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Number of suicides among youth highest in Singapore

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Number of suicides among youth highest in Singapore

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The above source talks about the increased number of suicide cases happening among youth and that youth have the highest number of suicide cases among other age group. "Suicide accounts for about one-third of all reported deaths in this age group,".

So from this source it gave us factual evidence that mental health is a big and growing concern among youth.

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SINGAPORE: The number of suicides in Singapore for those aged in their 20s remained the highest last year compared to those in other age groups, the Samaritans of Singapore (SOS) said on Monday (Aug 3).

A total of 71 people aged between 20 and 29 killed themselves in 2019.

"Suicide accounts for about one-third of all reported deaths in this age group," the suicide prevention agency said in the media release.

Suicide continued to be the leading cause of death for those aged 10 to 29 last year.

There were 400 reported suicides in 2019, compared with 397 the year before. Most age groups registered a slight increase in the number of suicides, said SOS.

However, the suicide rate for Singapore residents in 2019 dropped to 8.00 per 100,000, down from 8.36 in 2018.
RISE IN HOTLINE CALLS FROM PEOPLE IN THEIR 20S
Of those who revealed their age, people between 20 and 29 years old accounted for approximately 17 per cent of total calls attended to on the SOS 24-hour hotline, said the agency.

"In particular, the number of calls from this age group rose to 4,124, up from 3,396 calls in the previous fiscal year ending March 2019," it added.

Topics such as romantic relationships, difficulties coping with one's mental health and struggles managing challenging situations were often cited as contributing factors leading to their clients' acute distress, SOS said.

SOS chief executive Gasper Tan said that while the increase in hotline calls among young people was encouraging, the high number of suicide deaths in this age group was concerning.

"Much more remains to be done as a community to further understand and address the issues that may prevent our youths from seeking help," Mr Tan said.

In a recent survey conducted by SOS, one in three people in their 20s would not consider contacting others for help when emotionally overwhelmed.

"Stigmatising beliefs around suicide emerged as a common barrier to seeking help for this group," said SOS.

The fear of embarrassment, being judged, along with the sense of hopelessness that nothing will help, were also key reasons indicated in the survey.

A total of 2,497 respondents participated in the survey, including 580 participants aged 20 to 29.
TEXT-BASED HOTLINE
In the release, SOS also announced the launch of a text-based hotline service for people who prefer not to speak on the phone.

The text-based service, SOS Care Text, can be accessed via the SOS website.

With the increase in the number of calls and emails during Singapore's "circuit breaker" period, Mr Tan said that it was "crucial that SOS is able to readily provide an alternative form of emotional support".

Respondents to the SOS survey had also indicated text-based services as the most preferred platform to seek help.

"In this time when we are physically distanced from one another to stay safe, feelings of loneliness and helplessness may be amplified," Mr Tan added.

"It is important for us to show our care and concern for our loved ones by checking in on them periodically.

"While the journey forward may be tough, this action helps to show that we are willing to walk with them to make this journey a little less intimidating," he said.

Where to get help: Samaritans of Singapore operates a 24-hour hotline at 1800 221 4444, or you can email . You can also find a list of international helplines here. If someone you know is at immediate risk, call 24-hour emergency medical services.

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Number of suicides among those in their 20s highest in Singapore

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SINGAPORE: The number of suicides in Singapore for those aged in their 20s remained the highest last year compared to those in other age groups, the Samaritans of Singapore (SOS) said on Monday (Aug 3). A total of 71 people aged between 20 and 29 killed themselves in 2019.

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Youth with mental health disorders are more likely to be unhappy at school, be absent, or be suspended or expelled. Their learning is negatively impacted because of poor concentration, distractibility, inability to retain information, poor peer relationships, and aggressive behavior.

