Sep 25, 2023
What does it take to build a strategy that effectively addresses the mental health needs of Singaporeans? How can symbiosis be fostered between policymakers, service providers and mental health community initiatives in Singapore?
These were some of the issues discussed at the “Mental Health: Shaping Community Outreach and Policy Initiatives” webinar. Held on 18 August 2023, the dialogue was part of the Asia Thinker Series, and moderated by Dr Reuben Ng, Assistant Professor at the Lee Kuan Yew School of Public Policy.
It featured three speakers — Anthea Ong, mental health advocate, social entrepreneur, and former Nominated Member of Parliament; Dr Justin Lee, Senior Research Fellow and Head of the Policy Lab at the Institute of Policy Studies; and Dr Rayner Tan, Visiting Research Fellow at the National University of Singapore’s Saw Swee Hock School of Public Health, and Lead at SG Mental Health Matters. The panel voiced their opinions on what it would take to devise a comprehensive mental health approach to reach more Singaporeans in the community.
Mental health in Singapore
The speakers concurred that more community-led programmes should be in place. Many pressing issues remain regarding the state of mental health in the Singaporean community, with 2022 having recorded the highest number of suicides in Singapore’s history.
Dr Justin Lee pointed out that mental health care in Singapore remains almost exclusively focused on medical service provision and clinical support. This system tends to focus on those who are acutely unwell and in need of urgent help. There is inadequate emphasis on the patient’s day-to-day experiences with their mental health struggles, as focus is put on the treatment of symptoms and the recovery phase. This is in contrast to community-led mental health programmes which can serve a more preventative function, addressing root causes that lead to the development of mental health conditions.
Dr Rayner Tan highlighted the importance of the lived experiences of people suffering with mental health conditions. He argued that while the healthcare system is still very much indispensable in determining quality of mental health, validating patients’ lived experiences will empower them with directing their own care and put agency back in their hands.
Furthermore, Dr Tan discussed the findings of SG Mental Health Matters’ #PolicyWatch report on mental health in Parliament for the year 2022, which emphasised the intersectional nature of mental health and the need for a whole-of-government approach to addressing it. He highlighted how such complexities posed a challenge to the delivery of mental health care, and how different groups of people – for example the elderly versus the LGBTQ+ community – require different care plans.
People living with stigmatised health conditions such as HIV or substance use would naturally face more barriers to receiving help, and community support would be invaluable for these stigmatised health conditions. The current services available would need to be more inclusive to be effective on a national scale.
Possibilities for enacting future change
The COVID-19 pandemic has placed the global mental health crisis at the forefront of many policymakers’ agenda, drawing more attention to mental health initiatives.
The need for a national mental health plan was also discussed by Anthea Ong, who put forward a motion to construct one during her first Budget speech in 2020. There, she emphasised the need for more community-led initiatives.
Ong expressed hope that Singapore’s first mental health strategy would be unveiled during Budget 2024.
In 2021, the community initiative SG Mental Health Matters conducted the first-ever public consultation on mental health, which sought feedback from Singaporeans on mental healthcare and support in the nation.
The study concluded that more attention needed to be paid to vulnerable groups such as LGBTQ+ people, ethnic minorities, as well as low-income households. These observations signal the need for health policymakers to pay more attention to accessibility of care outside the medical system.
Dr Ng suggested that mental health is such a complex issue that it requires a whole-of-government approach.
Ong noted that Singapore has the past experiences and models to refer to for such an operation.
She mentioned her role in the creation of an ageing planning office. The office, which sat in the jurisdiction of the Ministry of Health, was actually an inter-ministerial committee that could bring about “horizontal levels of outcome and funding that are being organised around it.” This system would allow each ministry to coordinate its policies with the others and deliver a more comprehensive and considered mental health plan.
Building effective mental health support
Ong suggested that establishing a permanent mental health office with “the authority and the teeth to push through changes” would be instrumental in developing better mental health support for Singaporeans. She said that Singapore could not “put mental health any less a national priority than digitalisation and climate change,” and it would be one of the key pillars to Singapore’s stability, akin to the five pillars of the Total Defence campaign.
The speakers were enthusiastic about incorporating mental health education into the Healthier SG campaign, alongside currently featured health conditions like hypertension and diabetes. Above all, the need to train personnel and build up resources was determined to be most important in avoiding downstream problems arising in communities and affecting their ability to thrive as planned.
Dr Ng’s concluding thoughts were centred on the main narrative of resilience as central to the quality of one’s mental health. But he wondered if resilience has a “dark side” and if it should be the yardstick of growth for citizens and the nation as a whole. The need to avoid growth for growth’s sake and centering policy on people’s wellbeing needs to remain a core objective in Singaporean policymaking.
Mental health affects all aspects of Singaporeans’ lives. The speakers believe that a more unified approach to elevate the prominence of mental health in Singapore's national discourse would be a much-needed step forward in addressing the surge in mental health struggles.
Watch the full discussion here: