Singapore moves to improve young people’s mental health

By Medha Basu and Poon Yun Xuan

Interview with Dr Daniel Fung, Chairman, Medical Board, Institute of Mental Health and President of the International Association for Child and Adolescent Psychiatry and Allied Professions.

The leading cause of death in Singapore for people between 10 and 29 years old is suicide, according to the Samaritans of Singapore. Young people need more help in coping with mental health issues, fast.

Schools are a good place to start. “Healthcare in the future is not about being in the clinics and hospitals. It's about being where the kids are in school,” says Dr Daniel Fung, Chairman of the Medical Board at Singapore’s Institute of Mental Health (IMH) and President of the International Association for Child and Adolescent Psychiatry and Allied Professions.

GovInsider spoke with Dr Fung to find out how education, tech and citizen-led initiatives will help to support Singapore’s next generation.
 

Mental health literacy


Singapore has three main approaches to bolster young people’s mental health. First, it will teach young people about mental health issues, and how to cope with them. “We [teach] basic first aid, such as life support and CPR. What about mental health?” says Dr Fung.

Schools will place more emphasis on mental health education starting next year, former education minister Ong Ye Kung told GovInsider this year. Students will learn about common mental health problems and where to find help. IMH is working with the education ministry to reshape a new curriculum that places greater emphasis on mental health.

Education is crucial, as raising awareness about mental health issues can help to reduce stigma, Dr Fung says. This will in turn encourage more people to come forward for help.

Some students will undergo advanced training in mental health. While the basic curriculum teaches every student how to care for themselves, advanced students will also learn how to identify peers who need help and provide support. “We want to have different levels, so basic education for all, and some of you are going to do a higher level degree,” he says.

It’s also important to educate families so they understand how to support young people. For instance, caregivers need to understand that victims of child sexual abuse may become perpetrators themselves. If adults learn to pick up signs of child sexual abuse, they can get victims to help as early as possible and prevent further abuse, Dr Fung says.
 

Turning tech around for good


Second, tech can help young people cope with mental health issues. Social media and the digital world can put pressure on young people, but it’s possible to “turn [tech] for the good that it can do”, believes Dr Fung.

Apps can use AI, for instance, to identify if a person is in distress and nudge them towards help. Placing help near young people allows them to access professional counsel more easily, since they may prefer to seek help on their own rather than at a hospital, Dr Fung explains.

Some social media platforms also have safeguards in place. Twitter, for one, convened a Trust & Safety Council in 2016 to provide advice for its abuse policies and help build a safe space for users. Facebook has also included tools to report bullying on another user’s behalf, and to hide or delete multiple comments at once.

IMH has turned to gamification to teach children anger management and self-control. "Anger is the most common negative emotion that children experience. It is found in all sorts of conditions from ADHD to depression and when it gets really bad, it results in violence,” Dr Fung told The Straits Times.

In one of its gaming apps, instead of mindlessly slashing their way to victory, players have to control the number of blows they deal to the monsters in order to earn points. “With young people, this is quite a useful intervention,” Dr Fung says.

Telepsychiatry is another rising trend. Psychiatrists interact with their patients through video conferencing, so patients can still receive help amidst the Covid-19 pandemic. “We have local telemedicine guidelines that allow us to do treatments with patients, just that buy-in and takeup has been weak” before the pandemic, he notes. The clinicians’ response has been on the upturn since January, however.

More broadly, Singapore’s connectivity and smart nation vision means tech will become even more useful in targeting mental health issues. “I see [tech] as a way to predict problems before the problems become bad,” Dr Fung says. Our smartphones and wearable devices could give not just warnings for our physical health, but mental health as well, he explains.
 

Citizen-initiated programmes


Third, citizen initiatives can complement the government’s efforts in tackling mental health issues. Last year, a group of mothers who had lost their children to suicide launched the PleaseStay movement to raise awareness on youth mental health. The movement also supported policymakers when Singapore decriminalised suicide last May, Today reported.

Movements like these are “not something that the government can push for,” says Dr Fung. “A lot of it is in areas that are unique and niche.”

But ground up initiatives can fill the gaps that the state doesn’t have the capacity for. Mental health professionals can also learn from these groups to understand evolving needs and improve their care, he says.

Citizen-initiated programmes can help to bring in what Dr Fung calls an important but “taboo” aspect of health - religion and spirituality. “We don't do enough of it because we are so secularised, but it's so important to think about that because that is the meaning and purpose that is available,” he says. In a secular state like Singapore, the government may not be in a place to push for religious support and guidance, and so the community should step in.

The first step to solving a problem is to identify it. Mental health issues have gained more prominence in Singapore over the years, and education, tech and citizen initiatives will be crucial in creating a bright and safe future for the young.