Psychiatry •	Early Psychosis Intervention •	Addiction Medicine

Satellite Clinics
IMH runs the following outpatient clinics at various locations to make its psychiatric services more accessible to patients. •	Community Wellness Clinic, Geylang •	Community Wellness Clinic, Queenstown •	Child Guidance Clinic, IMH •	Child Guidance Clinic, Health Promotion Board

Community-Based Services
In 2007, the National Mental Health Blueprint was established by the Ministry of Health (MOH). With a reinvestment fund of $88 million over 5 years, its objective was to develop national capability in mental health services. IMH initiated a number of community-based programmes as part of the Blueprint, targeted at the three main population segments—children, adults and the elderly.

•	Response, Early intervention and Assessment in Community mental Health (REACH) REACH is a community-based mental health service which works closely with schools, community agencies and family doctors to help students with emotional, behavioural and/or developmental disorders. The REACH team supports helping professionals to broaden the scope of care given to students within the community.

•	Community Health Assessment Team (CHAT) CHAT is a national youth mental health programme that aims to make it easy and unthreatening for youths to seek advice and help for their emotional and mental health issues. The CHAT team does this by raising awareness of youth mental health, and providing a free, confidential assessment service and mental health information. CHAT also partners polytechnics and post-secondary institutions to reach out to and support their students.

•	Community Mental Health Team (CMHT) The CMHT comprising doctors, community psychiatric nurses, and allied health specialists provide community-based treatment and psycho-social rehabilitation of our patients so that they may continue to live in the community while working towards recovery. The team continues to monitor and care for patients after their discharge through regular home visits.

•	Aged Psychiatry Community Assessment Treatment Service (APCATS) APCATS is a community-based psychogeriatric clinical service which provides assessment and treatment for homebound or frail elderly patients with mental disorders. The APCATS team comprises geriatric psychiatrists, medical officers, psychologists, geriatric psychiatric nurses, occupational therapists, physiotherapists, and medical social workers. The team makes home visits to patients to ensure that they continue to receive care for their conditions.

Research
The key focus areas of research at IMH are mental health policy research and translational clinical research.

Key research spearheaded by IMH include: • Psychiatric Epidemiology: Singapore Mental Health Study, Well-being of the Singapore Elderly Study • Singapore Translational Clinical Research in Psychosis : Identification of Biomarkers of Schizophrenia and related psychoses • Neurocognition in Serious Mental Illness • Neuroimaging • Clinical Trials in Schizophrenia, Autism, ADHD, Addiction • Health Service Research in Mental Health

It has embarked on a S$4.4-million three-year nationwide epidemiological study – Well-being of the Singapore Elderly (WiSE) – that aims to establish high-quality data of 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. This study is a collaboration with international and local research investigators from Changi General Hospital,Ministry of Health,Singapore, National University Hospital and Raffles Hospital, Singapore, and King’s College London.

Education
IMH plays a leading role in developing the current and next generation of mental healthcare professionals. It provides pre-professional education for medical undergraduates and post-graduate education for those pursuing a specialisation in psychiatry. The hospital also trains nurses through its continuing nursing education programmes and offers internship and clinical attachment opportunities for students preparing to be allied health professionals.

Recognition & Awards
In 2006, IMH’s Early Psychosis Intervention Programme won the World Health Organisation State of Kuwait Prize for Research in Health Promotion.

In 2011, IMH clinched the inaugural Grand Award for the Hospital of the Year, at the Asian Hospital Management Awards organised by Hospital Management Asia. The award recognises and honours hospitals in Asia that carry out best practices.

In 2012, the Institute of Mental Health earned the Accreditation with Distinction from the American Nurse Credentialing Center (ANCC), for its nursing education, becoming the only institution outside the USA to receive this recognition.