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May 1, 2007

Stigma Worsens Mental Illness

A newspaper (MindYourBody) article from a few months (Jan 2007) back. My own views are placed below of the article.

========================================================
Stigma worsens mental illness

By Shefali Srinivas -
The Straits Times

A steady, simple job and acceptance from people are top of the wishlist for patients recovering from mental illnesses. But these very things are in short supply and have significant impact on whether the road to recovery is rocky or smooth.

Even though mental illness can strike any one at any age - people with these conditions face fear, hostility and disapproval rather than compassion, support and understanding.

This stigma and the role it plays in mental illness was the subject of a recently concluded study at Institute of Mental Health (IMH) in Singapore.

Nurse educator Poh Chee Lien, who was involved in the study, said the aim was to find out the extent to which patients encountered stigma and if they had any strategies to deal with it.

While the study results are yet to be published, it was conducted by nurses who looked specifically at schizophrenia and the stigma that recovering schizophrenics face.

For the full article, refer to the link below
Stigma worsens mental illness
======================================================

In one of the last few lines of the article, Prof Chong said "'You can gauge how civilised a society is by the way they treat their mentally ill." I would say, we can gauge how gracious and how kind/unkind a society is by the way they treat the mentally ill.

Those who go through mental illnesses are treated as outcasts. Yet I find myself seeing that their discrimination comes from their fears of what they do not understand. For a society like Singapore, it can be rather difficult to accept that we actually are still so ignorant, filled with so much misperceptions and intolerance. Yet as mentioned, in all honest truth, can we blame them? I don't think we can or should. For it is all too human for us to fear the unknown. What then can be done to fight the stigma? What can we do more to spread understanding and awareness.

How much are we all as part of society doing our part in listening?

I hope to see the day where mental illness sufferers here can be treated with more kindness, understanding and acceptance.

Off Centre

Off Centre

First staged in 1993 to critical acclaim, Off Centre is recognised as a
landmark play in the history of Singapore theatre, best remembered for
bringing mental illness and its patients’ plight to the attention of
the media and general public in Singapore. The play traces the
friendship of Saloma and Vinod and the hurdles they have to overcome,
including social stigmas, prejudices and personal conflicts.


Off Centre has also been selected by the Ministry of Education as the
first Singapore play to be offered as a GCE ‘O’ Level literature text
from 2007, and has been republished by The Necessary Stage.


9, 12 – 13, 16 – 20 May 2007, 3pm
9 – 12 May, 18 – 19 May 2007, 8pm

$30 | $21* (Excludes $2 SISTIC ticketing fee)
* Concessions for students, NSF & senior citizens

Get your tickets from 1 Mar 2007 at all SISTIC authorised agents,
online at www.sistic.com or via the SISTIC hotline at 6348 5555.

For more information or for school and corporate bookings, please
contact us at Tel: 6440 8115 or email: admin@necessary.org

May 2, 2007

Mediacorp's Radio Interview with Off Centre's Director Alvin Tan

An interview done by Mediacorp Radio with Off centre's (refer to the last blog entry for more information) director Alvin Tan about their journey and research that went into this play.

Read the interview here
http://www.rsi.sg/english/artsarena/view/20070426170427/1/.html


My thoughts.

I had the opportunity and privilege to hear and speak to Mr Alvin personally a couple of days ago spoke about his own experiences and story regarding his brother and his family. I won't go into details but it was heartwarming to hear from him his brother's route to recovery and will to live, as well as the support and patience his brother has received from their parents. I could see that it couldn't have been easy all these while for their family and I truly wish them well and hope that the play would help spread more awareness of mental illness.

Thank you Mr Alvin for sharing with me.

May 4, 2007

Mentally Ill Kids Face Widespread Stigma

This news report came from the US.

By Randy Dotinga
HealthDay Reporter Mon Apr 30, 7:01 PM ET

MONDAY, April 30 (HealthDay News) -- Children with mental illness may face a double burden -- the condition itself, and discrimination and stigma at school and elsewhere, a new survey shows.


Almost half of U.S. adults polled expected that children undergoing mental health treatment would be rejected at school, and half anticipate that these youngsters will also suffer problems later in life.

At the same time, almost nine out of 10 Americans believe that doctors overmedicate kids with behavior problems.

"It's pretty clear that there's a lot of prejudice and discrimination about children's mental health problems in American culture," said lead researcher Bernice Pescosolido, professor of sociology at Indiana University. "These attitudes and beliefs are very powerful in terms of what happens to kids and their families."

