Speech by Dr Amy Khor, Senior Minister of State for Health, at the National University of Singapore Students Political Association (NUSPA) Social Policies Forum 2017 'Mental Health in Singapore', 21 February 2017

Faculty Members,

Students,

Ladies and Gentlemen,

Good evening.

        I am very happy to join you all here today for the National University of Singapore (NUS) Students Political Association (NUSPA)’s Social Policies Forum 2017.

Healthy minds, healthy lives

2.       Mental wellbeing is an essential component of our overall health and wellness. It enables us to lead meaningful lives, helps us make good life choices, and strengthens our ability to handle challenges in life. 

3.       Conversely, poor mental health can disrupt a person’s life significantly, even in his or her prime. According to the Singapore Burden of Disease Study 2010, mental disorders contribute to 7% of the Disability-Adjusted Life Years (DALYs), also known as the healthy life years lost. Schizophrenia, anxiety and depression are the main causes of mental disorders burden, with schizophrenia found to be the main cause of disability before age 40.

4.       The Singapore Mental Health Study (SMHS) 2010, a research conducted by Institute of Mental Health, found a 12% lifetime prevalence of mental disorders among the general population in Singapore, slightly more than one in ten. Mental disorders can be treated effectively when picked up and diagnosed early with proper interventions. Depending on the trajectory of the mental disorders, persons with mental conditions may be able to preserve their quality of life, and continue to contribute as productive members of society. Upstream prevention and early intervention are critical to protect Singaporeans, and help them to maintain mental wellbeing throughout their lives.

Strengthening mental resilience and promoting mental wellbeing

5.       To strengthen resilience and enable Singaporeans to enjoy good mental health and wellbeing, we implemented the National Mental Health Blueprint in 2007, to improve early detection and treatment of persons who develop mental illness, as well as enhance mental health promotion in the community.

6.       First, it is important to raise awareness of mental wellbeing by equipping the public with mental health knowledge and skills, and facilitating help-seeking when necessary. To equip students with effective coping skills, the Health Promotion Board (HPB) conducts psycho-emotional programmes in schools. Beside the youth, our elderly may also be vulnerable to mental health issues. As part of the National Seniors’ Health Programme, seniors are taught social-emotional and self-care skills, and how to seek help where necessary. Increasingly, as we face an ageing population, there will be seniors who may suffer from dementia and also many who may suffer from depression, especially for those who are socially isolated. This is also why Minister for Finance Heng Swee Keat announced in his Budget speech yesterday that the government will put an additional $160 million into community mental health efforts. In addition, HPB conducts workshops at workplaces to educate employees, particularly mature workers, on mental resilience and well-being. We have these as part of our workplace health programmes. These programmes aim to impart skills in building positive coping and support networks, which can be tapped on throughout one’s life journey, and especially during difficult times.

7.       Early detection and treatment are key thrusts of our efforts to tackle mental health issues in our society. The Community Health Assessment Team (CHAT), a professional team located at an accessible and non-stigmatising location at *SCAPE, aims to reach out to youths on mental health issues, and provide avenues and information for help-seeking. CHAT also maintains an online portal, where our youths can access resources on mental health, or make appointments for mental health assessments. Another programme, the Early Psychosis Intervention Programme (EPIP) seeks to detect and treat psychosis at an early stage. The team provides individualised case management, talking therapy, as well as support groups for youths and adults between the ages of 18 and 40, who are newly diagnosed with first episode psychosis.

8.       However, some children and youths may not feel comfortable to take the first step and seek help. Schools are therefore an important platform for us to reach out to students who may need emotional support. To support schools in this endeavour, the Response, Early Intervention, Assessment in Community mental Health (REACH) programme was developed in 2007. Under the programme, multi-disciplinary teams of mental health professionals collaborate closely with our school counsellors to provide students with psychological, emotional and behavioural problems, with suitable school-based interventions. Certain students with more severe emotional and behavioural problems may require specialised treatment. The REACH teams thus provide training and support to schools to strengthen their ability to identify, manage, and if necessary, refer such at-risk children to specialists.

Creating a supportive community for those with mental health conditions

9.       Beyond promoting mental wellbeing, we also want to enable those with mental health conditions to manage their conditions well and continue to lead meaningful lives. The first step is to create a supportive community where they are empowered to live safely and confidently, with their loved ones’ support and the community’s support. This is the aim of the Community Mental Health Masterplan, which was launched in 2012. It aims to move towards a community-based model of mental health care, with mental health assessment, support and care concentrated within the community. Instead of acute-centric institutionalised care, we are moving care for recovering mental health patients to get support and care in the community, and to help them integrate into society as much as possible.

10.      On the ground, we have established Community Resource, Engagement and Support Teams (CREST) which serve as a community safety net for residents with mental health conditions and their caregivers, who may also need additional support. In fact, very often, the caregivers feel the stresses of caring for these people. These teams help to link residents to the right care and assistance in the healthcare and social service systems, and provide basic emotional support for them and their caregivers. At the same time, to raise awareness in the community, they also coordinate mental health training and education for residents in general.  

11.      We have also made it more convenient for those with mental health conditions to receive treatment and therapy near their homes, so as to encourage them to follow through with their treatment. At times, they may default from their treatment. In order to reduce this, the Agency of Integrated Care (AIC) has partnered hospitals to establish specialist-led teams in the community to provide clinical consultation and capability building for general practitioners (GPs). This is complemented by psycho-social intervention, counselling and education for caregivers provided by allied health-led teams, who are also roving in the community. Through this, those who have mild to moderate mental health conditions can visit their GPs, get treatment, and receive the holistic care they need to recover or manage their conditions well.

12.      Aside from detection and treatment, some residents may need rehabilitation and support at home following an episode of mental illness. To support such residents, Voluntary Welfare Organisations (VWOs) such as Club Heal work with community-based support teams to reach out to them in their homes, so as to provide psychosocial rehabilitation in a familiar environment within their homes. Regular visits by these teams also help to ensure continuation of care for these residents, with the hope of fuller reintegration back into their homes and communities, and reducing their chances of relapse.

Role of Individuals and the Community

13.      While the government will continue to do its part to raise awareness and provide a continuum of care for mental health patients, all of us also play an important role to proactively influence the mental health and wellbeing of our loved ones and friends, and in fact it’s very important to support your family and friends, and to help them build up personal resilience. At an individual level, we should take personal responsibility to learn more about good mental health and various conditions, and to build up our own personal mental resilience. This will allow us to take care of our mental health, and be able to pick up signs of poor emotional management, in order to seek help early when feeling emotionally distressed. Within our communities and social circles, we can do our part to pick up signs of stress and render emotional support to our family, friends and colleagues, who may be facing emotional challenges. Indeed, stress is part of life – we cannot eliminate stress totally and at different stages of our lives we may face different levels of stress, which affect our mental wellbeing. Therefore, each one of us cannot think that we are totally immune to mental stresses and mental ill health, and we need to build up our mental resilience.

14.      While stigma and perceptions may take a lifetime to change, I am heartened that all of you have taken the first step today by participating in this important conversation on mental health. Let me encourage you to continue speaking up, and raising awareness on the importance of mental resilience and mental wellbeing. I look forward to a most fruitful conversation with all of you.

15.      Thank you.