NS Adjust Disorder + Depression: Call 24/7 SOS Help Hotline?
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Seeking Help from anyone here.
I'm currently PES C, an ASA clerk, got downgrade temporarily for depression and anxiety disorder. A few days into my new unit, my symptoms got worse.. trembling...hiding in toilet...scared of everyone...dun even dare to go to cookhouse to eat so i skip lunch by hiding in the toilet. So i called up my SAF appointed doctor (he's a public doctor at khoo teck puat hospital but he used to be from SAF) and seeked help. He gave me 3 weeks mc and increased medication and asked me to see him 2 days before the mc ends, and when the mc ends, he wants me to try going in again.But every since the last week, it has been really torturous mentally for me, realizing that i eventually have to go back to that hell. i've developed signs of suicidal thoughts (slit my wrist once or twice at night cuz i was trembling and shivering so hard). It feels like my mind is about to snap. I tried taking extra medication (like 1 extra tablet a day) to see if it helps, but it doesnt at all....And then... probably since last week (lost track of exact day), there has been "voice" in my head, talking to me whenever i'm alone (like at night when i cant sleep, or when i'm hiding in my house toilet". That voice will just keep mocking me, like "useless", "you deserve to die", "disgrace to your family" and "commit suicide also no balls." then i will just hear laughter in my head and i keep trembling.
My parents have been trying their best to help me. I didn't tell them about the sucidal thoughts and voice as i don't want to stress them out anymore than they are now. My parent's want me to go in and keep trying until i can stay there, but i know deep down inside that, i would rather die than go back. But when i tell them its really difficult, feels worse than dying, they just kinda gave up on me. Not even talking to me anymore.So now i really dunno what to do. My medical appt with the SAF doc is 2 days from now. I've considered the following:
- Go see my private psychiatrist (i used to see one before shifting over to this current one) and ask for advice/help
- Report to IMH A&E
- Just wait until wednesday when i see my saf doc, tell him my symptoms and beg him to not let me go back.
I dunno if i can get discharged from army for this. All i know is that if i continue to go back, my mind will literally snap. I understand readers might think "clerk so relax, complain complain, etc". But my fear and anxiety is so bad now that even when see a NSF outside, i will start trembling and run away.
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Samaritans of Singapore (SOS): 1800-2214444
Singapore Association for Mental Health: 1800-2837019
Sage Counselling Centre: 1800-5555555
Care Corner Mandarin Counselling: 1800-3535800
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NS have counselling hotlines for you to call if need arises.
The counsellors are experienced professionals.You can call them at the following counselling hotlines:
- SAF : 1800-278 0022 (SAF Counselling Hotline)
- SPF : 1800-255 1151 (Police Psychology Service Department)
- SCDF: 1800-286 6666 (SCDF Counselling Hotline)
If you think you have been treated unfairly, you can bring up the case to your Commander. We will listen to your case. Do remember to bring along all facts and supporting documents.
We will do our best to address your concerns. Servicemen are to seek redress through proper channels. Together, we can address your issue more expeditiously.
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COUNSELLING
The SAF seeks to promote the well-being of every serviceman by providing
counselling support for those whom might be facing difficulties coping with their
personal or work/training related problems. Servicemen who are experiencing
difficulties can seek help through the avenues described below.
Commander interviews of all recruits are conducted within 48 hours of enlistment into full-time NS. Regular interviews are subsequently conducted on a monthly basis during the PTP/BMT phase. Special interviews are also granted upon request. Servicemen can highlight their difficulties during these interviews for assistance.
Orientation Officers identify, assist and counsel BMT recruits with adjustment
and/or other personal problems.
NS SAF Counselling Hotline is a 24-hour confidential telephone
counselling service provided by the SAF Counselling Centre. Manned by
trained counselling personnel, the SAF Counselling Hotline offers a crisis
and telephone counselling service to all servicemen. Callers may
choose to remain anonymous. Face to face counselling is also available
at the SAF Counselling Centre upon request/referral.
SAF Paracounselling Scheme complements other existing counselling
services and provides another avenue of help at the unit level for those who
need help to deal more effectively with their problems. Paracounsellors are
specially selected, trained by and work closely under the professional guidance
and support of counsellors from the SAF Counselling Centre. Paracounsellors
can be identified through their identification badges as well as through publicity
posters displayed in their units.================================================================
Being psychologically prepared is all about knowing what to expect and being prepared for it.
To be better prepared, you can participate in Total Defence activities and Open Houses organised by the SAF/SPF/SCDF.
Perhaps you should also talk to your family members and friends who have lived the NS experience. The more you discuss with others, the more comfortable and mentally prepared you’ll become.
Because NS life is different from civilian life before enlistment, there are many adjustments you need to make.
A good way to cope is to get support from your buddy and fellow recruits. They are going through the same tough training as you, so talking to one another will help relieve some tension.
In most evenings during your leisure time, you’ll also have some time to call your family or loved ones to talk. They can give you emotional support during NS.
You can have a one-on-one interview sessions with your officer to highlight any problems you may have. If you have a personal or family problem that need to be addressed, do let the officer know—he may be able to give you some advice or time off to settle your problems.
Life in NS revolves around structure, routine and discipline. This helps us stay united as a uniformed organisation as well as imparts the rigours necessary to protect our nation and citizens.
This does not mean there is just work and no play. In fact, after a few weeks in NS and you’ll find new friends and new reasons to smile!
As a soldier, one of the biggest adjustments you’ll have to make quickly is in regimentation and discipline.
Being in a uniformed organisation, you’ll have to obey orders from your superiors. Thus some of you may feel a sudden lack of freedom to do what you want and you may find yourself having difficulties accepting authority initially.
Regimentation and discipline build strong character and toughness, so that you’ll be tough enough to handle difficult combat, crime-fighting or rescue situations without giving up or breaking down.
When you first enlist into NS, you may have concerns of being in a new territory, with new faces and new things to do. But don’t let this get to you. Just remember the saying that “when the going gets tough, the tough gets going”.
Following are some tips on what you can do to prepare yourself psychologically:
- Adopt a positive perception
- Build up physical stamina
- Develop good working attitude and habits
- Overcome psychological stress
- Adopt teamwork spirit
- Learn to be independent
- Set realistic expectations
You can also speak to your friends or family members who have been through NS. Ask them to share their stories. The sharing will help you reduce some of your fears, uncertainties and doubts.
During NS you’ll be living with different people.
Because these people come from different backgrounds, they may not think like you do or react to situations like you would. Instead of trying to select your type of people, you should cherish the diversity. This is a chance for you to learn more about your fellow mates and their cultures.
You’ll find that you have many opportunities to absorb the different cultures—during training, eating, chatting or just seeing and listening. Take these opportunities and learn from people around you, you’ll have a much better appreciation of Singapore’s cultural diversity.
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Refer: www.imh.com.sgThe Institute of Mental Health (IMH) is a 2,000-bed acute tertiary psychiatric hospital situated on a 25-hectare campus at Buangkok Green Medical Park. Set amidst serene surroundings, IMH offers a comprehensive range of psychiatric, rehabilitative and counselling services for children, adolescents, adults, and the elderly.IMH’s tradition of care started in 1928. We were the first mental hospital in Singapore, starting with some 1,000 patients. Since then, many advances have been made in treatment, training, and research. Our treatment integrates evidence-based therapies, supported by the departments of clinical psychology, nursing, occupational therapy, and medical social work, to provide holistic care for our patients. IMH is equipped with modern facilities, with 50 wards for inpatients and seven Specialist Outpatient Clinics.IMH was the first mental health institution in Asia to receive the Joint Commission International Accreditation in 2005, a highly coveted international accreditation for healthcare organisations.Over the years, IMH has gained a reputation for quality research. In 2008, the Ministry of Health, Singapore, entrusted IMH with a S$25 million research grant to implement translational and clinical research into the causes of schizophrenia and related psychotic disorders.IMH also plays a key role in training the next generation of mental health professionals in Singapore. We train psychiatrists and mental health professionals through the NHG-AHPL Residency Programme for psychiatry and through collaborations with the local tertiary institutions.AddressBuangkok Green Medical Park10 Buangkok ViewSingapore 539747If you are facing a mental health crisis, please call our Crisis Helpline at 6389 2222 or seek medical help at our 24-hour Emergency Services located in our hospital.MOH to launch two new community-based mental health initiativesPosted: 12 November 2012 1930 hrsMinister of State for Health Dr Amy Khor announced in Parliament on Monday two new community-based mental health initiatives designed to improve Singaporeans' access to mental healthcare."We are developing Assessment and Shared Care Teams (ASCAT), which are specialist-led mental health teams based in the community, in order to improve access to mental health care. We are also developing Community Mental Health Intervention Teams (COMIT) to provide improved access to counselling and psychotherapy services in the community," said Dr Khor.Dr Khor also said that the Institute of Mental Health's (IMH) occupancy rate for the past three years averaged at about 80 per cent and that the hospital has sufficient capacity for new patients.There are currently about 2,000 beds across public hospitals in Singapore dedicated to mental health patients, with the majority in IMH.Responding to queries from Member of Parliament Mr Hri Kumar Nair on the criteria for admitting patients to IMH, Dr. Khor said those with conditions such as schizophrenia and depression may be admitted for closer monitoring.
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SINGAPORE - When patients feel at their most vulnerable, Head of medical social services at Singapore General Hospital (SGH) Ms Esther Lim steps in to help them make sense of what is happening.
Such patients may have tried to take their own lives or showed signs of wanting to do so. Ms Lim also helps families cope when they have lost a loved one.
The 39-year-old's helping hand is extended not just to patients, but also to hospital staff who face challenges at home or at work, for instance, if they have been abused by a patient.
