Research informs that there has been an increase in Singaporeans experiencing mental health disorders between 2010-20161. Not only is the quality of life of affected individuals are compromised, mental health disorders can also result in productivity loss2.
However, the treatment-seeking behaviours among those affected did not increase proportionately in comparison to the 2010 and 2016, period. There is a considerable treatment gap among the affected individuals3. This is despite having a steady expansion of mental health-care services, training sessions and research in Singapore4.
So, why are people not seeking help for mental health? Here are three factors and how they can play a role in minimising the impact on treatment-seeking behaviours.
According to World Health Organisation, stigma is seen as “a mark of shame, disgrace or disapproval that results in an individual being rejected, discriminated against and excluded from participating in a number of different areas of society5”.
Public stigma can lead to patients experiencing shame, loss of self-esteem and withdrawal from academic or vocational pursuits6. Furthermore, to avoid being labelled by others, many individuals avoid receiving a diagnosis or be seen seeking mental health treatment.
A local population-wide study in 2017 found presence of significant stigma towards people with mental illness7. In the same study, stigma was also observed as an inaccurate perception that the individuals (e.g., someone with depression) were “weak” and they may get better “with some willpower”; or “dangerous and/or unpredictable” as in someone addicted to alcohol and thus, the need for greater social distancing from them.
There are some things that we can do to reduce stigma:
- Having an increased awareness of our beliefs and attitude. When we cross paths with individuals who are suffering from mental health disorders or are having difficulties with coping, it can be helpful to examine our thoughts and (emotional and behavioural) responses to consider if we are being judgemental, and where the thought and emotions are stemming from (e.g., upbringing and society).
- Provide support with kindness and acceptance. Not everyone appreciates advice, to be offered help, or to be asked to visit a mental health professional. It may be more helpful and supportive to listen patiently to the person, and where necessary, discuss with the person the best way to address the issues and how you can provide specific help. In fact, most of the times, many appreciate the offer of a listening ear and good company.
- Be inclusive. Instead of social distancing individuals who might seem “weak, dangerous, or unpredictable”, consider how you can include these individuals in social activities (e.g., going for a walk or having a meal) or assisting in project works.
Mental health literacy
One of the key contributors to stigma is the lack of mental health literacy. Mental health literacy has been described as “knowledge and beliefs about mental health disorders which aid recognition, management or prevention”. Many untrained (mental health) individuals in Singapore are unable to recognise different types of mental health disorders8.
While there are increasing number of movies and dramas that feature mental health disorders, not all of them depict the mental health disorders accurately. Similar to some food sellers who add more seasoning to make their food more flavourful (translating to sales), some of these movies and dramas script writers dramatize the presentation of mental health disorders for the same purpose. Consequently, increasing misconceptions, stigma, and reducing treatment-seeking behaviours.
A good resource to learn more about mental health is the Singapore Psychologist, a publication by the Singapore Psychological Society. It provides a wide range of psychological perspectives on current mental health issues, ranging from anxiety, burnout, depression to eating.
Through the increased knowledge, we will be able to minimise the impact of mental health disorders through preventive actions, to recognise the symptoms of mental health disorder and to seek appropriate treatment earlier, which most often promises better chance at recovery.
“Individuals suffering from mental health disorders do not need to suffer alone, in silence. Treatments by mental health professionals are widely available.”
Awareness of resources
Lastly, there are individuals who recognise that they need help to address their mental health concerns but are limited by the awareness of resources in the community.
As highlighted earlier, mental health-care services have expanded over the years. At present, there are mental health professionals available in the public hospitals and polyclinics, family service centres, psychology clinics in universities as well as private practice. These places may vary in specialisation, cost and availability.
The Singapore Psychological Society (SPS) encourages the public and organisations to refer to the list of registered psychologists when seeking out psychological services. All psychologists wishing to be listed were rigorously examined before being included in the register. Some of the criteria includes having an appropriate post-graduate training in an applied psychology programme and having met international standards for hours of direct client work and supervision. Additionally, these registered psychologists are required to receive compulsory continuing professional development and to abide by the profession’s Code of Ethics to maintain their registration. In sum, individuals can be better assured that the registered psychologists deliver quality psychological service in an ethical manner.
Individuals suffering from mental health disorders do not need to suffer alone, in silence. Treatments by mental health professionals are widely available. Also, we can all play a part in alleviating their suffering by increasing our understanding of mental health disorders, minimising the impact of stigma, and directing them to appropriate resources in the community.
To explore the different perspectives of mental health disorders, here are some movies to watch:
- Inside Out (2015) for understanding emotions
- Silver Linings Playbook (2012) for understanding bipolar disorder
- The Perks of Being a Wallflower (2012) for understanding growing up with mental illness
- Welcome to Me (2015) for understanding borderline personality disorder
- Still Alice (2015) for understanding Alzheimer’s disease
The contributor is the Chairman of Singapore Register of Psychologists (SRP), a member of Singapore Psychological Society and a registered Psychologist under SRP.
1 Subramaniam, M., Abdin, E., Vaingankar, J. A., Shafie, S., Chua, B. Y., Sambasivam, R., … &Verma, S. (2020). Tracking the mental health of a nation: prevalence and correlates of mental disorders in the second Singapore mental health study. Epidemiology and Psychiatric Sciences, 29. from https://doi.org/10.1017/S2045796019000179
2 Mental Health By The Numbers. (2019, September 29). Retrieved March 2, 2020, from https://www.nami.org/learn-more/mental-health-by-the-numbers
3 Chang, S., Abdin, E., Shafie, S., Sambasivam, R., Vaingankar, J. A., Ma, S., … & Subramaniam, M. (2019). Prevalence and correlates of generalized anxiety disorder in Singapore: Results from the second Singapore Mental Health Study. Journal of anxiety disorders, 66, 102106. from https://doi.org/10.1016/j.janxdis.2019.102106
4 Kua, E. H., &Rathi, M. (2019). Mental health care in Singapore: Current and future challenges. Taiwanese Journal of Psychiatry, 33(1), 6.
5 World Health Organization (2001). The World Health Report: Mental Health: New Under-Standing. World Health Organization: New Hope, Geneva.
6 Corrigan PW, Druss BG, Perlick D (2014). The impact of mental illness stigma on seeking and participating in mental healthcare. Psychological Science in the Public Interest 15, 37–70. from https://doi.org/10.1177/1529100614531398
7 Subramaniam, M., Abdin, E., Picco, L., Pang, S., Shafie, S., Vaingankar, J. A., … & Chong, S. A. (2017). Stigma towards people with mental disorders and its components–a perspective from multi-ethnic Singapore. Epidemiology and psychiatric sciences, 26(4), 371-382. from https://doi.org/10.1017/S2045796016000159
8 Tonsing, K. N. (2018). A review of mental health literacy in Singapore. Social work in health care, 57(1), 27-47. from https://doi.org/10.1080/00981389.2017.1383335