Friday, September 25, 2009

The unsung heroes of healthcare: Part I

Medical Tribune August 2009 SFXII
David Brill

Born in 2004 from the legacy of SARS, the annual Healthcare Humanity Awards are given to those who go above and beyond the call of duty to improve the care and wellbeing of patients. David Brill spoke to two of this year’s recipients about their achievements, challenges and hopes for the future.

The children’s champion: Ensuring a bright future for Singapore

Some doctors continue their medical education by reading journals and taking exams. Others brush up by attending conferences or participating in workshops.

Dr. Ong Say How is different. He keeps up to date by watching cartoons and listening to pop music. Unlikely sources of information for most specialists, but an important part of the routine for this dedicated child and adolescent psychiatrist. Following popular culture helps him better relate to his patients, he says. And few would question his approach: in 2005, Ong received the Best Psychiatrist Award from the prestigious Columbia University in New York, US, for his volunteer work in Caring@Columbia – a program for underprivileged and at-risk children. Other accolades have followed since returning to Singapore, culminating in his recent Healthcare Humanity Award.

Engaging troubled children would be a daunting task for most, but Ong is completely relaxed around youngsters. This, he says, is his strength – allowing him to break down the formality of a clinic setting using humor, anecdotes and roleplays. “I think like a kid sometimes, so we can talk on the same page and be on the same wavelength. Most of the time when kids come to me they have already seen their teachers, seen their school counselors, talked at length with their parents, and nothing has helped. So I have to take a different approach to get them to confide in me,” he says.

As a consultant and deputy head of child and adolescent psychiatry at the Institute of Mental Health, Ong has spent much of his career engaging with the youth of Singapore. He also runs an outpatient clinic at the Child Guidance Clinic and is involved with various workgroups and committees, including the national Pediatrics Services Review Committee. His caseload is wide and varied, but most commonly involves anxiety, depression, stress-related conditions and attention deficit hyperactivity disorder.

Progress has been made but child psychiatry remains a “high-need medical area” for Singapore, he says. Surveys point to a fairly high number of undiagnosed psychiatric disorders among schoolchildren, suggesting that screening is one of the areas in need of strengthening. Improving step-down facilities and access to treatment in the community are also amongst the most pressing challenges, he says.

“Some kids fall through the gaps because they are not very aware of the services available to them, or sometimes still face a stigma about seeking psychiatric help. And parents alike … a lot of families are still stricken with fear when it comes to seeking help for their mental health. Rather they will bring the kids to see a non-professional, or a temple medium or a traditional healer, and in the end they suffer.

“Recently I lost a kid because the parents were not keen to bring the child forward and refused to seek help in the community setting. Someone so young and intelligent and with so many good things going for him – it’s just sad that the parents or the child himself refused to seek proper help.”

Despite the tragic stories such as this, Ong remains upbeat about the future of Singapore’s youth. New outreach programs are underway in schools, bringing psychiatrists closer to counselors and teachers, and opening up new avenues for screening and prevention. Mental wellbeing, Ong hopes, will one day be entrenched in the national curriculum. In the meantime he will continue to champion for the children through his tireless work in the clinics and community.

“Seeing them open up and let you into their thoughts and feelings is the first step to building that rapport and to making the first change. It’s very rewarding when they start to trust me that I will help see them through and see them smile again. The children are our future, and in order to secure a future for Singapore we must make sure that they are well taken care of,” he says.



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