December 2023 - Connections MindHealth - Mental Health Care

How can I convince a loved one to seek psychiatric help?

Poor mental health is a growing concern in Singapore. The National Population Health Survey (NPHS) 2022 revealed that poor mental health increased from 13.4 per cent in 2020 to 17 per cent in 2022

Posted on 18 Dec 2023

Written by
Dr Jared Ng, Connections MindHealth

Poor mental health is a growing concern in Singapore. The National Population Health Survey (NPHS) 2022 [1] revealed that poor mental health increased from 13.4 per cent in 2020 to 17 per cent in 2022 (with young adults contributing to the highest proportion of poor mental health at 25.3 per cent). Whilst this increase may not be dramatic per se, it is an indicator that the state of mental health in the country is significantly declining. The survey also revealed that young adults are most vulnerable to declining mental health.

In our lives, it is common to have an inkling about a loved one’s deteriorating well-being. Whether you’re a parent, sibling, friend, partner, or colleague, you may have felt the urge to intervene in the lives of someone you care about in hopes that they would seek professional psychiatric help. However, this display of love can be tricky.

The stigma around the topic of mental health is, unfortunately, still evident in our communities. A 2017 [2] study in Singapore revealed that almost half (approximately 44.5%) of respondents, made up of adolescents, associated mental illnesses with negative, derogatory terms like “stupid”, “dangerous”, “crazy”, and “weird”, while 46.2% of them said they would be “very embarrassed” if they were diagnosed with a mental illness.

Concerned Asian woman — Whilst young adults are most troubled with mental health in Singapore, our teenagers also seemingly have high levels of negative connotation to the issue.

Given the negative connotation around the subject, how can you masterfully suggest seeking help for the ones you love? In this article, we have provided a comprehensive guide on techniques to convince a loved one to seek psychiatric help.

1. Don’t push the trigger button

Culturally, Asians seem brasher in casual conversations, though it is not necessarily intended with malice. For instance, a mother may observe her son’s binge eating tendencies and voice it as “You are going to become fat if you keep this up!”. Whilst this sentence, when dissected, is harsh, there is often genuine concern about her son’s well-being and the impact that binge eating will have on his health.

However, the method employed by the mother will not halt her son’s binge eating tendencies. If anything, it may cause further upset and fuel the root cause masked by this specific behaviour. So, how can you approach your loved ones tactfully?

The first step is to understand their list of triggers. For example, for individuals dealing with anorexia, pointing out their weight loss, whether positively or negatively, could further encourage starvation behaviour. The trigger, in this case, is weight loss. If you’re dealing with a loved one who’s depressed, blatantly pointing out their behaviour change could result in self-consciousness.

consoling son — Be tactful and loving when approaching a loved one with concerns about their mental health.

Instead, frame your concern with more caution. For example, when initially approaching a loved one, your concern may be worded as:

“I am worried about your health and the future consequences. Do you have any intention of remedying them?”
“ I am deeply concerned and hope I am not overstepping, but it appears you are demotivated to nourish yourself. Would you like to talk about it?’”
“I intuitively feel that you may be burdened by something. Is there an issue that is lying heavy on your heart? I hope you know I am always ready to listen.”

As shown in the examples above for various cases, when initiating a conversation about issues presented by your loved ones, you first take away the spotlight from them by highlighting how YOU are genuinely concerned for them with I-statements [3]. Once the concern you have presented is received positively, you can open the doors to seeking psychiatric help.

2. Tone it down

As important as it is to carefully curate your words when approaching a vulnerable individual, the tone of your voice is crucial. Have you ever gotten into an argument because the opposing party claims your tone was disrespectful, condescending or even patronising? Most people lack awareness of how their tone of voice [4] could add more fuel to the fire. As the famous saying goes, it is not what you say but how you say it.

When speaking to a loved one in a troubled state of mind, it is important to present your intention as “concerned” versus “accusatory”. Your tone of voice will definitively play a significant role in how the message is relayed and received. When attempting to suggest to a loved one to seek psychiatric help, you should:

Speak in a lower tone: psychologically troubled people may be defensive and argumentative; however, that does not justify you raising your voice at any point. Stay firm with your intention and remind yourself they do not necessarily come from a malicious place.
Speak slowly: make sure to add pauses and provide conversation space. If you are talking over your loved one or rushing through your “speech”, it may be difficult for them to capture your intention. Remember, you are also creating space for them to open up about the issues they may be battling.

