In 2017, it was reported that mental illness was the largest contributor to years lost to disease among people aged 10-34 years in Singapore, and the second largest contributor across all age groups[1]. Even more alarming is the fact that suicide is the leading cause of death for Singaporeans aged 10-29, and that this rate is on the rise[2]. In a speech made in Parliament on 27 July this year, Education Minister Chan Chun Sing draws on data from the Immigration and Checkpoints Authority (ICA), highlighting that the suicide incidence rate among those aged 10 to 19 had risen from 4.0 per 100,000 in 2019 to 5.5 per 100,000 in 2020[3]. Our youths are clearly having trouble dealing with mental health issues.
This begets the question. What is causing these mental problems for our youths? According to Dr. Emily Ortega, Head of the Psychology Programme at SUSS, stress is a big contributor to mental health problems, but many other factors such as biological circumstances, past experiences, and the environment that we are in, play a part as well.
Delving into the current environment of our youths, we uncover reasons as to why they may feel stressed. The pressure to succeed academically, the desire to meet parental expectations, and the advent of social media have created unhealthy conditions that affect their mental wellbeing[4]. Social media, in particular, has ramped up and given rise to existing and new stressors. Such as the fear of missing out, social isolation, and amplified feelings of inadequacy.
It is impossible to completely get rid of such stresses, but we can and should create better support systems to manage the situation. In the wake of recent high-profile incidents this year, the Education Minister stated that The Ministry of Education (MOE) aims to deploy more than 1000 teacher-counsellors across Singapore in the next few years, an increase from the over 700 currently deployed[5]. While this represents a positive step towards alleviating our youth mental health situation, we should also take on a more holistic approach to tackle the problem.
A Problem Beyond Counsel
Currently, every school has one to two counsellors serving cohorts, and even with the increase, the counsellor-to-student ratio still pales in comparison to other developed countries[6]. The inconsistent experiences the youths have with counsellors also proves to be problematic. They sometimes feel that their problems are being belittled or misunderstood, or fear that counsellors will tell on them to their parents and teachers [7].
The stigma when it comes to mental health proves a formidable barrier as well. Dr. Ortega raises the point about how seeking help often meant getting labelled and being treated differently, and how it was widely believed that only “crazy” people sought help in the past. Additionally, due to the traditional Asian values widely-held in Singapore, where members of society do not want to disturb the status quo, people rarely share their emotions.
Reducing the stigma surrounding mental health is thus of paramount importance. After all, what use is having top notch resources for mental health if no youth is willing to use them? Increasing the number of counsellors is a first step, but there is more work to be done.
A Rising National Movement
In recent years, strides have been made by the Singaporean government to destigmatise mental health. In 2019, Singapore was the first country in the region to host the International Together Against Stigma Conference, a biannual international event organised by the World Psychiatric Association that shares the latest developments, research outcomes and best practices for mental health support and destigmatisation.
The National Council of Social Service (NCSS) has been quick to acknowledge the destabilising effects the pandemic can have on mental health as well. The agency followed up with their third Beyond the Label anti-stigma campaign, and helped set up the COVID-19 Mental Wellness Taskforce (CoMWT), which seeks to provide a coordinated national response to the mental health needs arising from the pandemic[8].
Meanwhile, MOE is taking steps to reduce the stress that youths face from the ground up, by introducing more flexibility to the education system. The plans include the replacement of secondary school streaming with subject-based banding, and the implementation of a new common national examination to take over the current GCE O- and N-Level examinations. This change will help to customise education for students, while minimising the effect of labelling and stigmatisation, and encourages a growth mindset [9].
The Power of Peer Support
According to Nicholas Gabriel Lim, Head, Graduate Diploma in Youth Work at SUSS, the power of peer support is crucial in providing mental health support for our youths. Citing how puberty and the onset of adolescence can be a physically and emotionally confusing juncture, he brings up how neurological studies show that youths seek out personal affirmation from people who “get” them during this period, who are more often than not, their peers. He suggests that good friends can form non-judgmental support groups to provide security and a sense of belonging that comes from being in a community going through similar experiences[10].
Dr. Ortega agrees on the potential of peer support when it comes to the youth. However, she points out the importance of keeping the right company, and making sure that peer support is part of the broader ecosystem with proper resources allocated for it.
There have been initiatives to help educate our youths on mental awareness and tap on the potential of peer support. Serangoon Secondary School implemented the use of Padlet, a digital tool that helps teachers and students in class and beyond by offering a single place for a notice board. Using the functions of the app, students can open discussions on how to identify stress and seek help. The school has also followed this up with peer support training, with sessions covering calming-down techniques and ways to detect changes in emotions[11].
Moving beyond peer support, SUSS is slated to launch the SUSS Graduate Diploma in Youth Work Programme in January 2022. This is a joint project with the Youth Work Association Singapore (YWAS), which focuses on creating mental health support for youths. It aims to educate learners on the challenges youths face, impart the scientific knowledge of working with and developing youths, and demonstrate the art behind building a trusting relationship with youths from where they are at.
More Than Education
While there are many initiatives to better our youth mental health support systems, other problems remain. According to former NMP Anthea Ong, high costs for treatments and long wait times remain unsolved problems[12].
She called for the elimination of the difference between Medisave and Medishield Life claim limits on treatment for physical versus mental health. Such a move makes a big statement. It lowers the barrier of entry for people to seek treatment for mental health, and signals to the public that we can seek help for it just like any other illness.
When it comes to youth mental health, there are no easy solutions. What is required is a holistic approach that addresses the issue from all possible avenues that cover education, support and treatment. The fact that various government initiatives are being introduced, coupled with more people speaking out about their mental issues, shows that we are at the beginning of a shift in the way we perceive mental health.
[1] Sean McKee The Burden of Disease in Singapore, 1990–2017
[2] Samaritans of Singapore Suicide Facts and Figures
[3] TODAY (JUL 2021) Covid-19: Suicide rate among 10-19 age group rises in 2020 year-on-year
[4]The Straits Times (JUL 2021) Singapore students say parental and self expectations, Fomo are sources of stress
[5] MOE (JUL 2021) Ministerial Statement by Mr Chan Chun Sing, Minister for Education, for the Parliament Sitting on 27 July 2021
[6] Anthea Indira Ong (MAR 2020) Mental Healthcare in Schools
[7] Channel News Asia (AUG 2021) ‘With school counsellors, it’s really hit-or-miss’: Behind the challenge of safeguarding student mental health
[8] The Straits Times (OCT 2020) New task force to tackle mental health needs of Singaporeans amid pandemic
[9] TODAY (JAN 2020) Secondary school streaming to be abolished in 2024, replaced with subject-based banding
[10] Channel News Asia (AUG 2021) Commentary: What if young people find it hard to talk to parents or counsellors?
[11] The Straits Times (FEB 2021) Students get mental health lessons on how to spot signs of distress and seek help
[12] The Straits Times (AUG 2021) Mental health advocates welcome plans to have more school counsellors but say barriers remain