Giving patients a glimmer of hope

Dr Joshua Kua is known for going above and beyond the call of his duty as a doctor.

The 46-year-old senior consultant at the Institute of Mental Health (IMH) reaches out to his patients and sacrifices his personal time during weekends and after office hours to attend to them and their caregivers.

In one instance, Dr Kua even chipped in with his friends to provide financial assistance to a severely depressed patient and his family, after the patient became unable to hold down a job. At the same time, he contacted the Community Development Council and various organisations to help connect the patient to financial assistance schemes and job opportunities.

The father of two is also actively involved in various volunteer projects. He is a board member of Sage Counseling Centre, contributes to various welfare projects, and speaks at public talks on depression and dementia.

Dr Kua, who is IMH's Chief of Department of Geriatric Psychiatry, also feels a special burden for the elderly who are mentally ill. Seeing the need for better mental health services for the elderly, he spearheaded the Aged Psychiatry Community Assessment and Treatment Service (APCATS). The programme is a community-oriented psychogeriatric outreach service that provides mental health services to older patients who would not or could not leave their homes to access hospital-based services. It aims to prevent unnecessary admission to inpatient mental health services and minimise the length of stay in hospital, while providing support for caregivers.

For his dedication and compassion, Dr Kua was awarded the Healthcare Humanity Award (HHA) earlier this month. The HHA recognises healthcare workers who embody the values that underscore the nobility of the healthcare profession - courage, extraordinary dedication, selflessness, steadfastness in ethics, compassion and humanity. Dr Kua was the only psychiatrist among the 61 recipients of the Award.

YourHealth finds out what motivates Dr Kua in this e-mail interview.

What inspires you to use your own personal time and resources to help your patients?

As a psychiatrist, I come into contact with patients who have experienced a lot of psychological pain and challenges in their life. A holistic approach to treatment involves the bio-psycho-social-spiritual concept where the various aspects of the patient's needs are addressed. We often try to harness the strengths of the multidisciplinary team such as the medical social worker, occupational therapist and psychologist to help the patient. However, there are times when patients fall through the cracks in the healthcare and social care systems as they may not qualify for certain assistance schemes. I feel compelled to think outside the box to help them and not give up.

I think it is very powerful when someone knows that there is another person who is genuinely interested to care and help. It gives them a glimmer of hope and motivates them to persevere in facing the 'giants' in their lives.

Working with mentally-ill patients (whom many people would consider to be the most difficult to deal with) must be emotionally and mentally draining at times. How do you stay calm and compassionate towards the people around you?

It can be emotionally draining. I try not to bring back home the issues I face at work or with patients. It helps when I discuss difficult situations with my peers and colleagues.

I also 'recharge' myself mentally and spiritually when I go to church and draw strength from my faith.

Regular exercise, spending time with my family and having hobbies to pursue are also very important.

One of your strengths is your ability to see your patients as people, rather than as cases. How do you do this, particularly since mental illness affects behaviour and personality?

To see the patient as a person with an illness - and not just treating the illness itself - is not easy. And knowing the developmental and autobiographic history of the person allows us to better understand the illness as well as behaviour of the patient.

I learned about person-centred care (or PCC) a few years ago, about how we should relate with people suffering from dementia. The book 'Dementia Reconsidered' by the late Tom Kitwood was very revolutionary. The philosophy can and should be applied for all mental healthcare settings.

How do you find the time and energy to volunteer in so many different areas outside of your work?

It is not easy. I remember there was a stage when I was so drained and tired when I reached home that I would just fall asleep on my dining chair after I had dinner. Fortunately, I got over it and learned to better manage my workload and time to prevent burnt-out.

How do you feel about winning the Healthcare Humanity Award?

I am actually a bit embarrassed to receive this. I see what I do as part of my duty of care and my calling for the last 18 years. The satisfaction I get when I see my patients getting better with the help I render is priceless. Mother Teresa once said, 'Joy is a net of love by which you can catch souls.' It couldn't be more apt.