“How do I know if my tone is right?’. For starters, try recording yourself and listen to how you sound. Often, this might suffice for you to correct your tone before approaching the one you love. You may also attempt a role-play with a trusted friend or family. Ask them to react negatively and observe if your tone changes when challenged.

This is not to say that you should put up with disrespect or that an emotional reaction is unwarranted when boundaries are crossed. We are fully aware that the average person is not a trained professional, so if the conversation becomes heated at any point, diffuse the situation immediately and hold the conversation for another day.

Partner consoling his wife — Speaking calmly and gently is essential in opening up conversations about seeking psychiatric help.

3. Set and setting

As mentioned before, it is possible for a well-intended conversation to turn sour quickly. Therefore, taking some time to choose the right location to have this conversation is just as important. We advise opening a sensitive discussion, such as seeking psychiatric help in a private setting, perhaps in a familiar and safe place, like homes or favourite cafes. Padding the location with some of their favourite foods or drinks adds an element of comfort and encourages your loved one to open up.

Essentially, you should try not to have sensitive conversations in a sterile environment, including their workplace or people they may react sensitively to. For instance, attempting to approach your sibling at home where your parents are possibly eavesdropping or would be quick to insert themselves in the conversation could cause further damage. Your intention may even be questioned as an attempt to humiliate or embarrass.

If you attempt to help a coworker or subordinate, doing so over a dinner, which offers some privacy, may be better than a “meeting” in a conference room. Alternatively, a video call could be advantageous as they would be at home, allowing them to ruminate about the conversation within the safe walls of their home.

Girl supporting loved one — Holding sensitive topics in a private and safe setting would help your loved ones to open up.

4. Be prepared for the rebuttals

In a society like Singapore, suggesting psychiatric help may cause a backlash. So be prepared for all the possible reasons your loved ones might oppose the idea, such as:

Are you suggesting I am crazy?: Just because I can’t visibly see the state of your mind doesn’t mean you should be deprived of help. I am in no way stating you are crazy, but I think it’s time you sought help in the name of self-kindness.
People will think I’m weird: weirdness is a subjective idea. I think you are an amazing person, and watching you deteriorate over poor mental health saddens me. It is my intention to preserve the beautiful person that you are, even if that means seeking psychiatric help.
I can’t afford an embarrassing diagnosis: a diagnosis is not a label nor a life sentence. It will help you accurately identify the issue at hand. You will then have all the tools to manage your life effectively and learn to navigate complex situations with a professional. I genuinely believe you deserve assistance to reach your peak potential in life. Please don’t allow a diagnosis to hinder you.

As presented above, these rebuttals are not argumentative but come from a place of empathy. You are also wording your rebuttal in ways that present elements of support and care.

5. Physical assistance

Assuming you are successful at the conversation phase of this process, it is now time to be physically involved. This includes guiding them to the appropriate healthcare provider, setting them an appointment (with their consent), following them to their first session, or even driving them to the clinic. When the person you love is vulnerable and potentially mentally distraught, these seemingly “simple” tasks could easily overwhelm them. Gifting them your time and effort will bring comfort and a sense of security to your loved ones.

We recognise that intervening in the lives of a loved one and taking up some load could easily overwhelm an individual. Do not risk your mental health in the process of helping others, as this would not be beneficial to any party. Carefully gauge your comfort level and the extent you are willing to commit. Refrain from overpromising and under-delivering, too, as this could further disappoint the ones you love.

Wrapping up

If you’ve reached the end of this article but feel uncomfortable executing any of these steps, you can instead identify the next best person to help the ones you love. This should be someone you believe also has your loved one’s best interest and can execute this process more efficiently.

If you believe the person you love is at risk of harming themselves or the people around them, you must consider contacting emergency lines in Singapore: 995 for an ambulance or 999 for a police emergency. You can also call the SOS Hotline (1767) or the IMH Helpline (63892222) If you believe the issues are urgent but do not warrant contacting the police/SCDF ambulances. If you have general inquiries, contact us to guide you per your specific situation.

We applaud you for caring for the people you love and doing the due research. We hope that stigmas surrounding mental health are eliminated in the years to come. Until then, as long as one is surrounded by people who care for them like yourself, hope remains.