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It is normal for children and youth to experience various types of emotional distress as they develop and mature. For example, it is common for children to experience anxiety about school, or youth to experience short periods of depression that are transient in nature. When symptoms persist, it may be time to seek professional assistance. While most youth are healthy, physically and emotionally, one in every four to five youth in the general population meet criteria for a lifetime mental disorder and as a result may face discrimination and negative attitudes. ¹ As with physical health, mental health is not merely the absence of disease or a mental health disorder. It includes emotional well-being, psychological well-being, social well-being ² and involves being able to

navigate successfully the complexities of life,

develop fulfilling relationships,

adapt to change,

utilize appropriate coping mechanisms to achieve well-being without discrimination.

realize their potential,

have their needs met, and

develop skills that help them navigate the different environments they inhabit.³

The presence or absence of various combinations of protective and risk factors contribute to the mental health of youth and efforts can be undertaken to promote positive mental health and prevent or minimize mental health problems. Youth with mental health disorders may face challenges in their homes, school, community, and interpersonal relationships. Despite these challenges, for most youth, mental health distress is episodic, not permanent, and most can successfully navigate the challenges that come from experiencing a mental health disorder with treatment, peer and professional supports and services, and a strong family and social support network.

¹ Merikangas, He, Burstein, et al., 2010
² Centers for Disease Control and Prevention (CDC), 2011; CDC, Health-Related Quality of Life, 2011
³ U.S. Department of Health and Human Services, 1999; National Research Council and Institute of Medicine, 2004

Other Resources on this Topic

Did You Know?

A child's response to toxic stress from negative environments is dangerous and can affect brain development.

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It is normal for children and youth to experience various types of emotional distress as they develop and mature. For example, it is common for children to experience anxiety about school, or youth to experience short periods of depression that are transient in nature. When symptoms persist, it may be time to seek professional assistance.

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The above source is President Halimah, talking about how Singapore has not done enough to raise awareness on mental health and helping those affected. She admits to the fact that schools lack the resources to effectively help students cope with their mental health issues. She also highlighted that there is still so much ignorance, stereotype, and prejudice towards people with mental health and that as a society we should end this stigma.
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Lately, in Singapore, there have been a lot of mental issues faced especially in the youth sector. Recently, there was a murder case in River Valley High. It was found that the 16 years old convicted murder has had mental health problems growing up. Said Madam Halimah: "This is a time for Singaporeans to band together to collectively heal. If you know of anyone who seems to be in distress, reach out to him or her. Especially during this trying time of the pandemic, let's be kind and compassionate to one another."
https://www.facebook.com/halimahyacob/posts/i-was-deeply-saddened-to-hear-about-the-tragedy-that-took-place-at-river-valley-/362103058608222/

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More can be done for youth facing mental health issues: President Halimah

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Schools need more resources to help such youth and parents to overcome fear of stigma to seek treatment for them. Read more at straitstimes.com.

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This source urges Singaporeans to rethink as to why teenagers are losing the will to live as a record of 19 teenage boys committed suicide in 2019.

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There should be urgent concern over the reported statistics on suicides among teenage boys ( Record 19 teenage boys committed suicide last year, July 30).

The number of such suicides in 2017 was seven, but even that is a needless loss of young lives.

We need to ask ourselves serious questions as to why these teenagers just snapped and lost the will to live.

As a small island state without any natural resources, Singapore's only resource is its people, and reading about the rising suicide rate is painful.

Singapore has progressed economically beyond anyone's imagination, with a standard of living that is among the highest in the world.

But has this come at a price as pressure in society builds up in different areas and across age groups and genders?

It is imperative that parents, religious and community groups, and government ministries pay special attention to this worrying development.

There are many reasons that cause a person to harbour suicidal thoughts. It could be work pressure, examination stress, family or financial issues.

Family, friends and community volunteers all play important roles in banishing suicidal thoughts from someone contemplating the act.

Equally important are various help groups in their efforts to strengthen mental health through varied educational programmes and activities.

It is a tragic state of affairs if a news report on teen suicide ends up to be just that - a statistical report and not much else is done.
Gabriel Cheng Kian Tiong

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Call for action to tackle teen suicide problem

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There should be urgent concern over the reported statistics on suicides among teenage boys ( Record 19 teenage boys committed suicide last year, July 30). The number of such suicides in 2017 was seven, but even that is a needless loss of young lives.

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https://www.channelnewsasia.com/singapore/in-focus-young-people-mental-health-singapore-treatment-613566
The above source talks about what kinds of challenges people can face when it comes to mental health. How each individuals were feeling when facing mental health and what is the price to pay for mental health treatment

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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.

"It's always the difficulty of choice in making the simplest decisions, like what kind of pasta should I buy? I can take 15 minutes just standing there before deciding which to buy," he said.

