Widening the net to spot mental illness

IF ANYONE doubts the worth of a ground-breaking initiative by the Institute of Mental Health (IMH), there is an extremely grateful national serviceman who can put them right. 
The 21-year-old soldier volunteered to be part of a study on mental illness for two years because his mother suffered from schizophrenia. That meant he was at risk of getting it too, and he wanted to get an idea of his situation. Several months later, he started to hear voices, and knew from what he had learnt through the IMH study that he should get help fast.
He had an assessment, was put on medication the same day and is now in remission, said senior consultant psychiatrist Chong Siow Ann, who leads the research programme called Lyriks (Longitudinal Youth-At-Risk Study). Unlike many other research projects, it is roping in the community to learn about such illnesses and identify sufferers, with the end-goal of understanding psychotic disorders and predicting their onset, which also means that those who really need help will receive it fast.
'Apart from helping researchers learn more about serious mental illness and how those at risk transition to psychosis, this project is also a public health initiative to widen the safety net for those who need help,' said Professor Chong, who is vice-chairman, medical board (research), at IMH.
The study, which was launched last year, has already screened 1,300 people aged 14 to 29. They give blood for genetic testing and take other checks to assess features such as memory and motor skills. Over five years, it hopes to gather 1,000 to 2,000 people who are at risk.
It has found 122 people to be at risk and 17 with psychosis - an umbrella term for serious mental illness that includes schizophrenia and manic depression. Participants are followed closely and told how to spot warning signs, and who to approach for help. The programme includes outreach activities, including training community volunteers to spot possible sufferers and get them help early - critical in treating psychoses such as schizophrenia. 'This is an entirely different approach from the traditional mode, where research participants and the community do not feel immediate benefits,' said Prof Chong.
Lyriks psychiatrists and psychologists have given 11 talks to more than 600 people since July last year, including counsellors, family service officers and social workers. More than 250 have taken part in hands-on workshops. Part of the impetus for the programme comes from Singapore's serious mental health issues. 
About 3 per cent of people here get schizophrenia and related psychotic disorders, which are characterised by symptoms such as hallucinations and delusions, lack of drive and energy, memory impairment and mood swings. There is no cure for schizophrenia, which ranks ninth here, together with breast cancer, in terms of disease burden - a measure that combines years of life lost through premature death and disability.
But the earlier patients are treated, the better the results, Prof Chong said.
Younger people are the most at risk, with 75 per cent of people having an onset of mental illness by the age of 25. Prof Chong said: 'The present state of affairs with psychosis is where heart disease was decades ago, when it was diagnosed only after a heart attack.
'Today, we are able to predict the risk of heart disease based on lipids in the blood and family history, and identify those who have heart disease through imaging, as well as preventing an attack with stents, medication and lifestyle changes. 'This is what we want to achieve for mental illnesses as well.'
Community workers have hailed the research initiative as revolutionary in its mission to reach out to mental patients. Ms Jenny Bong, group executive director of Methodist Welfare Services, told The Straits Times: 'Families may not be aware of the symptoms of psychosis; some may be troubled or in denial.
'This project can help assure families and young persons that help is available, and the illness can be managed.' More than 10 social workers from her centre have attended the IMH workshop.
One healthy volunteer, environmental engineering undergraduate Desmond Leung, 24, joined the study after hearing about it from a friend because he felt it was meaningful work. 'Many people have a stigma about mental illness. When you get to know more about it, you realise that patients are not so different from any of us,' he said.

Source: Straits Times, 6 Oct 2010