In 2003, she pioneered a programme in SGH to train health-care and social work professionals in suicide intervention. It is now also offered in SingHealth's Postgraduate Allied Health Training Institute.
Since becoming a social worker in 1995, Ms Lim, who leads a team of 85 medical social workers, has received more than 15 awards. Last year, she was one of two recipients of the Outstanding Social Worker Awards given out by the Singapore Association of Social Workers.
She is married to a 37-year-old police officer. They have a six-year-old daughter.
I specialise in suicide and crisis intervention because...
When I was working in the emergency department years ago, I saw how a crisis, such as a life-threatening illness, a serious road traffic accident or an attempted suicide, can throw a family off balance.
The sense of disbelief and loss can be overwhelming, so this is where I step in to help people make sense of what is happening.
The immediate goal is to reduce the intensity of the emotional, physical and behavioural reactions, while the long-term goal is to help families get back to as normal a life as can be.
A person's life is precious because...
We live only once, so we have to live it fully and with dignity, despite our circumstances.
One little known fact about suicidal patients is...
They are not mentally ill. Anyone facing a seemingly desperate situation can be vulnerable to feeling hopeless and helpless, which may escalate to suicidal acts if the person does not receive help or cuts himself off from others.
If I were to give an analogy for what I do, I would...
Be a bridge to connect the suicidal person with the resources around him, such as family service centres, care facilities and legal aid. Often, a person may think nobody can help him, which is not true.
The eventual goal is to reconnect the suicidal person with his family and loved ones through individual, couple or family sessions.
A typical day for me would...
Start at 8.30am with administrative duties, followed by morning staff meetings or journal club sessions. I meet senior staff members regularly to plan and implement assistance schemes which benefit patients.
Other medical social workers also come to me to seek advice on cases they are working on. I co-manage the difficult cases, such as those which may involve suicide, or in which patients or family members consistently display behavioural difficulties.
I also support hospital staff members who need help and teach them coping strategies.
I have come across all types of cases...
But I find that families with strong social support fare better in crises. After the initial shock and confusion, members organise themselves very quickly to protect the affected family member by providing physiological and emotional comfort.
I love patients who...
Make it a point to turn up for their follow-up counselling sessions because this shows their readiness and motivation for change.
Patients who are forthcoming, open to working with their families and willing to reflect on themselves often make better progress.
They pick up positive coping strategies to deal with life's challenges, which range from relationship discord, financial issues to mental health or addiction challenges.
Patients who get my goat are...
Those who blame everyone else for their problems, without realising that they have a part to play.
For instance, a suicidal husband may be domineering at home and may keep blaming his wife and children, without realising that he has failed to communicate properly with them.
This can also explain the persistent suicidal behaviour in some patients. This vicious circle may wear out their loved ones and cut patients off from the support they used to have.
Things that put a smile on my face are...
Receiving handmade cards from the children of one patient whom I saw for attempted suicide and depression over several years.
Every year, though the drawings and handwriting would mature, they always conveyed their appreciation to me for being there for their mother.
It breaks my heart when...
An elderly patient asks me if the doctor can help end his life because he does not want to burden his children.
I realise, through interaction with elderly patients, that they are so stoic and self-reliant that they feel useless when they cannot contribute financially, take care of their grandchildren or, worse still, become disabled.
They have laboured hard all their lives, yet they have not come to accept that there is a time to receive unconditional care in return.
I would not trade places for the world because...
There is still so much to be done that I cannot find enough time for everything. This is what I am trained for and playing a part to restore equilibrium to lives is a constant reminder to live mine fully.
My best tip is...
To learn to take charge of emotions, thus reducing the likelihood of acting on impulse when emotionally charged.
Some things which may help include taking slow, deep breaths, sharing your problems with a trusted mentor and putting vexing matters on the back-burner, that is, taking your mind off it and revisiting the issue when you are calmer.
Get a copy of Mind Your Body, The Straits Times or go to for more stories. -
SINGAPORE'S Institute of Mental Health (IMH) beat over 80 hospitals in Asia to snag the top accolade at the Asia Hospital Management Awards (AHMA) last night.
The hospital won the inaugural Grand Award for the Hospital of the Year, because of its good showing in six out of nine other award categories.
The awards were held as part of the Hospital Management Asia 2011 conference.
Dr Ashok Nath, chairman of Hospital Management Asia, said that the Grand Award was created to "encourage hospitals to excel in not just one award category, but to also strive for more wins".
The AHMA, held yesterday at the Resorts World Convention Centre, is in its 10th year. The judges include representatives from Johns Hopkins Medicine International and the International Hospital Federation.
Dr Chua Hong Choon, IMH's chief executive, said the hospital was honoured to win the Grand Award and that the win "gives us the affirmation that our programmes are evaluated by international consultants to be of best-practices standards".
The hospital also won the Most Outstanding Project in the Service Improvement for Internal Customers Project category for its Case Management Service, a follow-up service for discharged patients.
It was started in 2003 but was tweaked last year to include an information-technology system that supports the follow-up care process.
