How Singapore built mental health tech during Covid-19

Oleh Shirley Tay

Interview with Robert Morris, Chief Technology Strategist, Data, Science & Technology, MOH Office for Healthcare Transformation.

Mental health issues should be managed the same way as the common cold, believes Robert Morris, Chief Technology Strategist, Data, Science & Technology at Singapore’s MOH Office for Healthcare Transformation (MOHT).

Isolation in the pandemic has triggered a “huge upsurge in stress, severe anxiety, and depression”, but stigma around seeking help still exists. “People feel like if they work at it enough, or if they’re strong enough, they can overcome it. But that’s not the case, you need to seek help," Morris says.

He discusses how his team built tech to make it easier for Singporeans to seek mental health support during Covid-19.
 

Localised mental health tech


The pandemic was very hard on people, says Morris, hitting different parts of the community in different ways. Isolation, domestic abuse, and stress from remote working or learning emerged.

To respond to that surge, Morris’ team saw a need for a “one-stop shop” for people to seek mental health support from the privacy of their homes. MOHT collaborated with the Ministry of Social and Family Development, the National Council of Social Service, and the Institute of Mental Health to create mindline.sg.
 

Users can learn more about their emotional health by taking a “clinically validated self-assessment” for anxiety and depression. They will then be guided to support channels according to severity, he says.

Mindline.sg has since been enhanced with an “emotionally intelligent AI bot”, Wysa. Users can share their emotions with the bot - such as fears over losing their jobs - and receive suggestions on how these emotions can be managed. The bot can also direct them to the relevant job support or skills training resources, Morris says.

Directing users to local resources for caregiving, job, or domestic violence support has been crucial, he adds. “These resources are available in Singapore, but the problem is people are not aware of them.”

Having a “completely anonymous and confidential” tool like mindline.sg is “a powerful way for people to dip their toe in the idea of getting help”, Morris says. “They realise that this is a normal thing, and it just has to be managed in the same way as a cold.”

Mental health had been one of MOHT’s priorities even before the pandemic, he shares. With Covid-19 bringing attention to mental health issues, Morris believes the team is now in an “even better position” to expand mindline.sg, and plans to focus efforts on youth.
 

Covid-19 self-assessment tool


Tech has been key to counter-Covid efforts: healthtech innovators in Singapore have come up with an AI temperature scanning tool, apps to track the spread of the virus, and more. Morris’ team has constructed a self-assessment tool that would allow citizens to determine if they needed medical treatment.

The symptom checker is hosted on sgcovidcheck.gov.sg, and requires users to fill in information such as age, pre-existing diseases, and symptoms. Algorithms designed by a panel of medical experts then determine if the user should stay home, get tested, or visit the emergency department.

From building mindline.sg and the symptom checker, Morris’ team learnt that “very basic educational tools need to be put at people's fingertips”. Having localised, reliable information during the pandemic helped citizens feel more in control of their situation.

It also helped to reduce the strain on Singapore’s healthcare facilities. “If citizens visited the emergency room when they didn’t have to, they could actually pick up something worse.”
 

Enhancing telehealth


“We've believed for a long time in the idea of telehealth, and the pandemic accelerated that,” Morris shares.

MOHT is currently rolling out a telehealth programme across Singapore’s three polyclinic clusters to enable hypertension patients to monitor their blood pressure levels from home. “We want to keep them out of the healthcare institutions, so that they can reduce the risk of infection,” Angela Yeo, Assistant Director of the Future Primary Care programme at MOHT, told GovInsider.

Patients can use a Bluetooth-enabled device to transmit blood pressure readings to their polyclinic through a mobile app. The app will remind them to take their readings, and share tips on controlling blood pressure levels.
 

Shifting towards holistic care


One of MOHT’s biggest priorities will be to combine citizen’s medical records with diet and activity data, Morris shares. That would allow Singapore to understand the progression of chronic diseases like diabetes and kidney failure, and the best way to design health nudges and interventions.

“Singapore has one of the best clinical data collection systems in the world,” says Morris. Citizens’ health records can be monitored even across different hospital clusters.

The nation has also amassed an extensive repository of community health data. It gathers citizens’ eating and living habits through the Health Promotion Board’s National Steps Challenge.

Analysing the two types of data together will also help Singapore shift towards a more holistic and preventive model of healthcare, he says. MOHT plans to move a lot of its interventions away from the hospital and into the home. That’s where decisions around activity, diet, and stress happen.

Covid-19 has forced the issue of mental health into the spotlight. Tech is central to MOHT’s efforts to help citizens prioritise mental wellbeing and provide more holistic care.