By Janelle Wong
The current pandemic has unveiled many structural issues at home, from the cramped living conditions of migrant workers to the under-payed services that are often essential. While there are a host of things to work on moving toward a new normal, one important topic seems to have escaped mainstream discussion amid all that is going on – mental health in Singapore.
In these four months of lockdown and gradual reopening, there has been a mental health fallout across the country. AWARE saw a record increase in calls to its hotline, with a 137% increase in calls about family violence and a 436% increase in calls about emotional and psychological distress in the month of May alone. The T Project, a shelter for LGBTQ+ individuals, had a waiting list of people asking to stay there for the first time. And an online survey of 1,000 people here by market research company Ipsos between late April and early May found that one in four respondents said they were not in good mental health. The pandemic has no doubt had repercussions on the mental health of our citizens.
The government’s response has also been more than lacklustre. At the beginning of circuit breaker, mental health practitioners were declared as “non-essential”, resulting in many being unable to seek help if needed. This was exacerbated as people were unable to leave their houses, putting many in unsafe, dangerous or stressful environments. The decision to exclude mental health services was also at odds with the government’s decision to set up a national care hotline or the #SeeItBlue movement, where landmarks in Singapore lit up to shine a spotlight on mental health.
And while they ultimately backtracked on their decision, re-categorising these services as “essential” at the start of May, this is telling of three important things:
1. Mental health may not be a national priority.
2. Mental health services in Singapore may not be accessible and inclusive enough.
3. There is still a stigma towards mental health in Singapore.
The Difficulties of Seeking Help
This is a problem that has been brought up before. So why, even with a pandemic that further strains the mental health of our people, are we not trying to solve this?
In 2018, a public consultation of mental health in Singapore revealed shocking results. Over 60% of individuals cited high mental health care costs as a difficulty in seeking help. Many reported long waiting times for an appointment to see a professional. Another survey conducted by the National Council of Social Service (NCSS) in 2017 cited that two-thirds of adults with mental health conditions refused to seek treatment due to fear of being shamed. And even with the incident of the unmasked woman at Shunfu Mart, many were quick to mock her online, showing existing prejudice and ignorance towards mental health here.
These results are congruent with my own experience seeking help in Singapore. I have to preface that I am privileged – I am Chinese, I have savings from part-time jobs, and I am a student at a university. This gives me free access to services on campus and a student discount at certain mental health providers. Even then, it was difficult for me.
After making my first appointment, I still had to wait over 5 weeks before being able to see my therapist. There was a limit to the sessions I could have with the therapist at the National University of Singapore (NUS) due to the overwhelming number of students seeking help. And when I told my family members about my therapy, the initial reaction was confusion and shock at why I wanted to go in the first place. When I transitioned to therapy outside of NUS, the waiting time was even longer, and my family’s stance was that I was wasting money on something unimportant.
Imagine how much harder it would be for someone who is not a university student. Or for someone who is from a minority race. Or even for someone from the queer community. It is important to realise that barriers to accessing mental health care in Singapore are extremely high. And these barriers disproportionately affect those from minority communities, who in these times, might not have a safe space at home to access online therapy or even be able to afford it.
Not all has been bleak, however. Many peer support groups have emerged online, encouraging people who are lonely to come together to seek out new friends or have a simple conversation together. There have been round ups of mental health services spreading around, to increase awareness of avenues for individuals to seek help should they need it. And the government has recently announced a new action network to address issues related to mental health.
All these are steps in the right direction. But much work still remains to be done.
What Should We Do?
Firstly, it is imperative that mental health providers be more accessible and inclusive. Many current providers largely cater to those who speak English. Forget those who speak dialects, Malay, Tamil or even Chinese, there are little to no services who cater to those in those language groups. This already results in many falling through the gaps in our current system, as they are unable to seek help in the first place. For those in the queer community, there are even fewer options. There are a lack of dedicated queer affirming mental health care providers, which make individuals less likely to seek help even though the queer community suffers from a higher risk of having mental health issues.
Secondly, many mental health services are expensive. Many stop themselves from seeking help due to the fear of how much treatment will costs. Many mental health conditions also take months, or even years, of counselling for one to get better, which could significantly rack up bills. Furthermore, MOH’s expenditure on mental health in 2019 was only 3% of the whole healthcare budget, showing a significant lack of funding going into supporting and upgrading our current mental health care system. With the repercussions of the pandemic stretching months ahead, we have to prioritise mental health on an equal level as other challenges such as inequality, economic issues and housing.
Lastly, Singaporeans have to stop perpetuating the stigmatisation of mental health. We have to actively create a culture of acceptance for those who need more mental health support than others. We have to stop shaming those who have mental health breakdowns in public when they get filmed and shared online. We have to step up to support those who need out help, be it offering a listening ear or even just directing them to avenues of support they can access.
We have to go beyond hashtags of solidarity or mere movements of support. Moving forward, we need to walk the talk and truly create an inclusive and more empathetic society for all.