Under the service, patients of IMH are assigned a case manager who makes sure that they continue to receive care after they are discharged. Case managers also often double as confidants for their patients.
Said Joe (not his real name), 34, an IMH patient who was diagnosed with bipolar disorder in 2003: "When I have a lot of problems on hand and no one to talk to, that tends to increase my stress levels. As my condition is easily aggravated by stress, that triggers a relapse, causing me to check in and out of the hospital."
However, Joe's condition improved after he was assigned a case manager in December 2009. He spends time talking to her every time he goes for a medical checkup, and she counsels him on some of the problems that he faces.
Other patients were also found to have fewer relapses and re-admissions, after having a case manager assigned to them.
Between January last year and May this year, IMH saw an improvement in patients' compliance with follow-up treatment, from 78 to 88 per cent, partly due to the improved Case Management Service.
There was also a fall in re-admission rates and the number of patients not completing their treatment.
IMH also received two excellence awards in the Operational Customer Service Project, and Marketing, PR or Promotional Project categories for its Mental Health - General Practitioner Partnership Programme.
The programme aims to improve access to mental- health care, especially in the heartland, by providing general practitioners with psychiatric knowledge.
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It is more better to take the advices I have given rather than your own stated ones.
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Thu, Mar 08, 2012
The New PaperBurst the Silence is a social movement that highlights the danger of youths being silent about their problems.Justin (not his real name) was developing psychotic symptoms and began to have delusions. For a year, he felt confused and lost.
His grades at school suffered. So did his social life.
He was sent to the Community Health Assessment Team (Chat) at the Institute of Mental Health (IMH) and a youth counsellor convinced him to seek treatment early and to share his symptoms with his family.
With treatment and family support, Justin is now completing his final-year at a tertiary institution.
IMH's latest campaign, Burst the Silence, hopes to encourage young people with mental issues not to suffer in silence and to seek help early.
It is IMH's first such campaign following a suicide awareness campaign, One Last Breath, organised from October to December last year.
Chat youth support worker Nur Khairunisa Ngaiman said young people who stay silent cannot access the many resources available to them, including friends, family, school counsellors and therapists.
She said: "They may feel a sense of helplessness if the stressor gets more and more overwhelming... He or she may then resort to self-destructive coping habits like self-harm and excessive drinking."
Chat, set up in 2009, has assessment services for those between 16 and 30 years old.
Between April 2009 and last December, it provided psychiatric assessment to 169 young people and about 30 per cent of them were referred for follow-up treatment in hospitals.
Youth problems the team sees include adjustment issues in school or a new environment and family matters that the young people can't cope with.
Others have mental health issues like depression, anxiety and some psychotic symptoms, said Associate Professor Swapna Verma, Chat's project director.
Prof Verma said: "Youth is the peak period for the onset of major mental health problems and such problems are often associated with high levels of disability."
The Singapore Mental Health Survey last year found that most people with mental illness had their first onset of the illness when they were in their 20s.
The survey found that in most mental illness cases, sufferers were not seeking professional help.
Those suffering from alcohol abuse started at an average age of 23 and took an average of 13 years before they sought help.
People with bipolar disorder and obsessive-compulsive disorder (OCD) waited nine years before seeking help. Their illnesses started at the average ages of 24 and 19 respectively.
Common disorders
According to the survey, major depressive disorder (MDD), alcohol abuse and OCD were the top three most common disorders in Singapore.
It found that 6.3 per cent of Singapore's adult population have suffered from MDD at some point in their lives..
To encourage sufferers to get help, IMH is organising an event at *Scape on March 17 from 6pm that will feature performances and graffiti artists.
Last weekend, a performance outside Shaw Centre involved a "bubble" with a young person "trapped" in it.
A passer-by, Mr Luther James Balat, 32, called the bubble an "attractive" metaphor.
"It gets people to ask, 'What's the meaning behind this structure?'
"Young people do need to talk to parents about their issues. Some might just tell their friends, but the latter might not give sound advice."
This article was first published in The New Paper.
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Mon, Nov 21, 2011
The New PaperDepression, alcohol abuse and obsessive compulsive disorder (OCD) are the most common mental woes in Singapore.
One in 16 people had depression while one in 29 people suffered from alcohol abuse in their lifetime.
For OCD, the figure is one in 33 people.
The findings emerged from the Singapore Mental Health Study, which surveyed some 6,600 Singaporeans and permanent residents aged 18 and above last year.
Led by the Institute of Mental Health (IMH), the $6.9 million study is the largest and most comprehensive of its kind here.
The study also found that 12 per cent of people here will have some kind of mental disorder in their lifetime.
For most, mental illness will hit by the time they are 29 years old.
But there is a big gap between the onset of mental illness and the time a person seeks help.
It took an average of four years for someone with depression to seek help. For alcohol abuse, the treatment gap is some 13 years.
Clinical Associate Professor Chong Siow Ann, senior consultant and vice-chairman of Medical Board (Research) from the IMH gave three reasons for the time lag - failure to identify the illness, stigma and the lack of access to help.