Kevin did not know then that he had anxiety, which can interfere with decision-making. What he was familiar with, though, was the common refrain that he would hear from people around him urging him to stop worrying and thinking too much.

He went on with life struggling with not feeling "fully normal". It was another 13 years before he stepped into his first therapy session.

"It took me quite a while to say that I wanted to seek help," said Kevin, who is now 29 years old.

"People always think that it's (mental illness) just a phase, until it becomes too serious...I don't want to eventually (commit suicide)."

Statistics from the Samaritans of Singapore (SOS) 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.

A total of 71 people aged between 20 and 29 killed themselves in 2019. Suicide continued to be the leading cause of death for those aged 10 to 29 last year.

While Kevin took the first step to seek help after a long struggle, not everyone does so.

According to a Singapore Mental Health Study conducted in 2016, while one in seven in Singapore has experienced a mental disorder in their lifetime, more than three-quarters did not seek any professional help.

Respondents cited a "treatment gap" of 11 years as the median time between when they first experienced symptoms and when they sought help for obsessive compulsive disorder.

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.

In Singapore, there is a comprehensive network of mental health services - from helplines and Voluntary Welfare Organisations (VWOs) offering youth-centric counselling services, to clinics at government hospitals and in private practice.

However, some young people experience challenges in seeking professional help.
NAVIGATING MENTAL HEALTH SERVICES
Mental health awareness among young people appears to be growing.

According to the Ministry of Health (MOH), from 2017 to 2019, an average of 12,600 patients aged 15 to 34 years sought treatment for mental health conditions at public hospitals each year.

The Community Health Assessment Team (CHAT) - a community-based youth mental health outreach and assessment initiative - received around 1,800 referrals and conducted assessments for about 770 youths last year.

That is 36 times more referrals and 15 times more assessments than 2009, when the initiative was first launched.

In March, then Senior Minister of State for Health Dr Lam Pin Min said during the Committee of Supply debate in Parliament that recent engagements with young people showed "mental well-being continues to be a top concern".

In response, a new initiative offering mental health support and awareness to at-risk youths is expected to launch in the second half of 2020.

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".

Responding to queries from CNA, MOH said that the Integrated Youth Service began community outreach in the "Northern region in April 2020".

"In the midst of COVID-19, Care Corner's mental health department, INSIGHT, has had to adapt its outreach to youths through alternative online platforms such as Instagram, a Telegram bot and webinars," it added.

To date, these platforms have reached out to over 500 users.

This resource may be a welcome addition to helping young people navigate their way through the range of options so they can find a solution that works.

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.

"Medication reacts differently for different individuals even if it's the same condition - a certain medication may work perfectly well for one, but for another it can have more complicated side effects," said Mr Jackie Tay, the executive director of PSALT Care, a registered charity and mental health recovery centre.

On the other hand, psychotherapy and counseling involve the "human factor" or the social connection between the clinician and the patient.

"It's the chemistry and connection - some patients would connect better with certain styles of therapists. You also need to navigate around that," said Mr Tay.

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.

Finding suitable treatment requires time and effort from an individual. However, experts CNA spoke to suggested that improving the quantity and quality of information about mental health resources may encourage a young person to take the first step to seek help.

"This group of vulnerable people (with mental health issues) would already be cognitively overloaded," said Ms Anthea Ong, a former Nominated Member of Parliament who advocated for the prioritisation of mental health in the budget 2020 debate.

She added that while the National Council of Social Service provides a list of available mental health resources online, there should be a "community navigator" that goes beyond "just information".

"There's no guidance on where to go, the cost fees - at least list down some of the possible journeys or experiences and then map that.

"It's not a site that helps you to navigate the services available," she explained.

For those like Aisha*, who engages in self-harm and suspects she has depression, the plethora of options that a Google search presents her has posed a hindrance.

"I remember Googling 'Singapore counselling session' and 'affordable counselling'... but there isn't a site that narrows down your options for you or tells you what kind of treatment is appropriate," the 23-year-old patient service associate at a local hospital said. She has yet to see a professional.

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.

"Finding the appropriate mental health service can seem like an overwhelming experience."

Kevin for example, did not know the difference between a psychiatrist, a medical doctor who can diagnose mental disorders and prescribe medication, and a psychologist - someone who specialises in modes of therapy.

While he was hoping to speak to a therapist about his problems, he unknowingly set an appointment with a psychiatrist at a private hospital instead, who prescribed him medication like Lexapro and Xanax.

