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.

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.

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. 

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. 

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

1. 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).
2. 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).
   
3. 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).
   
4. 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).
   
5. 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).
   
6. 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).