Dr Chua Hong Choon, CEO of IMH, said: "Anyone who has a mental health problem or thinks he has a health problem should speak to someone about it."
Help could come from a doctor or a psychiatrist.
Said Dr Chua: "Every doctor in Singapore has basic training as a medical doctor to deal with mental health, but in the last few years, a lot more effort has been put in to increase the capability of our GPs (general practitioners) as part of the chronic disease management programme."
He added that there are 50 GPs trained to manage some mental illnesses.
Among those who had a mental illness, 22.1 per cent had consulted a psychiatrist.
Most sought help within the community - 21.6 per cent went to a counsellor, 18 per cent to a GP, and 12 per cent went to a religious or spiritual healer.
Apart from the IMH, the other three parties involved in the study were the Ministry of Health , the Nanyang Technological University (NTU) and Rand Corporation, an American non-profit research organisation.
This article was first published in The New Paper. -
Wed, Mar 23, 2011
The New PaperTWO strangers, worlds apart, but they both suffer from the same debilitating illness of depression.
They say their struggle with depression is one that few can understand.
And one of their biggest fears is that when their caregivers die, they will be alone.
Janice (not her real name), 28, was diagnosed with depression two years ago, while Dylan (not his real name), who is in his late 30s, was diagnosed more than 15 years ago.
Both found their present jobs through the Institute of Mental Health's (IMH) Job Club.
Janice is a receptionist and Dylan is a shop assistant.
Both their employers are aware of their conditions.
In Parliament on March 4, Health Minister Khaw Boon Wan said the stigma surrounding mental illness needs to be reduced, "so that the patients can be more confident to come forward for treatment and after receiving treatment, to integrate back into the community".
While Janice and Dylan try to integrate into the community, both say it remains hard for them to hold onto their jobs because it's a constant battle juggling their mental illness and the demands of work.
Janice was too shy to meet with this reporter, and agreed only to an interview over the phone.
But she had a happy, girlish voice and chuckled often during the interview.
Ten years ago, she was an "average teenager" studying at one of the "top six" junior colleges here, she said.
She was introverted but had friends, and even a best friend.
Most of her friends, including her best friend, went on to polytechnics or worked after their A levels, so Janice went to university alone.
"I was very, very lonely and I had no friends. I constantly felt ostracised by my peers in university too," she recalled.
She admitted that at that time, she was already prone to being "over-sensitive".
She also had problems with her mother.
"She's not the affectionate type and I could never get any verbal affirmation from her. She never listened to how I felt," she said.
"I decided that unless I did something drastic, she would not care about me. I decided to rebel."
A few weeks into university, she dropped out. That decision "forced" her mother to pay more attention to her.
At her mother's insistence, she found an administrative job in a factory.
But once again, things took a turn for the worse because she couldn't get along with her boss.
She left the job after three weeks, cooped herself up at home for a year and "did nothing".
Her temper also went from bad to worse, she added.
"I not only threw tantrums, I threw things. I knew I needed help, but I was in denial. I felt that going to a psychiatrist meant something was really wrong with me," she said.
During this period, Janice also lost her best friend, who could not understand her mood swings.
They have not spoken since.
While she had consulted private psychiatrists before, at 26, Janice decided to go to IMH, where she was diagnosed with depression.
Since then, she has been on medication and sees her doctor at IMH once every month.
Although she feels better these days, she said medication does not make her "self-esteem issue go away".
Janice has had four jobs so far, but she leaves when she cannot cope with the stress.
She has been in her current job for the past three months, but hopes to find a full-time job soon.
She still finds it tough adapting to changes in her workplaces, but said: "When I have a job, I feel I have purpose in life. Without one, I feel inferior, useless, and have low self-esteem."
That sentiment is also echoed by Dylan. When he's not working, negative thoughts surge into his mind.
"I just keep thinking, 'Why, why, why. Why am I like that?' So I need to keep myself occupied," he said.
Dylan said he has been suffering from low self-esteem since young, but didn't know it was an issue as he did not have problems with his studies.
It was only during national service that something in him snapped.
"I don't know why, but I just could not take the stress in the army," he said.
His mother took him to a psychiatrist and he was diagnosed with depression.
Even though he has a business degree, Dylan says work poses a huge challenge for him and stress would trigger his depression.
His condition became so bad that in 2006, he was warded briefly at IMH for having suicidal thoughts.
He has since improved and sees his doctor at IMH once every two to three months. But he is unsure whether he will ever fully recover.
"I don't have that much hope. I've been dealing with this for so long. I've never really been happy before," he said.
Dylan hardly goes anywhere else apart from work, preferring to stay at home to watch TV.
But watching drama serials sometimes triggers his condition, especially if the show features "useless sons".
"I feel like I'm a useless son. My mother implies that about me too," he said.
His mother, who is in her 70s, works part-time in a funeral procession band. They live in a terrace house in the east.
