SINGAPORE, Dec 29 — Spurred to seek help for his gambling problem before he lost his family, the punter called the Institute of Mental Health’s (IMH) National Addictions Management Service (Nams) helpline early last year, and tried to negotiate for a shorter wait than four days for his appointment.

Helpline para-counsellor Nazirah Abdul Aziz was unable to get an earlier slot for the man, but provided support by calling him twice before his appointment date.

Since July last year, however, Nazirah has been able to offer appointments on the same day or the day after to first-time callers. This has benefited more patients and improved staff productivity.

For years, more than one in two first-time callers to the Nams helpline would not show up when the time came for their appointment — typically in about a week’s time — with a psychiatrist. This was lost opportunity for IMH’s staff to see other patients, and meant a loss of staff productivity, said Dr Gomathinayagam Kandasami, consultant and chief of Nams.

To cut the number of no-shows, the IMH rolled out a same-day appointment scheme in July 2015. It has cut the default rate of first visits from 54 per cent to 22 per cent as of October this year, and about 1,200 patients have been referred so far.

"If they have to wait longer for their appointment, they may lose the motivation to seek help during the interim before their appointment,” said Dr Gomathinayagam.

Other experts agree that time is of essence. "Generally speaking, for people with addiction, their motivation goes up and down. So it comes and goes,” said psychiatrist Thomas Lee of The Resilienz Clinic. Securing them an appointment when motivation levels are high increases the chances of getting them into the recovery stage, he said.

"If there is no appointment, (the person) has to fend for himself and chances are, the person will turn to the quickest and fastest way he has used to solve the problem before, and go back to the place of gambling,” said Maximilian Koh, principal counsellor at Thye Hua Kwan (THK) Moral Charities’ Centre For Family Harmony at Circuit Road, which helps problem gamblers.

It contacts clients within three working days, and the appointment date depends on the counsellor’s and the client’s availability. Same-day appointments are possible if the client’s schedule permits it, said Koh.

At Changi General Hospital, which treats people with gambling, alcohol and benzodiazepine (tranquiliser and sleeping pill) addiction, cases are usually referred by general practitioners or polyclinics, and the waiting time for a first appointment is two to four weeks This is because its Addiction Medicine Clinic is part of its Psychological Medicine Centre, which sees patients with other psychological disorders, said CGH principal addiction counsellor Ng Yoke Chiang. Hospital staff will contact those who do not show up for appointments, said Mr Ng.

Besides prompt first-time appointments, establishing rapport during the first session is essential, said Resilienz’s Dr Lee. Getting an addict’s family members involved is also key, as relatives "can actually be the ones causing a patient not to return for treatment”. They may be too critical of the patient or have unrealistic expectations of the recovery process, for instance.

To further reduce the default rate of visits, Nams is piloting calls to patients before appointments, besides the usual SMS or reminder letters. Patients unable to make it for appointments are given alternative dates or asked to call the hotline to make a same-day appointment.

After the first visit, Nazirah, an All Addictions Helpline para-counsellor, and her colleagues will follow up with calls to those who welcome the support. — TODAY