"I didn't know where to start and where to search ... (the private hospital) came out with the first few searches of Google," he said.

"I was quite taken aback because it was more of a clinical setting (with the psychiatrist) and it was not very nice. I didn't feel very comfortable."

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, we know that when there's a fire, we call 995. When you need the police, you call 999. But when you've got a mental health problem, who do you call?"
THE PRICE OF MENTAL HEALTH TREATMENT
Given the long-term nature of mental health treatment and recovery, financial concerns can be a factor in deciding whether to seek help, experts said. Most youths who spoke to CNA also said that the cost of treatment has been a concern.

Under the Chronic Disease Management Programme (CDMP), patients with schizophrenia, major depression, bipolar disorder and anxiety can withdraw up to S$500 from MediSave per year to defray the cost of outpatient treatments such as therapy and counselling treatment.

Each claim is subjected to a 15 per cent co-payment in cash.

To receive further subsidies at the Institute of Mental Health (IMH) - Singapore's only tertiary psychiatric care institution - one can get a referral from a doctor at the polyclinic. The first consultation costs S$40 and S$37 for the subsequent ones.

This is much cheaper compared to private clinics that charge anything between S$100 to S$250 for one session - depending on the training, specialisation and experience of the clinician.

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.

While there are government subsidies available at public healthcare institutions, Dr Lazaroo said that some patients need prolonged care.

"These disorders require consistent long-term care on a weekly basis especially within the first year of symptom onset, commonly spanning over the course of a few years," she added.

"Unfortunately, some of these patients may struggle maintaining employment while receiving therapy or psychiatric treatment, which will inevitably cause them to have insufficient MediSave or MediShield Life funds."

The cost of weekly treatment will also "stack up very quickly".

To further encourage help-seeking behaviour, Ms Ong said that there is a need to "do even more" to keep mental healthcare affordable in Singapore because mental illness "does not necessarily have any obvious physical symptoms" and treatment will not take "just one session".

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.

"The claims limit is already lower compared to physical health conditions and you might need to go for more treatment. It's a double whammy," Ms Ong added.

During the Ministry of Health's 2020 Budget debate in Parliament, then-Minister of State for Health Dr Amy Khor said that MOH reviews the amount of financial support regularly to ensure that it is adequate.

Based on the latest data, fewer than three in 10 persons' subsidised bills exceed MediSave's daily withdrawal limit, she said.

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.

In an email response to CNA's queries, MOH said that from Jan 2021, patients with "complex chronic conditions" will be eligible for a higher annual MediSave withdrawal limit of S$700.

"No one will be denied appropriate healthcare because they cannot afford to pay. Those who cannot afford their treatment at the public healthcare institutions even after subsidies, MediShield Life and MediSave, can approach the medical social workers for MediFund and other financial assistance."

Even so, experts highlighted that treatment at a private clinic or voluntary welfare organisation (VWO) may be more suitable for some but that means they would have no access to MediSave withdrawals.

"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.

That is something that Ms Aleesha Khan can relate to. The 23-year-old was diagnosed with generalised anxiety disorder, depression and PTSD nine years ago and sought treatment at IMH's Child Guidance Clinic for about five years.

Ms Khan went on to seek treatment for PTSD at a private clinic, where she received Eye Movement Desensitisation and Reprocessing (EMDR) - a four to six-week psychotherapy treatment that helps to alleviate distress associated with trauma.

As useful as that may be, she is paying about S$235 for every session.

"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.

On top of that, she is also seeing a therapist to help with her anxiety and depression. To save money, she makes the "conscious choice" of going for one monthly session, if not it would "really be too much".

"If I had a choice, I should actually be going to therapy more often...(but) I'm already spending S$235 a month, at least S$2.8k a year just on therapy," Ms Khan said.

"I'm middle-class but I know so many people who need it but they can't afford it."
SELF AND SOCIAL STIGMA STILL EXIST
"It's like waves and waves of sadness...you feel like the world is not a place for you." This is how being depressed feels like to Aisha, who said she maintains a "strong look" daily even though she can break down several times in private.

"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.

While Aisha has been considering seeking help ever since she was in secondary school, the idea of receiving a diagnosis and "being sick" scares her.