Dylan's father died when Dylan was 17 years old.
Said Dylan: "When she goes, I'll be alone. I might even end up dying without people realising until there's a bad smell in the house."
In the meantime, he's trying to save up to buy a new computer, so he can set up Facebook and Twitter accounts and make more friends.
He hopes to find a girlfriend in the future, though he lamented: "I've no money, who would want me?"
Agrees Janice: "It's hard to find someone who will accept me. But it would be nice have someone love me the way I am."
For now, she's content going out with her mother and relatives.
She said: "All these years, I have not socialised with anyone else. I'm not in touch with people I've met at work either."
Janice wants to find a stable job so she can start giving back to her parents.
"I don't want them to worry about me anymore. I want to rediscover myself.
"For a long time, my mind has been a blank. I'm trying now to learn what it means to be me," she said.
This article was first published in The New Paper.
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Mon, Mar 23, 2009
The Straits TimesBy Lee Hui Chieh
THE national mental health hospital is looking at how it can better track and care for its outpatients, especially those more prone to violence.
The Institute of Mental Health (IMH) has set up a committee to study this, after a former patient allegedly torched Member of Parliament Seng Han Thong.
Questions about how IMH's more than 30,000 outpatients are monitored surfaced after 70-year-old Ong Kah Chua, who has been in and out of the hospital with a history of paranoid delusion, allegedly set the MP for Yio Chu Kang on fire at a community event in January.
Ong is now back in IMH, where he will remain until the Law Minister decides otherwise, based on doctors' reports.
The Straits Times understands that one of the changes being considered by IMH involves ensuring that patients at high risk of hurting themselves or others, are followed up more closely if they miss their appointments.
All patients are sent reminder letters, but those with suicidal tendencies, aggressive behaviour, or a history of violence, will be visited at home by nurses if they remain no-shows despite the letters.
This had been done previously, but less systematically.
Doctors said that community care is the way to go, rather than institutionalisation.
Dr Lee Cheng, the chief of IMH's department of community psychiatry, said: 'The best indication of violence is a past history of it. If a patient has no past history, is it justified to keep him institutionalised forever?
'If we admit him by force, it's too extreme. At the end of the day, no one would dare seek treatment because by doing so, you would be deemed dangerous.'
To ensure chronic patients stick to treatment and prevent relapses, IMH already runs two home-visit programmes, similar to those in countries like the United States, Australia and Britain.
Dr Joshua Kua, the chief of IMH's department of geriatric psychiatry who heads the seniors' home-visit programme, noted: 'The concept of having patients with mental illnesses going back to the community, leading as normal a life as possible, is in line with the international movement of psychiatry.'
The programmes have shown good results - patients have been re-admitted fewer times, and have stayed for shorter periods when hospitalised.
Retiree Amos Madina, 62, said of his father, who has dementia and is on the seniors' home-visit scheme: 'He's so much better now. He smiles at visitors, watches TV quietly, and doesn't spit and scream.'
General practitioners (GPs) have been roped in for another programme that lets stable patients get treated in their own neighbourhoods, making it more convenient for them. It also reduces the stigma that some still attach to visiting IMH.
The results so far show that GPs' care is 'not worse than specialist care', said the programme's director, Dr Nelson Lee.
One GP, Dr Roy Ang, treats about 50 such patients, and has sent only two back to IMH since joining the scheme in 2006.
'Most of them are very stable and compliant. In fact, they are more compliant than my other patients with high blood pressure or high cholesterol,' he said.
A 31-year-old woman who refused to seek medical help for depression for five years before her mother convinced her to go, has been well for the last six years.
She switched to seeing a GP in 2005 because she works and finds it more convenient to see the doctor during weekends.
Her mother, who takes her to her monthly appointments, said: 'I also make sure she takes her medication every day, as I don't want her illness to come back.'
This article was first published in The Straits Times.
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The Singapore Association of Mental Health (SAMH) will launch a mobile outreach team in July that will conduct house visits to members of the public with mental health concerns.
The measure was announced by Deputy Prime Minister Teo Chee Hean at the annual SAMH charity dinner held on Friday at Resorts World Convention Centre. In his address, he repeatedly emphasised the need to "foster a more inclusive society".
"By working together, the sum of our collective efforts is larger than what we could each do on our own," Mr Teo said. "It is important to encourage people to seek help early through education, and to reduce discrimination against those with mental illness."
Mr Teo also highlighted the achievements of SAMH in recent years. The Creative Hub at Goodman Arts Centre, which promotes mental health recovery through expressive arts such as music and dance, attracted 1,558 people in 2012. The facility opened in October 2011. Some 460 youth and their families also benefited from the YouthReach Centre, a specialised community mental health service for children and youth, since it started in August 2006.