Pescosolido said she and colleagues began examining attitudes about mental illness after reading news reports that stigma had begun to disappear. These came alongside what she called an "extraordinary tidal wave of [media] response" that was largely critical of changes in the treatment of mentally ill children.

Drugs are being prescribed more often to kids, and psychiatrists are diagnosing illnesses at much younger ages, Pescosolido said. Indeed, there are reports of kids being diagnosed when they are little more than babies.

For this study, her team examined the results of a 2002 survey of almost 1,400 adults; the margin of error was plus or minus four percentage points. The findings are published in the May 2007 issue of the journal Psychiatric Services.

Forty-five percent of those surveyed believed that kids who were undergoing mental health treatment would be rejected by their classmates at school, and 43 percent said that stigma around mental health issues would create problems for them in adulthood.

"No matter what that person attains later in life, this will follow them around," Pescosolido said. "This is classic stigma, when someone is marked and seen as less than (others)."

But stigma also could prevent people from getting the treatment they need, Pescosolido said.

Meanwhile, most of those polled were "very negative about the use of any kind of psychoactive medication for children's mental problems," she said. In fact, 85 percent of people surveyed said kids are already overmedicated for common behavioral problems, and over half (52 percent) felt that psychiatric medication "turns kids into zombies."

Could they be right about kids taking too many medications? "I'm sure there are some [cases], but how much do anecdotal stories really match the reality? I don't think the science is there" to provide answers, Pescosolido said.

She added that there are big differences in how people view the use of drugs to treat physical illness and mental illness. "If your child had diabetes, and you needed insulin, would you wring your hands over that?" the researcher said.

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Schneider Children's Hospital in New York City, said he encounters bias against the use of psychiatric drugs every day.

"There's a disconnect," he said. "The public is generally looking to embrace evidence-based treatments (for other conditions) yet rejecting pharmaceutical interventions when data suggest it works."

What to do? Pescosolido called for a better mental health care system and more discussion about prejudice and discrimination that targets mentally ill kids.

http://news.yahoo.com/s/hsn/20070430/hl_hsn/mentallyillkidsfacewidespreadstigma;_ylt=AvO5ewSo7iupjffLVBMh3WrVJRIF

May 5, 2007

Study Guide For Local Play (Off Centre)

Mr Alvin is kind enough to forward this article to me.

Life! Arts
The Straits Times
Thursday, May 3, 2007
Pg 12

Study guide for local play

A former lead actor in the play Off Centre, which is a GCE O-level
literature text, has written a guidebook to it

Adeline Chia
ARTS REPORTER

YOU could say Abdulattif Abdullah is the perfect man for the job.

The 39-year old English and literature head in Bukit Batok Secondary
School, who played lead character Vinod in Off Centre when it was first
staged in 1993, has written a student’s guidebook to the play.

He had married a fellow cast member, Sakinah Dollah, who played the
female lead, the following year. The study guide was written because
the work by playwright Haresh Sharma of The Necessary Stage (TNS) has
been selected as a GCE O-level literature text this year.

The seminal work about mental illness is the first Singaporean play to
become an O-level text. Not all schools have to study it as they can
use another play on the syllabus, but 13 schools are doing so this
year.

The play is about the friendship between Vinod, a top debater in school
who has a mental breakdown, and a 19-year old, schizophrenic called
Saloma. It is best remembered for bringing the plight of mental
patients to the public’s attention.

For the past six months, Abdulattif and colleague Ruth Tan, 28, have
been writing a 40-page guidebook, which includes sections on
characterization, plot, themes and sample essays.

“It has a lot more details than your typical Cliff Notes
guidebook,” he
says. They are still looking for a publisher but hope to have the book
ready by July in time for the school exams in September.

He says his involvement in the play more than a decade ago gave him
unique insights.

Together with Sharma and TNS artistic director Alvin Tan, he spent
months researching and interviewing mental patients and working out the
roles in workshops.

Also, having played Vinod gave him a deeper understanding of the
character’s motivations which he hopes to share with students.

“If anything else, I can talk to my wife about it,” he says with a
laugh. He has three children with Sakina, 34, who now runs a
pre-school.

Off Centre joins two other Singaporean texts in the O-level curriculum.
They are Heartland, a novel written in 1999 by lawyer Darren Shiau,
and Island Voices, a 2007 anthology of Singapore short stories
commissioned by the Education Ministry.

