Suicide continues to the leading cause of death for youths, with a total of 71 people aged 20 to 29 taking their own lives last year. CNA looks ...
SINGAPORE: Kevin* has known his mind “works differently” ever since he was in Secondary 3. Things like grocery shopping may be therapeutic for some, but it is an incredibly stressful task for him.
Statistics from the Samaritans of Singapore last week showed that the number of suicides in Singapore for those aged in their 20s remained the highest last year compared to those in other age groups. It was four years for bipolar disorder and alcohol abuse, two years for generalised anxiety disorder and one year for major depressive disorder.In the same study, youths between 18 to 34 years were presented as the most vulnerable group - one in five would have experienced a mental disorder in their lifetime.
“The increasing number of referrals that CHAT received reflects a growing awareness of the importance to seek help early for mental health concerns and recognition of CHAT as a potential avenue available to seek help from,” said a spokesperson in an email interview. The Integrated Youth Service, jointly developed by the MOH, Institute of Mental Health, Agency for Integrated Care and Care Corner, was described in an MOH press release as a"one-stop service where at-risk youths can access coordinated mental health and support services such as individualised basic emotional support, needs identification and befriending services".
Broadly, there are two approaches for treating mental health conditions: Medication and psychotherapy - both of which can be used on its own without another, with different effects on an individual. As such, the continuum of care for mental health conditions can also be long, intensive and complicated. For example, one young adult whom CNA spoke to likened the process of finding suitable treatment to finding a soulmate on matchmaking sites like Tinder. Kevin agreed.
“I do want to spend some time looking at the services ... but that’s just something I’m not ready for at this point of time - not when your mind is already in a mess.”As much as there are many avenues of care out there, there may not be enough education on selecting an appropriate one, said Dr Tracie Lazaroo, a clinical psychologist from Inner Light Psychological Services and LP Clinic.
Mr Tay added that the awareness of the availability of health and resources has not increased significantly over the last five years, neither has the “ease of search”. For example, Raffles Medical Group states on its website that a session with a counsellor or psychiatrist will cost at least S$160.50 and S$214 respectively.
She noted the difference in inpatient MediSave claims - while the daily limit is S$450 for physical illnesses, it is S$150 for psychiatric treatment. However, financing for treatment may be a challenge for those with conditions not covered by CDMP such as post-traumatic stress disorder and eating disorders, according to the experts CNA spoke to.
“If you are seeing a psychologist every week and you can’t afford it because the fees are not claimable, you will have to stretch your therapy. Consequently, it takes that much longer to get well,” said Mr Tay. Ms Khan went on to seek treatment for PTSD at a private clinic, where she received Eye Movement Desensitisation and Reprocessing - a four to six-week psychotherapy treatment that helps to alleviate distress associated with trauma.“It’s worth it because it’s helping me, but it’s so much money. Not everyone can afford that and there’s no way to get subsidies because they just don’t cover it,” she added.
“It’s especially hard to be working in healthcare because you can’t show that to your colleagues or patients. But at the end of the day, when you go home and you are left alone to your thoughts - that’s when it really kills me,” the patient service associate said. The fear of being judged or being associated with negative stereotypes may result in youths hiding their struggles.
“There’s probably a very big mindset difference,” said Ms Charlotte Chen, a therapist from Counselling & Care Centre. “Anytime they see me feeling sad, or angry, their first advice to me is to seek God. They mean well but these words are not really effective… it's the brain chemicals in your brain that's going off,” she said.
The account executive added that while “working very hard” is one of her outlets for coping with depression, doing well in school or at work has not helped in convincing her parents that mental health treatment is necessary. “Kids might think, ‘My parents send me to a good school, I’m from a well-to-do family and all that - how can I have this issue? I have everything I want.’ That’s when they start to beat themselves up, thinking they are self-indulgent.”
Dr Kum added that seeking help at VWOs or private clinics does not require a referral unlike in public hospitals where a psychiatrist will have to make a diagnosis before someone can be directed to a psychologist. However, VWOs that CNA spoke to reflected challenges in sustaining affordable services. Ms Chen said that while there was a pro-bono scheme in the past, the centre has not been able to continue that service due to the lack of funding.
According to MOH’s latest data, NCSS provided S$8.7 million and S$5.7 million in funding to Social Service Agencies for mental health support services and counselling programmes, respectively, in 2018.
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