Signs of psychological trouble
WHAT are some of the signs that your child may be suffering from psychological problems? Psychiatrists point to some of the things that you could look out for:
Sleep or appetite problems
Behaviour and speech that seem out of character
Difficulty concentrating or a lack of motivation
A drop in academic performance
Becoming increasingly withdrawn from families and peers, preferring to keep to oneself at home
Becoming argumentative towards family and friends
Hallucinations, delusional beliefs, odd or impulsive behaviour and even suicidal tendencies.
If there has been a recent crisis such as the loss of a loved one, a divorce or school stress, be sure to check on how the child is coping. Take note of how he is performing in school and how he is interacting with others.
Who to call for help:
Touchline: 1800-377-2252
Youth Challenge: 6336-3434
Tinkle Friend: 1800-274-4788
Befrienders of Youth: 6256-4440
SOS: 1800-221-4444
Parentline: 6289-8811
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Originally posted by bbxx:
It is more better to take the advices I have given rather than your own stated ones.
You mean just call the counsellors and ask for advice?
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Yes, please call all the hotlines as above.
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Should I check myself in at IMH, a tertiary psychiatric public hospital?
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Refer: www.imh.com.sgThe Institute of Mental Health (IMH) is a 2,000-bed acute tertiary psychiatric hospital situated on a 25-hectare campus at Buangkok Green Medical Park. Set amidst serene surroundings, IMH offers a comprehensive range of psychiatric, rehabilitative and counselling services for children, adolescents, adults, and the elderly.IMH’s tradition of care started in 1928. We were the first mental hospital in Singapore, starting with some 1,000 patients. Since then, many advances have been made in treatment, training, and research. Our treatment integrates evidence-based therapies, supported by the departments of clinical psychology, nursing, occupational therapy, and medical social work, to provide holistic care for our patients. IMH is equipped with modern facilities, with 50 wards for inpatients and seven Specialist Outpatient Clinics.IMH was the first mental health institution in Asia to receive the Joint Commission International Accreditation in 2005, a highly coveted international accreditation for healthcare organisations.Over the years, IMH has gained a reputation for quality research. In 2008, the Ministry of Health, Singapore, entrusted IMH with a S$25 million research grant to implement translational and clinical research into the causes of schizophrenia and related psychotic disorders.IMH also plays a key role in training the next generation of mental health professionals in Singapore. We train psychiatrists and mental health professionals through the NHG-AHPL Residency Programme for psychiatry and through collaborations with the local tertiary institutions.AddressBuangkok Green Medical Park10 Buangkok ViewSingapore 539747If you are facing a mental health crisis, please call our Crisis Helpline at 6389 2222 or seek medical help at our 24-hour Emergency Services located in our hospital.
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But I already having a SAF-assigned doctor at a public hospital.
Do I have to ask for his permission first before seeking prior counselling or going IMH, another public hospital? Say, a second opinion/ alternative doctor or psychiatrist?
I have an upcoming appointment with him on this Wednesday.
My only fear factor is that he may think I'm just not that serious, maybe due to his ex-SAF job. I hearsay that rumours as from what I know that for SAF MO may tend to be strict and careful to see if whom NSFs are genuine medical or malingering cases, or is it? -
AddressBuangkok Green Medical Park10 Buangkok ViewSingapore 539747If you are facing a mental health crisis, please call our Crisis Helpline at 6389 2222 or seek medical help at our 24-hour Emergency Services located in our hospital.
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Should I call them/ go IMH before or after seeing the SAF doctor?
Is it anytime I can call/ go? Like as soon as possible (ASAP)? Like right now?
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If you are facing a mental health crisis, please call our Crisis Helpline at 6389 2222 or seek medical help at our 24-hour Emergency Services located in our hospital.
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Samaritans of Singapore (SOS): 1800-2214444
Singapore Association for Mental Health: 1800-2837019
Sage Counselling Centre: 1800-5555555
Care Corner Mandarin Counselling: 1800-3535800
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If you are facing a mental health crisis, please call our Crisis Helpline at 6389 2222 or seek medical help at our 24-hour Emergency Services located in our hospital.
Samaritans of Singapore (SOS): 1800-2214444
Singapore Association for Mental Health: 1800-2837019
Sage Counselling Centre: 1800-5555555
Care Corner Mandarin Counselling: 1800-3535800
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Helping servicemen serve
Story by Benita Teo
Serving in the military is certainly no mean feat. And when the security of the nation is in one’s hands, mental strength is as important as, if not more so than, physical fitness.
When the going gets tough, it is often helpful to talk it out with a trusted family or friend. But, even with the best of intentions, not everyone is able to fully comprehend the intricacies of military life.
To help the servicemen and women of the Singapore Armed Forces (SAF) cope with the challenges of their military roles, the counsellors of the SAF Counselling Centre (SCC) are always ready to lend a listening ear. In fact, the team at SCC provides professional counselling services not only to all members of the Ministry of Defence (MINDEF) and SAF, but also to their families.
Learning to live the military life
Unlike civilian counselling centres, the SCC comes under military mandate, and its primary purpose is to provide mental health care to ensure that servicemen are able to carry out their duties efficiently.
