Mr Patrick Tay, Chairman, Mental Health Board Committee of the National Healthcare Group
Associate Professor Daniel Fung, Chief Executive Officer, Institute of Mental Health
Ladies and gentlemen
- Good morning. It is my pleasure to be here at the inaugural Biennial International Congress on Mental Health.
- The conference theme “Building Bridges for an Effective Mental Health Ecosystem” aptly reflects the need for a multi-prong approach to managing mental health needs. It recognises that support and management for mental health and illnesses should not be confined to medical intervention. The impact of mental health extends beyond the individuals to their families, and communities, who in turn can be pillars of strength to support the recovery journey.
- In Singapore, we launched the National Mental Health and Well-being Strategy last October. Our aim is to create an ecosystem where help is accessible to those who need it; and those providing it, have the necessary knowledge and skills. The Strategy further recognises that mental health exists on a continuum, and hence, we introduced a tiered care model to organise services according to the severity of mental health needs.
Optimisation in Mental Health Care
- At one end of the spectrum of the tiered care model are healthy individuals. We want them to maintain their mental well-being. At the extreme end are individuals with high mental health needs who require specialised and perhaps long-term care. At this point, they would require specialist care in a hospital setting. An example is schizophrenia, a form of psychotic disorder that requires intensive treatment and support, especially during the early onset. And when the condition stabilises, continued support in the community is provided to help them stay on track the recovery course.
- Over the next two days, we will be able to glean fresh insights from speakers at the Asian Congress of Schizophrenia Research on how the various facets of the ecosystem can come together to optimise recovery.
- As far as possible, we focus on prevention, and early, to achieve better outcomes. The 2016 Singapore Mental Health Study[1] by IMH found that the local treatment gap among those with schizophrenia and other psychotic disorders is low, with 80.4% of them having sought help for their symptoms. That means that the remaining 20% did not seek help and why is there such a gap?
- Several factors contribute to the treatment gap for mental illness, with a lack of mental health literacy, seen as a significant contributor in several studies.
Singapore’s Mental Health Literacy Level
- Let me now refer to the Mind Matters cross sectional nationwide study which was done in 2014[2] to examine Singapore’s mental health literacy. Recognition for conditions like dementia, alcohol abuse and depression were relatively high, between 50% and 66%, but recognition for conditions like obsessive-compulsive disorder (OCD) and schizophrenia was low. In particular, only about 12% of the population were able to recognise the symptoms of schizophrenia.
- Now, 8 years on, mental health literacy in Singapore has increased. The overall recognition of mental health conditions rose from about 42% in 2014 to about 59% in 2022. The sharpest increase was recognition for OCD, which rose from about 29% in 2014 to about 62% in 2022. Recognition for depression, dementia and alcohol abuse also improved by about 11% to 19%. While the overall recognition for schizophrenia remains low, we did observe a 3.5% improvement from the first Mind Matters study.
10. Besides recognising the symptoms, stigma can also deter an individual from seeking help. The same study, Mind Matters, also measured attitudes towards those living with a mental illness in three domains: (a) the perception that those with mental illnesses are ‘weak not sick’, (b) the belief that they are ‘unpredictable/dangerous’, and (c) the extent to which one would distance himself from those living with a mental illness.
11. The latest study saw a significant drop in stigma scores in all three domains when compared to 2014. When we looked at socio-demographic factors, we see that when you are younger aged, of the female gender, and of higher educational levels, these were associated with lower stigmatising attitudes.
12. The lower stigmatising attitudes seen among the younger age group (18-34 years) may reflect changing knowledge and perceptions about mental illnesses. It is likely that younger persons are better informed about the causes, treatment, and outcomes of mental illnesses as a result of exposure to campaigns and mental health content in places of education, as well as through social media.
13. I would like to give a special shout out to my NCSS colleagues, Ms Tan Li-San. NCSS has been very instrumental in pushing forward mental health awareness and destigmatising.
Building Mental Resilience from a Young Age
14. Another conference taking place under the BICOMH is the International Society of Addiction Medicine Regional Conference 2024. There are many forms of addictions, but this edition will deep-dive into behavioural addictions, looking into areas such as problematic gambling, gaming disorder and the risks of excessive digital use.
15. In an era where technology is woven into the fabric of our lives, digital use may come across as commonplace and innocuous but when you look at the lives of youths, you know they are immersed in a world that is rich in digital media for work, education, and leisure. However, excessive use of digital platforms can adversely affect their mental health, potentially leading to digital addictions or disorders. It is thus imperative to promote a healthy balance between digital engagement as well as offline experiences to safeguard their overall well-being.
16. Today, our young are inundated with vast amounts of information and interactions – much of which they may not have the maturity to fully process the information. This constant engagement that they have online often displaces physical play and real-world interactions with real people and situations and all that is crucial for healthy development. Over time, these imbalances can impact their mental health and resilience.
17. So we have to look at enhancing mental health literacy in our young to equip in them age-appropriate skills to manage technology effectively.
18. Addressing behavioural addictions requires collaboration across public agencies, schools, healthcare providers, and the broader community. By integrating education, prevention, and treatment strategies, we can mount a more effective response to addiction. Early detection and timely intervention are crucial in preventing these issues from escalating.
19. We must thus ensure that there are clear and practical guidance available and accessible across healthcare settings, schools, and homes. Locally, there will be new measures to manage digital device use. It will be rolled out in the coming months, reinforcing our commitment to strengthening the mental resilience of our youth.
20. Shortly, we will also be launching a book on internet gaming disorder, produced by the National Addictions Management Service. This resource will guide professionals, such as clinicians, youth workers, and other professionals, on how to support young people in navigating the digital landscape safely.
Enhancing the Mental Health Ecosystem in Singapore
21. As challenges evolve, we must ensure our mental health ecosystem remains robust and adaptable. Our tiered approach to supporting mental health challenges ensures timely diagnosis, early intervention, and tailored support for every level of need. This strengthens Singapore's mental health ecosystem.
22. Through cross-sector collaboration, we are building an inclusive, responsive, and sustainable mental health ecosystem, ensuring that every individual has the support they need to lead a fulfilling and mentally healthy life.
Closing
23. This congress reaffirms our commitment to building an effective and inclusive mental health ecosystem. Together, we can make meaningful progress in supporting the mental well-being of our community.