References

Ministry of Health Singapore (2022) National Population Health Survey 2022 , NATIONAL POPULATION HEALTH SURVEY 2022. Available at: https://www.moh.gov.sg/docs/librariesprovider5/resources-statistics/reports/nphs-2022-survey-report-(final).pdf (Accessed: 08 December 2023).
Pang, S. et al. (2017) Stigma among Singaporean youth: A cross-sectional study on adolescent attitudes towards serious mental illness and social tolerance in a multiethnic population, BMJ open. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652546/ (Accessed: 08 December 2023).
Rogers, S.L., Howieson, J. and Neame, C. (2018) I understand you feel that way, but I feel this way: The benefits of I-language and communicating perspective during conflict, PeerJ. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5961625/ (Accessed: 08 December 2023).
Raeburn, D.C. (2022) Improving and watching your tone of Voice, Raeburn Psychology . Available at: https://carolinaraeburn.com/improving-and-watching-your-tone-of-voice/#:~:text=Your%20tone%20of%20voice%20is,language%20through%20conversation%20with%20others. (Accessed: 08 December 2023).
Ho, R.C. et al. (2015) An overview of mental health legislation in Singapore, BJPsych international. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618915/#:~:text=The%20Mental%20Health%20(Care%20and%20Treatment)%20Act%202008,-The%20Singapore%20Mental&text=Under%20the%20new%20Act%20(see,for%20up%20to%2072%20hours. (Accessed: 08 December 2023).
Institute of Mental Health Homepage (no date) Institute of Mental Health. Available at: https://www.imh.com.sg/Pages/default.aspx (Accessed: 11 December 2023).

TAGS

Mental Health

Exploring the Rising Concern of Teenage Depression in Singapore

The rising rates of teenage depression in Singapore underscore the urgent need for early intervention and community support, with parents playing a crucial role in fostering open communication, recognizing symptoms, and seeking professional help when needed.

Key takeaways

The prevalence of teenage depression in Singapore, highlighted by a recent NUS study, emphasizes the critical importance of early intervention and community support.
Academic pressures, societal expectations, and the impact of social media contribute to the rising rates of depression among Singaporean youths, creating a complex web of challenges.
Parents play a pivotal role in addressing youth depression by fostering open communication, building resilience, and taking immediate steps, such as seeking professional intervention, if they suspect their child is depressed.

Posted on 8 Dec 2023

Written by
Dr Jared Ng, Connections MindHealth

Teenage depression is not just a ﬂeeting phase of adolescence; it’s a serious mental health issue that has been gaining increasing attention. A recent study by the National University of Singapore (NUS) has found that one in 10 teenagers in our nation suffers from at least one mental health disorder. This study, which surveyed over 3,300 adolescents, also revealed that a significant number of youths are turning to digital media as a form of self-therapy. Additionally, the study highlighted a crucial need for improved mental health literacy among parents and these findings add urgency to the issue of teenage depression. This article aims to delve into the complexities of teenage depression in Singapore, emphasizing the critical importance of early intervention and community support.

Differentiating Normal Stress from Depressive Disorders

Navigating a new environment, grappling with the pressure to forge new friendships while possibly parting ways with old ones, and adapting to new teachers and academic challenges can all contribute to feelings of stress and anxiety among teenagers. Normal stress often arises from these specific situations and usually subsides as the child adjusts to the new setting. Symptoms like temporary mood swings, mild sleep disturbances, or short-term changes in appetite are often related to these transitional challenges and should not immediately be a cause for alarm.

In contrast, symptoms of depressive disorders are more pervasive and persistent, affecting multiple areas of life for an extended period, often for more than two weeks. These may include sustained changes in eating and sleeping patterns, withdrawal from friends and activities, and a decline in academic performance. Unlike normal stress, depressive symptoms often lack a specific trigger and may be accompanied by feelings of worthlessness, excessive guilt, or thoughts of self-harm or suicide

Why Depression is on the Rise Among Youths in Singapore

The increasing prevalence of depression among Singapore’s youth is a multi-faceted issue with a range of contributing factors. One of the most significant is the intense academic pressure, often exacerbated by high societal expectations. Interestingly, this pressure is not solely external; many youths internalize these expectations, placing immense pressure on themselves to meet high academic standards, even when parents and teachers may not explicitly demand it.

The role of social media is another crucial factor. While it oﬀers a platform for connection and self-expression, it also has a darker side. The constant exposure to curated lives can lead to unhealthy comparisons, aﬀecting self-esteem and body image. Cyberbullying is another significant concern, with the anonymity of the internet providing a shield for harmful behavior. The emotional toll from cyberbullying can be severe, leading to feelings of isolation, anxiety, and depression.

