Polyclinics to train all front-line staff to better help people with intellectual disabilities

“So, we also need to provide the proper training and make these capabilities available before we stand this up,” Rahayu said.

Health Communication Passport

MOH will also collaborate with SG Enable to implement a Health Communication Passport from 2027 at selected polyclinics for people with intellectual disabilities and autism.

The passport will capture key information on the communication preferences and support needs of such patients.

Bhavani Sriram, a doctor and clinical lead of the MINDS Developmental Disabilities Medical Clinic, said the passport is a practical way to support these patients.

It would help make clinic visits less stressful, as caregivers would not have to repeat information about how to best engage with the patients.

Responding to queries from The Straits Times, MOH said that during the initial phase, participating social service agencies will work with their clients to complete the passports and submit them to the polyclinic ahead of their upcoming healthcare appointments.

Not all PWDs will receive a passport in the initial phase, as MOH and SG Enable have to refine the passport and its operational processes for implementation at more polyclinics and other suitable healthcare settings.

The ministry did not say which polyclinics would be involved in the initial phase, but it said that it will also explore how the passport can be adapted for people with other types of disabilities.

MINDS’ Bhavani said that healthcare staff being able to directly engage with patients in the way they prefer can reduce anxiety, support rapport-building, and help practitioners make a more accurate diagnosis.

“For example, we won’t ask patients ‘What is your name?’, if we know that they are non-verbal. If details show that they can write or type, we will use that instead to engage them,” she said.

Bhavani, who has worked with PWDs for more than 30 years, said navigating the public healthcare system can be a challenge for these patients and their caregivers, and MOH’s new measures are a step in the right direction towards making clinical visits a more comfortable experience for them.

Some of the key challenges such patients face in general clinics and polyclinics include communication barriers, crowded environments and long waiting times.

“They tend to get quite fidgety, and so their parents worry about how long they can keep them occupied in a crowded area where there’s a lot of sensory overload,” Bhavani said.

These patients tend to exhibit behaviours that may appear concerning or challenging to the public, and caregivers find it difficult to explain that this is how they express themselves, she said.

Furthermore, when patients see different doctors at every visit, they could experience “stranger anxiety”, and providing an accurate diagnosis is difficult when a doctor is unable to establish rapport with his or her patient.

“It becomes a lot more challenging because you are not talking to the patient. You are talking to the caregiver, and then the patient is completely disengaged during the consultation,” Bhavani said.

At MINDS’ specialised clinic, which opened in 2018 and is the first of its kind here to serve people with intellectual disabilities, patients are provided with “reasonable accommodation”, such as quieter spaces and shorter waiting times.

The clinic also tries to have the same doctor attend to each patient, giving the doctor the chance to understand the patient’s communication styles and build rapport with the patient and his or her family.

“We also get the families to prepare the patient in advance… So they tell them the doctor will check you with a stethoscope, how they will check blood pressure or perform a simple blood test,” Bhavani said. This helps patients feel less anxious during the appointment.

Apart from these accommodations, Bhavani said equipping front-line staff with the knowledge and skills to communicate with and support PWDs also goes a long way towards improving patients’ comfort during clinical visits.

“Body language is very important so that they feel at ease with you… by looking into their eyes, calling them by their preferred names, and using really simple language – like words and phrases instead of structured sentences – with a combination of gestures to help them understand what’s happening,” she said.

Help with planning for the future

Under another initiative that the inter-agency task force will put in place from 2027, PWDs and their families will be able to work with care planners to identify their short- and long-term goals, aspirations and needs.

The Ministry of Social and Family Development and SG Enable will help these families plan for PWDs’ care across life stages, which will involve adult disability services such as day activity centres and enabling services hubs.

Building on the Individual Transition Plans already offered in special education schools for all students, care planners will map out options to address their needs and possible contingencies when they graduate, and connect them with relevant services.

Plans can be updated whenever circumstances change, and families can reach out to their care planner to revisit the plan.