"It's like, 'I'm working in the medical line and I'm like that?' I think that will be the perception of people ... so I just suck it up," she said.

The perpetuation of stigma can come from various sources, such as the public, family or even within oneself. Young people are also more prone to its effects as they are in a "developmental phase" where they are trying to "form their identity".

"They might be self-conscious and are typically more concerned about how others may see and perceive them, especially so by like-minded peers," SOS added.

"To avoid being judged or associated with the perceived negative stereotypes, youths may choose to hide their struggles in order to avoid being seen as 'weak' ...even if they harbour thoughts of suicide."

"There's probably a very big mindset difference," said Ms Charlotte Chen, a therapist from Counselling & Care Centre.

"I noticed that (youths) seem to be more open to sharing with their peers than adults, especially their parents. They have the impression that their parents won't believe that mental illness is real."

Most youths that CNA spoke to have not told their families about seeking treatment or their struggle with mental health.

*Kiara, a 27-year-old early intervention teacher said it took her a few years before she went to a professional for her depression and borderline personality disorder as she came from a "very religious, conservative family".

"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... (they don't understand that) it's the brain chemicals in your brain that's going off," she said.

"So I just kept telling myself, it's okay I can handle this. What's the point of seeking help when I'm gonna end up dead anyway?"

Similarly, 27-year-old Yi Wei* said that it is "very disheartening" whenever she brings up the topic of mental health with her parents.

"They don't understand what it is ... they just see it as something difficult that you have to overcome like everything else in life."

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.

"That translated to my parents thinking, 'She's doing very well in school, so it's not as bad as what she makes it out to be? How can it be so hard when you are actually excelling?'"

"Living with that sort of mentality within your family is hard. That's why it took me so long to get diagnosed and seek help," she added.

Not only is "destigmatising" mental illness important, there is also a need to undo the "narrative" that it only happens to certain individuals, said Ms Anthea Ong.

"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."

She added: "But that is not true ... there are so many ways to be challenged mentally in the society that we're living in."
THE ONES WHO FILL THE GAP
While affordability and uncertainty about who to turn to are key barriers for some young people who need mental health treatment, there are charities and VWOs aiming to address some of those concerns.

Shan You Counselling Centre, for example, charges S$80 for every hour of counselling and offers a 50 per cent subsidy for students.

"In some instances, some of the young people may still not be able to afford (it), then we will offer further subsidy," said its director Dr Kum Yew Siew.

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.

"Not only is there a delay but also on a psychological level, having to go through multiple professionals and having to decide whether you even want to go through multiple people before you can talk to someone can pose as a barrier."

"In my opinion, you do not need a diagnosis to provide help and intervention," he said.

Ms Chen from Counselling & Care Centre added: "When youths come to a counselling centre, we are not trained to diagnose a mental health condition so we work with wherever they are, whatever struggles they're dealing with and we support them from there through talk therapy."

"Given that we are a VWO, I imagine they feel a little bit safer in terms of their records being kept confidential. That sense of safety and anonymity is really important (to youths)," said Ms Chen.

"Sometimes in seeking employment they might ask if you have any psychiatry issues. If they have received an official diagnosis (at the hospital), I imagine they would face a dilemma of whether they should or should not disclose."

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.

"That is a real challenge and struggle. I do have one or two clients who can't quite continue counseling because of the fees," she added.

The difficulty of fundraising can also be tied to the stigma of mental illness, said Mr Tay from Psalt Care, and this prevents patients from sharing their stories and experiences with the public.

"Most of us in the charity sector ... try to do our best with the limited resources. We would certainly hope we can have more so that we can do more."

According to MOH's latest data, NCSS provided S$8.7 million and S$5.7 million in funding to Social Service Agencies (SSAs) for mental health support services and counselling programmes, respectively, in 2018.

While there are counsellors in school and upstream efforts from the Ministry of Education - such as plans to give more focus to mental wellness in the Character and Citizenship Education (CCE) curriculum - Ms Ong suggested that more funding needs to go to "community support" and VWOs.

"It is important to let young people know that there is trusted, third-party support available out of campus that is affordable. We know the ratio of counsellors in school to the number of students," she added, noting that waitlists exist for university counselling services as well.

