Speech by Mr Hawazi Daipi, Senior Parliamentary Secretary, Ministry of Health and Ministry of Manpower, at the Singapore SOKA Association's (SSA) Community Mental Health Symposium

25 Sep 2010

By MR Hawazi Daipi

Venue: Singapore SOKA Association’s (SSA) Community Mental Health Symposium

Ladies & Gentlemen

1. Good Afternoon and thank you for inviting me to be here with you today. It is my pleasure to be with for the Singapore Soka Association’s Community Mental Health Symposium entitled ‘Healthy Mind, Happy Life’. I am happy to note that SSA has been partnering Silver Ribbon Singapore for more than three years in various mental health awareness issues. With support from the Health Promotion Board, this event has been made possible to showcase a series of relevant topics on mental health related issues and the services available in the community.

2. Let me begin by sharing on the topic of mental well-being. The World Health Organisation (WHO) defines mental health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Mental well-being is an important and integral component of our health. Good mental health is not just the absence of mental illness.  It is the presence of well-being where individuals have the mental ability to live, work, play and contribute well to society.

3. Indeed, in recent times of the economic downturn, many of us would have experienced psychological and emotional stress that would have put our mental resilience to the test. The Singapore economy has made a strong recovery, and while we have weathered through the storm, we should continue with our efforts in promoting good mental health and well-being. Having good mental well-being not only improves our ability to deal with daily challenges but also enables us to have a positive outlook on life and to enjoy living.

4. The first National Mental Health Survey In 2004 found that the prevalence of anxiety & depression among Singaporeans was about 7%. The survey also showed that up to 16%, or 1 in 6 Singaporeans, would have some form of mental health problem other than anxiety and depression. These could include milder problems such as phobias and mild depression that affect their effectiveness and well-being, but may not be so severe where they need to seek help in a hospital setting.

A Holistic Approach to Mental Health 

5. Thus to address the mental health needs of the nation well, our efforts must span the entire spectrum of mental wellness and diseases. We should also make care and treatment available and easily accessible across the healthcare spectrum, from tertiary hospitals to GPs and other community services. We need to consider how to support the population at large, to preserve mental wellbeing and promote mental resilience.

6. For people with disease, we need to look at early detection and intervention to minimise the need for institutionalised care. For patients recovering from mental illness, we need to look at care within the community, support to prevent relapse, and reintegration within society, so that they can continue to lead purposeful lives. For caregivers of patients, we need respite and support care to ensure that the caregivers of mental health are well-looked after too.

7. Underpinning all this is our strategy of improving care towards a more decentralized, community-based system of care. This strategy of decentralized mental health care is not unique to Singapore. It is a key recommendation of the WHO Report on Mental Health . Countries such as the United States, United Kingdom, and Asian counterparts like Malaysia and Hong Kong have been moving towards this strategy, and for good reasons too.

8. Let me take a minute to emphasize the rationale behind this strategy. A move towards community care has been widely hailed as an approach that enables patients to live and work in an environment as close to their natural one as possible. It provides a better quality of life for patients. Patients are also more accepting to community-based care, rather than the institutionalised setting in a psychiatric hospital. Furthermore, confining care to isolated hospitals or institutions has the effect of removing the mentally ill from their friends and families. These friends and families form an important part of our lives and provide the social support and assistance that shape our sense of wellbeing.

9. However mental illness makes people fearful. High-profile crisis incidents often lead people to think that all mentally ill are dangerous and should be locked away. In reality, only a very small portion of patients are. We should not over generalize and deprive the majority their preferred care and treatment option.

10. IMH makes great efforts to ensure that only stabilized patients are discharged from inpatient care. These patients must respond positively to treatment, have sufficient family or social support, and pose minimal danger to themselves or to others. IMH then teaches such patients and their families on the need to comply with medication and regular follow-up to avoid future relapses. Under the Community Mental Health Team project, IMH staff oversees the care and support of the more severe patients discharged to the community and also strengthens the capabilities of community agencies in the early detection and management of individuals with mental health problems.

11. With proper treatment and support, most mentally ill patients can recover and function in the community. However, for these patients to successfully recover in the community, these patients need the community’s support and understanding as well. We need to remove the perceptions of fear and prejudice that surrounds mental illness. This is primarily an issue of stigma. The stigma is so strong that more often than not, people will not want to seek the necessary help they need. This is in part a lack of awareness and understanding of the illness, and society’s lack of acceptance to persons with mental illness.

12. It is not only people with mental illness who experience discrimination and stigma. Rejection of people with mental illness inevitably spills over to the caregivers and family members. They play an important role in the care and treatment process by helping recovering family members go for regular medical appointments, care for them when they are at home. Above all, they provide the support and love that is needed in the recovery and rehabilitation of a mental illness. These caregivers and persons with mental illness need the support and understanding of the community so the recovery process in the community can be at its most effective.

13. The reality is, mental illness is just like any illness, and it could happen to anyone. The treatment of mental illness cannot be alienated from the rest of medicine and health care in isolated asylums, but should be integrated with both healthcare and social sectors.

14. More importantly, a person with mental illness needs both the medical treatment and also the care and support from family members and the community so they can recover and reintegrate back into the community. As our society learn more about mental illness, I hope family and caregiver closest to the mental health patient can also provide the care and support needed. Together, let us help our patients recover better and faster.

Healthy Mind, Happy Life 

15. This is why we are focusing on raising public awareness about mental wellbeing, de-stigmatize it, and help people to acquire simple coping skills when under pressure. The ‘’Healthy Mind, Happy Life’’ Community Mental Health Symposium serves just this purpose as it creates positive awareness on mental health issues to the community. This symposium is held in commemoration of World Mental Health Day, and is an ideal platform to learn about various issues on mental health and demystify mental illness.

16. Let me close with a quote from the philosopher Socrates. “My friend…care for your psyche…know thyself, for once we know ourselves, we may learn how to care for ourselves". Let us join the World Health Organisation’s call and commemorate World Mental Health Day by being more aware and accepting of persons with mental illness.

Thank You.