Of the types of cases the SCC sees, Mrs Marlene Koh, Head of Education and Prevention Services, noted that the majority were Full-time National Servicemen (NSFs) with adaptation issues. "Not everybody is used to dealing with authority. They all came in as students who only had to take care of their own studies."
She added: "The second, smaller group would be Regulars with career or family issues. A third group comprises families and soldiers affected by critical incidents that happened around them, for instance training incidents or a death in the family."
Servicemen in distress may seek help directly with the SCC through two channels: face-to-face sessions or the 24-hour SAF Counselling Hotline. On top of these, a Family Support Helpline is also available for the family members of soldiers deployed overseas who are in need of assistance.
Eyes and ears on the ground
To help junior and senior commanders to identify and assist men under their charge who are at risk of emotional distress, the SCC conducts regular workshops. In addition to basic counselling skills, stress management and suicide prevention are also taught at the workshops.
Ms Cheryl Chia, an SCC counsellor with 14 years of experience, explained that equipping commanders with these skills is essential because "they are the eyes and ears on the ground".
Another set of eyes that the SCC relies on to spot at-risk servicemen are the paracounsellors - Regulars who volunteer to help look after the mental welfare of servicemen at the unit level. To be appointed as paracounsellors, they have to go through a five-day course organised by the SCC that teaches basic counselling, suicide prevention and crisis management skills.
Military Expert (ME) 3-3 Sulinder Singh, a Logistics Warrant Officer, has been a paracounsellor in his unit, 201 Squadron (SQN), since 2010. And being a familiar face in the unit means that servicemen know what to expect when they confide in him - trustworthiness.
"I'm quite approachable, and they know that if they talk to me, it will be confidential."
Allaying fears
Besides assuaging doubts over client confidentiality, the counsellors and paracounsellors also dispelled the stigma of seeking help.
"(For) those who are in a position of command, it may be a 'face' issue," said SCC counsellor Lawrence Yap. "But so far, I've not encountered any clients (Regulars) who claimed that attending counselling affected their careers."
ME3-3 Singh echoed his sentiments: "Is there a stigma attached to people in the unit who see paracounsellors? No, not at all. They are not mentally ill, we just need to help them find the right way to organise their thoughts."
The counsellor is in
Help for a distressed soldier often begins with a visit to the Medical Officer (MO) with complaints of symptoms of stress. Said Ms Chia: "Usually they will say that they are unable to sleep or eat. When the MOs probe deeper and realise that the problem goes beyond a medical issue, they will refer them to us."
At the SCC, the soldier will be assigned a counsellor. Through the sessions, counsellor and soldier will work together to identify the problems and set goals towards overcoming them. The counsellor will also impart skills such as stress or anger management techniques.
When facing mental turmoil, a soldier may despair and lose his sense of self. One approach a counsellor may take is to remind him of his capabilities.
"Counselling is about instilling a sense of hope," said Mr Yap, who specialises in substance and drug addiction counselling. "Everyone has it in them to overcome a difficult situation. We just need to help them see that they are not as helpless as they think they are, and that the situation is not as hopeless as they think it is."
SCC counsellors also work with psychiatrists and psychologists from the Psychological Care Centre (PCC) at the SAF Medical Corps' Military Medicine Institute to provide all-round care to the soldier. PCC psychiatrists prescribe medication for conditions like depression while psychologists run tests to ascertain if a behavioural problem is linked to a learning or intellectual disability.
Helping others help themselves
With the ever-evolving social landscape, counsellors must stay up-to-date on new behavioural problems or addictions, such as social media addiction.
Mrs Koh also pointed out that there are now more cases of servicemen suffering anxieties about not performing well or meeting expectations, and that many expected others to solve their problems.
Mr Yap agreed: "To change, clients have to take personal responsibility for their actions."
Nonetheless, the counsellors take comfort in the knowledge that they are changing lives for the better.
Mrs Koh remembered a recruit who had attempted suicide after his girlfriend of four years ended their relationship and started seeing a friend of his behind his back. Mrs Koh helped him acknowledge his feelings of hurt and disappointment, and taught him constructive ways of managing his anger.
The recruit started to improve his relationship with his family and make new friends in his unit. Nine months later, he was finally able to move on from the break-up.
Ms Chia also recounted a recent case: "I had a client who wanted to kill himself. But after working with his unit and the psychiatrist, just before his ORD (Operationally Ready Date) he said, 'You gave me hope. Even though life ahead will be challenging, at least I know now that there are people who care, and that there is more to life than thinking about hurting myself.'"
She added: "He even baked us cupcakes as a 'thank you'. It's the little things like these (that let me know I’ve made a difference)."If you are in need of help, or know someone who needs help, please call the following 24-hour hotline:
SAF Counselling Hotline
1800 278 0022
Families of service personnel deployed overseas who are in need of help can call the following 24-hour hotline:
Family Support Helpline
1800 278 0023
If you are interested in volunteering to be a paracounsellor, call the following number for more information:
6373 1066