Additionally, the fast-paced lifestyle and competitive nature of Singaporean society can contribute to emotional distress. The constant race to “keep up” can lead to burnout and feelings of inadequacy, further fuelling the cycle of depression.

The Role of Parents in Addressing Teenage Depression in Singapore

Understanding the root causes of depression is one of the first steps parents can take in oﬀering eﬀective support to their children. Open communication is crucial; a strong parent-child relationship can encourage your child to share their feelings and concerns openly. This open dialogue can serve as an early warning system, helping to identify symptoms of depression before they escalate.

It’s important for parents to recognize that adolescence is a time of individualization and identity formation. Behind the symptoms and behavioral issues is a teenager trying to find his or her own place in the world. This process can be emotionally taxing and may lead to internal conﬂicts that the teenager might not readily share, especially if the parent-child relationship has not been strong.

Parents also have a role in building resilience in their children. Activities that encourage problem solving, a positive home environment, and emotional support can all contribute to resilience. The recent NUS study emphasized that higher resilience scores were associated with better mental health, underlining the importance of emotional support and resilience-building activities. Moreover, parents should be aware that their children may not always be forthcoming about their struggles, particularly if the parent-child relationship has been strained. This makes it even more essential to foster a supportive and open environment where the child feels safe to share their feelings without fear of judgment or repercussions.

The Importance of Early Intervention for Teenage Depression in Singapore

Early intervention is key in managing and treating depressive symptoms in youths. The sooner the symptoms are recognized and addressed, the better the chances of preventing the escalation of the condition into more severe mental health issues. Untreated depression can lead to a host of negative outcomes, including academic decline, social withdrawal, and worsening emotional well-being.

Most critically, untreated depressive illnesses significantly increase the risk of self- harm and suicide. According to various studies, adolescents with depressive disorders are more likely to engage in self-destructive behaviors, including self-harm and suicidal ideation. Early intervention can be a life-saving measure, providing the necessary medical and psychological support to manage these severe symptoms effectively.

By acting early, parents, healthcare providers, and educators can work together to develop a comprehensive treatment plan that addresses the child’s unique needs. This collaborative approach not only helps in treating the immediate symptoms but also equips the child (and family) with coping mechanisms and resilience skills that will benefit them in the long term.

Immediate Steps Parents Can Take If They Suspect Their Child is Depressed

If parents notice or suspect that their child is exhibiting symptoms of depression, immediate action is essential. The first step is to have an open and non-judgmental conversation with the child. It’s crucial to approach this dialogue with sensitivity, ensuring that the child feels safe and supported in sharing their feelings.

If the symptoms persist or worsen, professional intervention becomes necessary. Consulting a healthcare provider for a comprehensive evaluation can provide a clearer picture of the child’s mental health status. Depending on the severity of the symptoms, treatment options may include psychological therapy, medication, or a combination of both.

It’s also important to engage with the school as part of the intervention process. Every school in Singapore has trained counsellors who can offer additional support and resources. Open communication with schoolteachers is equally vital; they can provide another perspective and may have more insights into the child’s stressors and triggers, especially if academic performance is declining or if there are concerns about the child’s social interactions.

Moreover, parents can seek out support groups or educational resources to better understand how to manage and cope with their child’s condition. Knowledge is power, and the more parents understand about depression, the better equipped they will be to support their child effectively.

Caring for the Parents

While much focus is given to the well-being of the child, it’s crucial not to overlook the emotional and mental health of the parents. Parenting a child with depression can be an emotionally taxing experience, often leading to feelings of helplessness and guilt. Remember, you’re not alone, and it’s okay to seek help for yourself. Support groups, counselling, and even talking openly with friends and family can offer much-needed emotional relief. Taking care of yourself is not an act of selfishness; it’s a necessity. When you are emotionally healthy, you’re better equipped to provide the support your child needs.

Conclusion

The rising rates of mental health disorders among Singapore’s youth are a pressing concern that calls for immediate action from parents, educators, and healthcare providers. Parents play a crucial role in early detection and intervention, but it’s important to remember that help is always available, especially when the emotional toll becomes overwhelming.

Schools offer additional support through trained counsellors, and healthcare providers can provide professional treatment options. Early intervention is key, as untreated depression can lead to severe consequences, including self-harm and suicide. Together, we can create a supportive environment to address this growing issue effectively.

