When we see someone choking, our first instinct is to perform the Heimlich Manoeuvre. But when we see a person crying or in distress, we usually walk away.
Growing up, we learn that CPR is a life-saving skill. But not many see the importance of psychological first-aid, which provides humane and practical assistance, said Prof Chua Hong Choon, Chair of the COVID-19 Mental Wellness Taskforce and Deputy Group CEO (Clinical) of the National Healthcare Group.
This is vital, with mental health issues rising over the last decade in Singapore – even before COVID-19. While there are safety nets and existing mental health services, the Republic can do more to anticipate future crises.
1 in 7 suffer from mental illness
The number is small but increasing. Adults experiencing a mood, anxiety or alcohol use disorder went from 12 per cent in 2010 to 13.9 per cent in 2016, based on the 2016 Singapore Mental Health Study (SMHS) conducted by the Institute of Mental Health (IMH). There are no recent updates.
The top three most common mental health conditions are:
- Major Depressive Disorder or MDD (affecting 6.3 per cent of Singaporeans)
- Alcohol abuse (4.1 per cent)
- Obsessive Compulsive Disorder (3.6 per cent)
“We’re going through rapid changes in terms of tech advancement and access to never-ending information. These lifestyle changes may cause a significant amount of stress,” explained Prof Chua about the rise in mental illness here.
Yet, compared to other countries, Singapore’s numbers are not as bad. For example, the lifetime prevalence of MDD in the United States and Europe are double that of the Asian city-state – at 16.6 per cent and 12.8 per cent respectively.
The difference could be due to more severe societal pressures faced in other countries such as poverty and racial inequality, observed Prof Chua. Singapore also adopts a more conservative approach, diagnosing patients only after proper evaluation to prevent unnecessary labels.
Despite the smaller group of sufferers here, what is more worrying is that 75 per cent do not seek help, according to the SMHS in 2016.
Prof Chua outlined two key reasons: the lack of literacy on mental illness and the fear of stigmatisation. “People don’t recognise when others or themselves have a mental health condition. They must also overcome a reluctance to get help,” he stressed.
The youth are not spared
Another growing concern is how mental health stigmatisation has also had a profound impact on today’s youth.
They are bedevilled by various issues, from academic stress to the sustainability of the economy and environment for their future, said Mr Asher Low, founder of Limitless, a non-profit organisation that provides counselling for youths.
Two things are not making it easier on youths – their parents and social media.
One, Singaporean parents are less open to getting mental health support for their children compared to those in the United States and Australia.
Two, social media “creates false impressions”. “This generation has never known a world that is not connected. They grew up with expectations to show a highlight reel of their life for the world to see,” said Mr Low.
To counter this, Limitless is looking to better engage youths by cultivating a sense of community. One initiative is a Discord channel where youths can discuss everything from school to gaming. Trained staff will be online to provide support.
Psychological impact of the pandemic
Making mental matters worse is, of course, COVID-19. During the circuit breaker in 2020, people of all ages were forced to be isolated without many coping resources.
Speaking for youths, Mr Low shared: “Whether or not you enjoy being with your parents, you will become irritated at times. What more youths who are physically and emotionally abused?”
Youths with pre-existing mental health issues struggled even more in the new normal. In 2020, Limitless received 373 cases, up from 237 a year before. This year, the number is expected to double, with over 600 new cases projected.
Looking at the broader society, Prof Chua said the pandemic has caused widespread job disruptions and losses, and a fear of infection, with long-term effects that could harm one’s mental health.
The impact is clearly recorded with the increased number of calls to IMH’s helpline in 2020. It suggests that people want more online support and counselling as they may have lost their jobs, are socially isolated or fear infection, he added.
This surge in calls for help was replicated across Singapore, including suicide hotlines, reported media outlets. Some healthcare experts shared that the pandemic not only led to new cases, but also worsened pre-existing conditions in some patients.
But the silver lining was the increased awareness in mental health issues. This resulted in the launch of new initiatives such as mindline.sg and Temasek Foundation’s My Mental Health site in 2020 to provide resources and tips about mental health.
With improved literacy that will also combat misinformation, Prof Chua believes people will be better able to spot warning signs and destigmatisation will naturally follow.
Don’t stay in a state of helplessness
While Singaporeans are coping with COVID-19, the IMH is developing a training programme for frontline workers, grassroots leaders and workplace managers to be the first line of defence – not against the virus, but mental health problems.
Ultimately, Singaporeans have the power to do more for mental health, be it educating themselves or getting help.
“The COVID-19 situation makes it difficult to socialise, and we need to pay attention to that as humans are social beings,” noted Prof Chua.
Social service agency partners will teach people how to detect stress and offer help. This includes active listening, offering comfort and providing practical help such as information. The IMH will also train more general practitioners to deal with mental health issues so that patients are able to seek help more easily.
Ultimately, Singaporeans have the power to do more for mental health, be it educating themselves or getting help. “What’s important is for all citizens to be aware that they shouldn’t take mental health for granted,” he added.
So instead of dismissing issues, seek help and treatment. And rather than walk away from a person who is hurting inside, offer comfort and counsel.
If you are facing a mental health crisis and require urgent help, please call
- IMH (24-hour Helpline) – Tel: 6389 2222
- Samaritans of Singapore (SOS) 24-hour suicide prevention hotline: 1800-221-4444
- TOUCHline youth counselling hotline for cyber wellness: 1800-3772252
- Limitless SG – firstname.lastname@example.org