"Community mental health agencies can also be a great resource to young people."
NEED TO "SOLVE STRUCTURAL ISSUES"
As awareness of mental health issues among young people has grown, even more efforts are being put into providing help and support. This includes the 24-hour National Care Hotline launched in April this year, which is manned by more than 300 psychologists, counsellors, social workers, psychiatrists and public officers.

According to MOH, there are consolidated sites that list mental health resources and "function as navigators", such as the My Mental Health microsite that was launched this year by Temasek Foundation, in collaboration with the AIC.

"It is a resource hub that provides online mental health resources such as mental health-related articles, online forums and information on support groups to support one's mental health during the COVID-19 period," it added.

Another website with various resources on mental health was also launched to help users assess their wellbeing and match them with forms of assistance if needed.

The website, called mindline.sg, consolidates access to many resources and tools to help people "access and navigate care, with an emphasis on stress and coping".

While there has been a "groundswell" of community efforts in recent years - such as the Beyond the Label campaign by NCSS to address mental health stigma - Ms Ong said that the prevalence of mental health concerns among youths is indicative of the work that still needs to be done.

"That already empirically tells you that as much as we rally on the ground, we are not solving the structural issues of our mental healthcare such as affordability, accessibility and quality."

In the meantime, young people like Ms Khan are playing their part. The psychological science student shares her personal experience in help-seeking and resources on her Instagram page, including a compilation of affordable mental healthcare in Singapore.

"Back then, there weren't a lot of resources ... a lot of support and answers I needed were not available to me. So my objective (now) is to provide information that I needed as a teenager who was in distress," she said.

Ms Khan added that she receives many messages from youths who follow her page - some of them needing a listening ear, others looking for information on where to seek help.

"Some get overwhelmed looking at hospital websites...I have my own list that is categorised - if someone comes to me, I make it a point to refer them to the appropriate information," she added.

"What I really try to do is to make sure that they are as informed as they can be so that they can advocate for themselves."
*Name has been changed to protect identity Where to get help: Samaritans of Singapore operates a 24-hour hotline at 1800 221 4444, or you can email pat [at] sos.org.sg . If someone you know is at immediate risk, call 24-hour emergency medical services.

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IN FOCUS: The challenges young people face in seeking mental health help

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Suicide continues to be 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 into why some young people delay seeking mental health treatment, despite growing awareness in Singapore.

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Mental health is a big concern, and it will affect my generation in the near future​

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Mental health is a big concern, and it will affect my generation in the near future​

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This source reminds fellow Singaporeans as well as the Education Ministry that even though the approach taken towards younger and older students differ, the reality is that many of the mental health triggers students face in school and Universities are largely similar.

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It is gut-wrenching to think that it took the death of a student and the charging of another in court to spark a nationwide conversation about the mental health of Singapore's young people.

But I am heartened to read about the timely parliamentary debates and the overwhelming attention that has been put into investigating the state of mental health in our schools.

Increasing counselling resources, tackling the stigma around the issue and even training teachers to better support students with mental health challenges are commendable initiatives.

However, as a university student, I am deeply concerned that many of the ongoing debates and conversations are centred on primary, secondary and pre-university students, with little regard for the mental health challenges faced by university students as well.

After all, it is only logical to think that the mental health problems present in our formative schooling years, when left unaddressed, may worsen at university.

While the approach taken towards younger and older students may differ, the reality is that many of the mental health triggers, stressors and barriers that students face in schools and in universities are largely similar.

To that end, I urge the Education Ministry and our parliamentarians to adopt a more inclusive approach in their discussions and to take comprehensive steps to tackle mental health deficits within all parts of the local education landscape, before it becomes too late.

Madhumitha Ayyappan, 21

Year 3 university student

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Voices of Youth: Don't neglect mental health of university students

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It is gut-wrenching to think that it took the death of a student and the charging of another in court to spark a nationwide conversation about the mental health of Singapore's young people. But I am heartened to read about the timely parliamentary debates and the overwhelming attention that has been put into investigating the state of mental health in our schools.

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This article talks about the seniors being affected by mental health and that there are many awareness raised. There still more work needed to be done as the seniors are not comfortable to share. And that people from different age group treat mental health among seniors as "think too much or simply forgetful or careless” and that their mental state is a normal aspect of ageing.

So from this source it shows that mental health concern not only among youths but also among seniors. That seniors are not receiving the attention needed for their mental health.