TAGS

Depression

References

https://www.channelnewsasia.com/singapore/teens-youth-mental-health-disorder-nus-study-support- parents-resilience-3448571

Not Just a Label – Embracing Potential and Personal Triumphs in ADHD

The recognition of Attention Deficit Hyperactivity Disorder (ADHD) has evolved significantly over the years, shedding outdated stereotypes that once led to mislabeling children as naughty or unintelligent.

Key takeaways

From being initially mislabeled, there has been a significant shift in understanding ADHD, emphasizing support over punishment.
The heightened awareness of ADHD has resulted in a surge in non-therapeutic diagnoses, necessitating comprehensive assessments and collaborative approaches for accurate diagnosis and effective management.
A holistic strategy is advocated, emphasizing the combination of medication with non-medication interventions, recognizing the complexity of ADHD and its co-existing conditions.

Posted on 8 Dec 2023

Written by
Dr Jared Ng, Connections MindHealth

The recognition of ADHD has expanded significantly in Singapore, yet this heightened awareness has its downsides. There’s a growing tendency to hastily ascribe various behaviours to ADHD, precipitating an upsurge in diagnoses and requests for medication. This is particularly noticeable in academic contexts where students may seek an ADHD diagnosis, not necessarily for managing symptoms but to secure special accommodations or get prescribed stimulant medications. Such a trend muddles the clarity of genuine ADHD cases and ignites ethical debates about the appropriateness of using ADHD medications as tools for cognitive enhancement rather than their intended therapeutic purpose.

Diagnosing ADHD necessitates a comprehensive approach, incorporating detailed assessments and corroborative information from various sources like caregivers and educators, to accurately understand a child’s behaviour in different environments. Medications like Methylphenidate and Lisdexamfetamine have been pivotal in managing ADHD, enhancing brain neurotransmitter levels to improve focus and decrease impulsivity.

While these stimulant medications can be transformative, improving school performance and interpersonal relationships, they require careful monitoring for side effects such as loss of appetite, sleep problems, and mood swings. Hence, it is crucial for psychiatrists to collaborate closely with parents and educators, fine-tuning treatment plans to ensure the best outcomes for the patient.

Effective management of ADHD often requires combining medication with other non-medication strategies.

Behavioural therapy is instrumental in teaching children organizational skills, focus enhancement techniques, and impulse control. Additionally, parental training provides caregivers with strategies to establish supportive home environments, fostering consistency and positive reinforcement.

Yet, the narrative of success for individuals with ADHD should not be narrowly defined by occupational attainment or academic accolades. True success is about harnessing one’s potential and finding joy and fulfilment in life. Jamie’s story embodies this. I first saw Jamie because he was struggling in a “traditional” academic setting in Singapore. He eventually found his calling in the culinary arts, leveraging his ADHD traits of creativity and quick thinking to run a successful small restaurant. He recently told me that he is planning for a sister restaurant! Jamie’s contentment in his career choice and the sense of community he has built are his personal measures of success.

It is important to note that ADHD’s complexity is often compounded by co-morbid conditions like learning disorders, depression, and anxiety, which require equal attention in diagnosis and treatment. The presence of learning difficulties such as dyslexia or dyscalculia can magnify the academic challenges faced by children with ADHD. Mental health conditions like depression and anxiety can stem from or exacerbate ADHD symptoms, creating an intricate cycle that demands a comprehensive treatment approach.

The treatment for ADHD and its co-morbidities is not uniform but tailored to each individual. A child may benefit from stimulant medication for focus but may also need support for reading comprehension or managing social anxiety. Behavioural therapy and parental support play multifaceted roles in treatment, offering strategies to manage ADHD symptoms and cope with associated emotional and learning challenges.

As we assist those with ADHD, we must be vigilant for signs of co-morbid conditions, providing a holistic support system that nurtures not only academic capabilities but also emotional well-being.

Our goal is to facilitate a state of well-being where individuals with ADHD can realize their potential and find contentment—this holistic perspective is the essence of treating ADHD.

In summary, success for those with ADHD is deeply personal, characterized by achieving well-being and happiness. It is about creating environments where their unique abilities are recognized and cultivated, ensuring that the true mark of success is living a life enriched by their experiences and talents, where they feel content and valued.

TAGS

ADHD

Volunteer Stories: From Hours to Impact

Posted on 8 Dec 2023

Written by
Connections MindHealth

TAGS

SIF