Mr Alvin Tan, Minister of State, Ministry of Culture, Community and Youth & Ministry of Trade and Industry
Associate Professor Daniel Fung, CEO, Institute of Mental Health
Mr Tay Choon Hong, CEO, Health Promotion Board
Colleagues, friends, ladies, and gentlemen,
Good morning. I am happy to join you today at the 7th Singapore Mental Health Conference. Running up to World Mental Health Day, the activities relating to mental health have been fast and furious. The Inter-agency Taskforce on Mental Health and Well-being has been working for two years now and has finalised their recommendations, which they will be delivering publicly tomorrow. My speech today will try not to cover what they will share tomorrow. I would like to thank the IMH, HPB, National Council of Social Service (NCSS) and Agency for Integrated Care (AIC) for organising today’s conference.
2. In my address today, I want to set the context for this conference by covering three areas. First, to explain why I feel that mental health has become a significant health and social issue. Second, we need to manage mental health holistically and avoid over-medicalising the response. As today’s conference says, we are co-creating an ecosystem that must go well beyond the healthcare system. Finally, I will touch on the Government’s role in spearheading the creation of this ecosystem.
A Significant Global Issue
3. Let me start with my first message – that over the decades, mental health has gained importance as a global health issue. It picked up momentum in the 2000s, at the turn of the millennium, when the World Health Organization (WHO) released its Mental Health Action Plan 2013-2020. That was probably a major turning point in the way we look at mental health.
4. However, at that time, there was still a perception that the rising prominence of mental health issues may have reflected a softer generation who could not cope with stress and who have not gone through hardships, and cannot cope with mental health issues. That perception was there and I think it still exists somewhat today. After all, the explanation was that an earlier generation had to cope with war, riots, uncertainty about survival, deep recessions, yet mental health never gained the level of importance then that it has today.
5. It was also around that time, in 2015 that I was appointed Minister for Education. As a new Minister, I soon felt something was amiss, when I noticed that an increasing number of students, either through writing to me or during dialogue sessions, were raising mental health issues. Gradually, I began to realise that it is a big issue among the younger population. In 2016, the Singapore Mental Health Study reported that one out of seven people in Singapore has experienced a mental health condition over the course of their lives. That is quite a high proportion.
6. I decided to learn more about mental health issues and enrolled in an online mental health course. The course I picked was “The Science of Well-Being” conducted by Professor Laurie Santos of Yale University. It was at that time and probably now still the most popular course in the university’s history.
7. It turned out to be a highly educational experience, and I understood why it was so popular. From the course, I learnt that mental health is an important challenge for this generation, and reaffirmed it what I felt. It pre-occupies the current generation. I also learnt various coping techniques when one is in a bad state of mental health.
8. While the younger generation did not encounter wars and racial riots, they are going through a different kind of stress and anxiety. They worry about climate change. It affects their entire outlook and optimism for the future. They worry about the survival of the planet. They are trying to make sense of the rapidly changing world, fast pace of life, and intense competition in school and at work. At that time, as much as I tried to cut down on exams as the Minister for Education, remove streaming, change the Primary School Leaving Examination system, the stress somehow did not go away. It was somehow embedded in the system, not just in government policies.
9. The young generation are also struggling with social media which redefines how social interactions are being carried out. Peer affirmation started to feature strongly in our self-awareness, not just for the young, but adults as well. Fear of missing out (FOMO) often creeps into our emotions. On social media, rules of engagement can resemble that of the ‘Lord of the Flies’. It can be cruel, fierce and aggressive. Our children are simply not prepared to navigate the social media space safely and are not mature enough to cope with these complex social environments. All these factors explain why mental health challenges are felt globally, not just in Singapore.
Tackling the Issue Holistically
10. We have entered an era of the mental health challenge. This leads to the second area I wish to address today – how should we then tackle it?
11. I moved to the Ministry of Health (MOH) in 2020, where I learnt about all the work that the Ministry has been undertaking to address the issue of mental health. We are expanding our resources, like psychiatrists and mental health wards and hospitals, for effective treatment of mental health conditions. That is a basic thing that we have to do. However, like all diseases, if we take a purely curative approach, it is too late, and the effort will be unsustainable. It is just like how you cannot win an Asian Games Gold medal by just taking care of your injuries, but you have to train to be fast. If you tackle mental health issues purely by looking at the curative aspects, we cannot overcome it. For any disease strategy to succeed in delivering long-term results, it has to be holistic, with a strong emphasis on prevention and building health, including mental health.
12. Hence, going back to the online course I attended, although Professor Laurie Santos is a member of the Yale School of Medicine, the techniques she taught were not medical in nature. They are highly accessible that even I could understand, and are good habits that we can practise daily, such as better sleep, socialising, exercising, and helping others. Her course is targeted at the general student population, and naturally focused on prevention and the building of health.
13. Hence MOH has embarked on a range of interventions, including prevention. For example, HPB has been organising mental health literacy workshops to educate people. We have established MindSG, an online resource portal that provides resources to guide individuals to cope with mental health challenges and guide them to seek help when they need to. IMH and Temasek Foundation are spearheading the delivery of Mentally Lit to students to learn about common mental health conditions. There are also initiatives such as NCSS’ Beyond the Label movement which addresses stigma and promotes inclusiveness. There are now many community initiatives which are ongoing.
A Coherent National Strategy
14. This leads to my third point today, which is that in implementing this holistic approach and co-creating this mental health ecosystem, what is the role of Government? The role of Government is a decisive spearheading one.
15. It will have to start with incorporating a mental health element in our key health national initiatives, namely Healthier SG, our preventive care strategy, and Age Well SG, our national effort to encourage active and healthy ageing in homes and communities.
16. Through Healthier SG, we should aim to help individuals build their mental resilience, cope with stress, and seek help early when needed. In this regard, many members of the public and Members of Parliament have been asking if we could dovetail mental health services into Healthier SG.
17. We will do so. We have set ourselves a target of about two years. In the coming two years, we will be developing mental health protocols, and incorporating mental health prevention and support as part of the General Practitioners’ (GPs) scope of practice under Healthier SG, just as we have done for many other chronic diseases. To date, we have more than 400 GPs who are trained to manage mental health cases and work closely with the Community Intervention Teams and hospitals to meet their patients’ mental health needs. We will progressively expand this group in the coming few years.
18. As for Age Well SG, by keeping our seniors physically and socially active in the community, we directly tackle the challenge of social isolation of seniors, which is a key risk factor of mental illness among our seniors.
19. To consolidate and coordinate all our efforts to tackle mental health issues, we set up the Inter-agency Taskforce on Mental Health and Well-being in July 2021, chaired by Senior Minister of State of Health Dr Janil Puthucheary. The Taskforce has developed a National Mental Health and Well-being Strategy with many recommendations. The key thrust is to tackle the issue coherently and holistically, from both preventive and curative perspectives, and through the community, schools and workplaces. The recommendations have been finalised, and tomorrow the Committee will release the recommendations publicly.
Closing
20. At MOH, our clinicians are acutely aware of the need to take care of the physical, mental and emotional health of individuals simultaneously. All these aspects of health are interdependent – you lose one, you lose it all. In this phase of globalisation, digital connectivity and climate change, and FOMO, mental health has emerged as a significant health issue. Our response cannot be over-medicalised. We need to recognise that this is fundamentally a socio-economic challenge, albeit with significant health consequences. This is the approach which Singapore will try to adopt in addressing the mental health challenge.
21. On this note, I wish everyone a fruitful conference ahead and hope that the insights you gain from this conference will enhance our efforts and contribute to a mentally healthier Singapore. Thank you.