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SINGAPORE: When Mr Ng Kok Sing's mother started showing signs of poor memory and became bad-tempered six years ago, the eldest of four sons noticed the changes.

His mother, Madam Lee Lye Kuen, ran a hawker stall and could remember her customers' orders, but she was misplacing things, and forgetting to brush her teeth.

She had a group of friends at the local community centre, but her bad temper drove them away, he told CNA in a phone interview.

Mr Ng's daughter took Madam Lee to the doctor, and the elderly woman was diagnosed with dementia at Singapore General Hospital (SGH).

"I didn't know much about dementia. After getting the report from SGH, I just could not understand. I was a bit shocked," Mr Ng said.

Mr Ng said his knowledge of dementia was initially minimal, but he made an effort to find out more so he would be equipped to take care of his mother. He did not understand why his mother had the condition as there was no history of it in his family, he said.

"After I found some articles and attended some talks, slowly I understood what dementia is. I had to face it," he said.

On the other hand, Madam Lee is aware of what dementia is from media articles and talks at the Fei Yue Retirees Centre where she goes, Mr Ng said. But she does not know that she has the condition.
MORE MENTAL HEALTH AWARENESS AMONG SENIORS AND FAMILIES
A spokesperson for Fei Yue Community Services said that in recent years there has been more mental healthcare screening at polyclinics.

"We do see more diagnosed with dementia," she said, noting that seniors are more aware of dementia and depression because of communications though various media channels.

"Their family members, friends, peers and neighbours who may be diagnosed with similar mental health conditions have also made them more aware," she said. She added that the elderly are also more open to finding about mental health issues by attending talks and workshops on mental health.

The COVID-19 pandemic has also "surfaced many mental health cases within the community", she said.

"There is now more prominence and light given to mental health wellness," she said.

"Together with some of the Government initiatives, the community has become more aware and embraces (the fact) that mental health issues and mental well-being are important to one's health. The younger generations like the baby boomers help to detect early symptoms and signs amongst the elderly, to seek intervention and treatment."

The Samaritans of Singapore (SOS), which provides emotional support to those in crisis or are thinking about suicide or affected by suicide, also said that awareness of mental health has "generally increased in the past few years".

The organisation has observed an increasing number of community initiatives to support the elderly and their caregivers as well as to increase awareness around mental health conditions, said its chief executive Gasper Tan.

"Specifically, we have seen a greater understanding of dementia," he said.

SOS noted that agencies such as Lien Foundation, Khoo Teck Phuat Hospital and the Agency for Integrated Care (AIC) have been fronting educational campaigns.

"(They) had played a vital role in equipping and training more with the necessary knowledge and skills to identify symptoms of dementia as well as how to support affected people in the community," he said.

Mental health among seniors came into the spotlight in Parliament last month, after MP Mohd Fahmi Aliman (PAP-Marine Parade) asked about the effectiveness of Government initiatives in reducing elderly suicide and the support mechanisms for old people who are socially isolated.

Senior Minister of State for Health Janil Puthucheary said that there were 400 reported cases of suicide in 2019. Of these, 122 cases, or 30.5 per cent, involved persons 60 years and above.

"The causes of suicide are complex and multi-faceted, often involving family, social and mental health issues," he said.

"Therefore, the Government works closely with Ministry of Social and Family Development and community partners on multi-pronged approaches, comprising promoting mental health and well-being, raising awareness on suicide prevention, and providing professional support and crisis interventions to at-risk groups, including targeted support for older adults."
MORE WORK NEEDED
While awareness among seniors is improving, more can still be done so they and their families are more familiar with mental health issues, eldercare groups said.

"In our counselling experience, a lot of times older people don't feel comfortable sharing and talking about their mental health issues," said Ms Wang Jing, assistant director of Hua Mei Counselling and Coaching at Tsao Foundation. Even when they do share openly, their families sometimes might not understand their challenges, she said.

People may come to the wrong conclusions that seniors who are depressed or anxious "think too much or simply forgetful or careless" and that their mental state is a normal aspect of ageing, she said.

"Mental health issues can be invisible and be misunderstood," she said.

She added that the behaviour of older people that can hint at a sense of anxiety or distress can be seen by others as being unreasonable or insecure.

"More can be done to promote awareness and understanding that these are not necessarily part of ageing but a mental health issue which we can all solve together," she said.

