COMMENT: Yearning for dignity from people with mental health conditions in Singapore

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By Anthea Ong

SINGAPORE — I can only be heartened by recent announcements in Parliament for mental health. New initiatives include a whole-of-Government review on mental healthcare, a review on existing disparities for Medishield Life claim limits between physical and mental health conditions, and even a pilot programme in supporting caregivers of individuals with mental illnesses.

Gaps in affordability, accessibility and quality

However, as I leafed through close to 400 responses received as part of the first-ever SG Mental Health Matters public consultation my team and I conducted on mental health in Singapore, I can’t help but feel that my efforts in the Budget debate were still insufficient in conveying the extent of the pain and suffering that the respondents have endured.

Respondent 17 shared with me how an entire family was left in agony as the father struggled with his mental health, unable to consult a psychiatrist promptly due to long waiting times.

Respondent 146 spoke about becoming exhausted from living a “double life”, attempting to appear fine to the outside world despite being constantly embroiled in internal turmoil.

I was stunned by Respondent 303’s admission of having to stop fortnightly therapy sessions priced at $17 each due to lack of affordability!

Because of institutional gaps in the affordability, accessibility and quality of our mental healthcare system, many fellow Singaporeans have been left to struggle on their own, feeling that they have been abandoned. It pains me to realise how many have fallen through the gaps in Singapore’s world-class healthcare system, unable to access the treatment they require.

The indiscriminate nature of mental health

Mental health affects us all, in case we think it only happens to some of us.

Respondent 253 was an exemplary university graduate who was placed on the Dean’s List, before suffering a severe mental breakdown during the transition to the working world.

Respondent 180’s mother - a housewife in her 50s - lacked community support and was barred from accessing community mental health programmes as they were targeted at seniors older than her.

Respondent 186 despaired of having to constantly struggle with depression, overwhelmed by internalised homophobia and low self worth due to negative stereotypes against LGBT people.

In my recent Budget speech, I made the call for a paradigm shift in viewing mental health as a critical component of total well-being - that we are all on the continuum of mental health. If we are honest with ourselves, we will realise that it is part of the human experience to have struggled with our mental well-being at some point of our lives. Because who hasn’t had to face the loss of a loved one? Who hasn’t had to deal with failure, in one form or another? Who hasn’t ever had to feel down, grappling with worry, sadness, loneliness, fear or despair?

A cry for dignity

We all have “dignity needs”. Those with mental health conditions struggle to live a dignified existence because many feel belittled by the lack of understanding and community support.

Respondent 108 shared about not knowing there is help available for dealing with mental health issues given the stigma that “you must have something wrong if you see someone for mental health”.

Respondent 204’s parents believed that seeking treatment for mental health only applied to those seen as “crazy”, and was afraid of the impact on employment prospects.

Respondent 105 feared seeking help through the public healthcare system, petrified by the exposure of medical records, leading to specific labelling under mental illness.

In her book ‘This is what inequality looks like’, Teo You Yenn described stigma as being the opposite of dignity. The self-directed shame and low self-worth as attested by the experiences of the respondents pain me. We need to do much much more to ameliorate the debilitating effects of stigma experienced by people like the respondents.

We must avoid invalidating the struggles of those with mental health issues, portraying their suffering as self-inflicted behavioural choices. For example, it is important to understand that providing incentives for people to seek help, such as the decriminalisation of suicide, do not encourage suicidal behaviour - rather, they allow those who are struggling to feel more comfortable in seeking treatment.

This is what true resilience looks like

Despite the less-than-adequate state support and societal stigma, I continue to be in awe of the extraordinary displays of resilience shown by those who are struggling, aided by the kindness of those who are willing to extend their support.

Respondent 376 credited healthcare professionals and school management in extending support and understanding to the respondent’s family, without which they “could not imagine how to move on”.

Respondent 229 had recovered from the depression caused by the mother’s passing through “strong and unconditional support” from loved ones, and chose to become a community volunteer to help others who may be struggling.

Respondent 91 expressed the hope of a day when people don’t have to “feel alone in their mental health journey” despite their “very dark and lonely” experiences.

In these trying times of COVID-19, and in the spirit of SG Together, I implore us all to remember we are responsible for our collective mental well-being. Let us begin by recognising the struggles of those with mental health conditions, while ensuring that our mental healthcare services are of world-class standards and universally accessible. No Singaporean should be left behind.

Anthea Ong is Nominated Member of Parliament, social entrepreneur (Hush TeaBar, A Good Space, WorkWell Leaders Workgroup) and author of 50 Shades of Love.

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