• The Resilience in Children and Adolescents with Psychosomatic symptoms Programme (RECAP) at KKH has provided mental health support to more than 350 young people since 2021.

• Those who completed the five-session intervention showed improvements in their school, family, friendships and activities of daily living.

• Get video resources to support youth mental health and learn more about making a referral to RECAP.

Psychosomatic symptoms are on the rise amongst young people locally. In Singapore, preliminary surveys found that one in eight (12.5%) of the total attendances at the Children’s Emergency in KK Women’s and Children’s Hospital (KKH) constituted of children and adolescents with possible somatic symptoms.

The KKH Resilience in Children and Adolescents with Psychosomatic symptoms Programme (RECAP) provides tiered mental health support for young persons with psychosomatic symptoms, to help them to thrive at home, school and in their communities.

Sustained improvements in youth mental health outcomes

RECAP is designed for children and adolescents aged 10 to 17 years old, and has provided care for more than 350 young people from 2021 to 2025. The team has found that:

• Patients who received interventions showed improvement in follow-up outcomes measures* such as their functioning in school, family, friendships and activities of daily living, when compared to baseline outcomes.

• Patients who completed the RECAP five-session intervention maintained improvements 12 months later. These results demonstrate that early intervention for mild-to-moderate psychosomatic symptoms improve the severity and impact of symptoms and that patients continue to remain well.

• Initial findings amongst patients who received the five-session intervention showed that 43 per cent had an undiagnosed comorbid mental health disorder, in addition to their underlying psychosomatic symptoms. This may point towards psychosomatic symptoms acting as a warning sign for other hidden mental health symptoms that have yet to be verbalised.

These findings are key to helping medical professionals better understand the qualitative experience of children and their families with mental health needs, and the long-term impact of early intervention to support them on the journey to healthy coping and resilience.

*Scales include: Children’s Somatisation Inventory (CSI-24), Clinical Global Impression scale (CGI) and Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). These measure the presence of psychosomatic symptoms and other mental health symptoms, severity of symptoms and impact/functioning in school, family, friendships and activities of daily living.

RECAP – Tiered support for personalised care

RECAP aims to achieve:

1. Early identification of psychosomatic symptoms to prevent chronicity and improve socio-occupational functioning;
2. Early psychoeducation and intervention according to a stepped care approach; and
3. Early identification of stressors and mental health symptoms with appropriate right-siting of care.

Intervention is provided using a tiered care model (Diagram 1), which is appropriate to the severity and chronicity of the child’s symptoms and psychosocial stressors.

Diagram 1. RECAP Tiered Care Model

RECAP is a cross-disciplinary collaboration between the KKH Department of Psychological Medicine, General Paediatrics Service, Department of Emergency Medicine and Psychology Service. To date, it has trained more than 500 paediatricians, advanced practice nurses, medical social workers, school counsellors and community counsellors.

Dr Vicknesan Marimuttu, Head and Senior Consultant, Department of Psychological Medicine, KKH Dr Vicknesan Marimuttu has a broad range of experience in treating children and adolescents with mental health disorders. His areas of clinical and research interest include mood disorders, self-harm, suicidality, somatoform disorders and brief psychotherapeutic interventions. Dr Vicknesan is also Clinical Assistant Professor, Duke-NUS Graduate Medical School.