Fei Yue Community Services also said that there is still much work that can be done.

"The stigma and misconception, and lack of knowledge still exists. Many prefer to not talk about it or dismiss the idea if they should share with someone their emotional state of being," a spokesperson said.

She added that family members and friends are "critical" to getting seniors to attend workshops or talks to get themselves more acquainted with managing their mental health.

Given that dementia and depression are common mental health issues among seniors, the AIC said that families should look out for signs of these conditions. A spokesperson said that signs of dementia include difficulty performing daily activities like cooking and dressing, changes in behaviour like becoming socially withdrawn and more easily upset, and issues with cognition such as difficulty remembering things and having problems with language and calculations.

For depression, signs include thoughts of suicide, a change in sleeping patterns, and irritability and outbursts of anger, she said.
SUICIDE PREVENTION
Mr Tan said that among those who called the 24-hour SOS hotline and disclosed their age, about 20 per cent of calls between April 2019 and March last year were from people aged 60 and above.

While some call to reach out for a listening ear or vent their daily frustrations, "others may call SOS when they are in crisis, and in need of emotional support to cope with their negative thoughts and suicidal ideations", said Mr Tan.

"In such calls, our priority is to ensure the safety of the caller. In general, we strive to give clients a safe space where they can share their thoughts and feelings openly as we may be their only resource for support, he said.

He said that suicide is an "inherently complex issue", with no single cause.

"It is often due to culmination of a variety of factors. When one experience feelings of hopelessness for a prolonged period of time, one may contemplate and even attempt suicide," he said.

Loneliness, physical illness, loss of independence and loss of loved ones can contribute to seniors' sense of despair, he said.

"The process of growing old is inevitably accompanied with physical and social changes. It can be difficult to cope and adapt to these transitions, there may be fear and feelings of loss with their physical deterioration, and even concern that they are putting on burden to the people around them," he said.

He added that guilt is another emotion that they may encounter.

"When one is in such a situation, especially with a weak social support and no one to turn to, feelings of loneliness and alienation may be amplified," he said.

SOS views education as key for suicide prevention, he said.

"The community must take an proactive commitment to destigmatise suicide and create more open and constructive conversations on how we can empower the elderly, such that they can sustain meaning especially in their late age," he said.

"Furthermore, we believe that the onus should not lie only on the elderly, but the community at large to empathize and support these individuals."
HOW FAMILIES CAN HELP
AIC echoed the view that it is important for the community to continue to come together, be aware of the various mental health conditions as well as their signs and symptoms, in order to be supportive of those living with such challenges.

They suggested that families supporting elderly loved ones at-risk of, or living with, mental health conditions should be aware of signs and symptoms of mental health issues, and know who to turn to for information, treatment or support.

The families should also learn about the condition and what to expect of those living with it, treatment options and how to manage their medication, and take time out from caregiving to practise self-care.

"This is important for caregivers so as to manage their own mental wellness and prevent burnout," a spokesperson for AIC said.

Fei Yue Community Services said that families can support their elderly by being more patient and showing empathy when they display symptoms.

"The family's willingness to adjust their own living lifestyle to fit the elderly's needs and not the other way round will help and goes a long way too," its spokesperson said.
Where to get help: Samaritans of Singapore Hotline: 1800 221 4444 Institute of Mental Health's Helpline: 6389 2222 Singapore Association of Mental Health Helpline: 1800 283 7019 You can also find a list of international helplines here. If someone you know is at immediate risk, call 24-hour emergency medical services.

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Better mental health awareness among seniors, but more can be done, say experts

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SINGAPORE: When Mr Ng Kok Sing's mother started showing signs of poor memory and became bad-tempered six years ago, the eldest of four sons noticed the changes. His mother, Madam Lee Lye Kuen, ran a hawker stall and could remember her customers' orders, but she was misplacing things, and forg

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This research shows the infographic and statistic of youths age 5-16, 14 and 24.
These statistics covers:
- age where mental health problems starts
- the increase rate mental health problem among youth
- personal concerns
- major problems
- symptoms
- digital technology harms
- strengthening positive mental wellbeing

This is an in-depth research about youth mental health and it shows that it is indeed a growing concern as the rate of mental health increases greatly and that the public agrees that Anxiety and depression as major problems. Whether it is due to money, work, health, economy or even personal care that leads to mental health problems.