[Content Warning: Mental Health, Depression, Suicide]
“I got diagnosed with depression. I also couldn’t see my (very few) friends nor my therapist since they were deemed to be “non-essential.” While I had therapy online, it definitely did not have the same impact as my usual face-to-face sessions.” said one participant of our online poll.
Indeed, the COVID-19 pandemic has brought about an unprecedented wave of distress for many in the community. A recent study published by insurer AIA Singapore found that 91 per cent of its survey respondents reported a decline in their mental health due to concerns over job security and income loss.
This was what prompted our team at SG Mental Health Matters (SGMHM) to conduct the #AreWeOkay poll, as part of our public consultation 2021, to spark a conversation on mental health among Singaporeans amid the pandemic.
SG MENTAL HEALTH MATTERS AND OUR PUBLIC CONSULTATIONS
SGMHM is a citizen-led initiative advocating for equitable mental health policies in Singapore. The community conducted its first public consultation in 2020 which provided insight on issues of access, affordability, and quality of mental healthcare in Singapore. In 2021, SGMHM conducted the #AreWeOkay poll from 26 March to 30 April 2021 among 561 participants, who provided both quantitative and qualitative contributions on their perceptions of mental health policies in Singapore, including the impact of COVID-19 on mental health, perceptions of mental healthcare, and the mental health of vulnerable communities.
Our public consultation this year led to several key findings.
First, we found high consensus around cost being a barrier to mental healthcare access. For instance, 78.9 per cent of the total participants agree with the statement: “Cost is a barrier to quality mental healthcare in Singapore”.
Second, we found high consensus around the greater mental health vulnerabilities of low-income households, people living with disabilities, LGBTQ+ individuals and healthcare workers. For instance, 89.6 per cent of total participants agree that people with disabilities are at greater mental health risk and believe that they should be given additional support. Additionally, 85.8 per cent of total participants believe the same applies to healthcare professionals.
Third, we found high consensus around the need to address suicide in Singapore. A total of 79.1 per cent of respondents believe that not enough is being done to prevent suicide in Singapore. Furthermore, 89.2 per cent agree that the role of family as a prevention strategy for youth suicide risk has not been explored enough.
Fourth, COVID-19 and its related control measures have negatively impacted the mental health of participants, especially those who identify with having past mental health challenges.
In brief, these findings indicate that improving the mental health of our nation will require addressing not just structural barriers to mental healthcare — issues of affordability, accessibility and quality of such care — but also a range of upstream factors that place individuals at greater risk of mental health challenges, such as in vulnerable groups.
A CENTRAL COORDINATING BODY FOR MENTAL WELL-BEING
In light of the findings from our consultations, it is clear that we urgently need a whole-of-government (WOG) approach to build a strong and mentally-healthy Singapore. The government has announced that the COVID-19 Mental Health Task Force will be transformed into an inter-agency task force to provide a coordinated national response to mental health and well-being beyond the pandemic. This task force was set up by the Ministry of Health and Ministry of Social and Family Development, and will be overseeing mental health efforts beyond COVID-19, focusing on issues that require interagency collaboration.
It was also announced at Budget 2021 and in recent news that the new task force, the Interagency Taskforce on Mental Health and Well-being, was set up with three priorities in mind; first, to develop a national mental health and well-being strategy as a guide and framework for agencies; second, to develop a national, consolidated mental health resources webpage to help individuals access useful and accurate information; and third, to establish a national mental health competency training framework.
These three priorities are necessary and welcomed. Yet a more important implementation question that should have been asked in response to this announcement is missing: Is a task force enough to address the significant and long-term challenge of mental health in Singapore?
To tackle the tsunami challenge of a rapidly-ageing population, we have the inter-ministerial Ageing Planning Office with dedicated resources, not just an ad hoc task force. To address the existential challenges for digitalisation and the future economy, we have the Smart Nation and Digital Government Office (SNDGO) under the Prime Minister’s Office (PMO), not under the Ministry of Communications and Information or Ministry of Trade and Industry.
Shouldn’t a mentally healthy society be as existentially consequential as a smart nation in terms of our whole-of-government vision and implementation strategy?
Beyond a task force’s potential, we draw inspiration from SNDGO’s whole-of-government strategic structure and implementation model to advance the mental well-being of our nation. We suggest that this national coordinating body may be called the Mental Well-being and Sustainable Development Office (MWSDO), overseen by a Ministerial Committee made up of relevant ministers e.g., education, health, manpower and social & family development. Like the SNDGO, the MWSDO would allow the government to be more proactive, integrated and responsive to policies that may have implications for mental well-being.
What can the MWSDO help us address?
First, while a national strategy and framework to guide agencies is necessary to address the mental well-being of our nation, we also need to consider how such strategies need to be flexible, dynamic, and responsive to emerging crises such as the pandemic. A national coordinating unit under the PMO will be able to take on such a task, and engage in iterative reviews to ensure that our frameworks align with the changing times. Like the SNDGO, the MWSDO can prioritise, coordinate, and lead mental health transformation efforts in our government.
Second, while we do need an authoritative resource on mental health-related information, we also need an authority to ensure that our targets are met across ministries. Like the SNDGO, the MWSDO could lead and guide strategic national projects, and be empowered with resources to bring such projects to fruition.
Third, a national mental health competency framework is a great start to ensuring that our nation is better-equipped to deal with our ongoing and future mental health crises, but we also need a coordinating body to lead the charge in enabling a systemic, cultural shift. Like the SNDGO, the MWSDO can be empowered to continuously review policies and legislation that would facilitate a culture of not just competence, but compassion.
It has taken an unprecedented crisis of a pandemic and recent tragic incidents for us to realise as a society that “it’s okay not to be okay”; it’s okay to seek help.
“I hope to be alive to be able to see that mental health in Singapore will be prioritised instead of overshadowed by other things,” urged another participant.
Indeed, Education Minister Chan Chun Sing recently called for a redefinition of success in his ministerial statement in Parliament on the River Valley High School incident. This is a hopeful statement which would necessarily mean that we must relook at our measures of growth towards sustainable development to ensure mental well-being of our people as an equally weighted outcome; one that the Prime Minister’s Office must spearhead.
So, will we be okay? We will be, depending on how much and how fast we invest in mental well-being as a national priority to become a Mentally Healthy Nation with a MWSDO as fiercely and intentionally as we have become a Smart Nation with the SNDGO. So as to achieve “happiness, prosperity and progress for our nation”.
Access SGMHM’s full report here: https://sgmentalhealthmatters.com/sgmgm-full-report
Anthea Ong is a former Nominated Member of Parliament, Social Advocate and Entrepreneur (SG Mental Health Matters, WorkWell Leaders Workgroup, A Good Space, Hush TeaBar), Leadership Coach and Author of 50 Shades of Love. www.antheaong.com
Rayner Tan is a Postdoctoral Fellow at the University of North Carolina at Chapel Hill Project-China in Guangzhou, China, and a Visiting Research Fellow at the Saw Swee Hock School of Public Health, National University of Singapore and the National Centre for Infectious Diseases in Singapore. He is the lead author of the SG Mental Health Matters public consultation 2021 report.
Top Photo from Unsplash.