The ministry said the play was included because it satisfied the
criteria for literature texts, which include To Kill A Mockingbird by
Harper Lee and A Midsummer Night’s Dream.

“Off Centre explores a wider range of themes such as marginalisation,
friendship, and societal and familial pressures. The play has good
characterisation, dramatic potential and accessibility,” said a
ministry spokesman.

The play has been restaged thrice since its debut in 1993. The most
recent revival was in Malay, called Otak Tak Centre in Kuala Lumpur two
years ago.

Over the past 14 years, Off Centre has also been made into an
experimental feature film and adapted into a television movie, both
with the same title. It has also been given a full reading in Britain
and taught at the International Islamic University Malaysia in Kuala
Lumpur.

Sharma, 41, has been giving talks to teachers since it was announced
the play would become a school text, and even had a webchat with
students on it.

“I feel like a mini-literary celebrity,” he jokes.

And for an entire generation of students who had missed the first run,
TNS is restaging the play this month.

Alvin Tan, 44, who directs the play, says Off Centre remains relevant
today because prejudice against mental health patients still exists.

“I still hear of people whose salaries get halved because employers
think that if you have mental health issues, you’re not so
productive,” he says.

He adds that Off Centre is also a timeless play about human
relationships, such as the friendship between the lead characters Vinod
and Saloma.

Playing Vinod this time is Melvinder Kanth, 34, an actor and
documentary film-maker. Saloma is played by Mislina Mustaffa, 36.

And reprising her 1993 role as Saloma’s mother is actress Alin
Mosbit, 33.

Alin says she is now closer to the actual age of her character, who is
in her late 40s. In the first Off Centre production, she was only 19.

She adds: “The character is more curt and much harsher – she has a
darker streak this time.”

chiahta@sph.com.sg

Off Centre will be staged at the Esplanade Theatre Studio from May 9
to 20 with 3pm shows on May 9, 12 and 13, and from May 16 to 20; 8pm
shows on May 9 to 12, May 18 and 19.

Tickets at $30 from Sistic (www.sistic.com.sg, tel: 6348-5555).

May 9, 2007

Fighting And Understanding The Woodbridge Stigma

A well written article in the below link about the nature of the Woodbridge Hospital (now known as the Institute of Mental Health) stigma by a local undergrad.

http://www.singaporeangle.com/2007/02/fighting_and_understanding_the.html

There is a stigma to IMH/woodbridge even among those who's mentally ill. Mention to some of them that they have to get hospitalised there, and you can just see how terrified they can get.

May 13, 2007

Off Centre Post Event Talk – About Schizophrenia

This event and news is taken from SilverRibbonSingapore's website at
http://www.silverribbonsingapore.com/news.htm


Off Centre Post Event Talk – About Schizophrenia
22 May 2007
Institute of Mental Health
Lecture Hall
Free Admission
*First-come-first serve basis.
To register at info@silverribbonsingapore.com

Join the following speakers to understand more about Schizophrenia!

Dr Lim Choon Guan
Psychiatrist, Institute of Mental Health

Mr Alvin Tan
Founder/Artistic Director, The Necessary Stage

Mr Haresh Sharma
Resident Playwright, The Necessary Stage

Mr Harris Ng
President, Association for The Open Mind

Dr Rita Goh
Founder, Aspiron Services

May 15, 2007

What We Can Do To Fight Stigma And Help Those Who Are Mentally ill

My below are my own thoughts and suggestions on how we can help fight stigma and to better reach out to those who are mentally ill or grieving.


1) The first and foremost is to understand and educate ourselves on what mental illness is about. What it means to those who go through mental illness.
That however as I mentioned in my previous posts isn't enough.

2) Reach out to those going through mental illness. Don't judge. Learn what it means to truly listen and empathise. Offer them the gift of your listening and understanding. Don't try to fix them or offer advice. Simply listen to them and understand.

Practice makes perfect.

"The way of being with another person which is termed empathic means temporarily living in their life, moving about in it delicately without making judgments.... To be with another in this way means that for the time being you lay aside the views and values you hold for yourself in order to enter the other's world without prejudice...a complex, demanding, strong, yet subtle and gentle way of being."
Carl Rogers

3) Learn what it means to truly listen. Practise how to listen.

Reassuring someone isn't the same as listening.

4) With every opportunity possible, do what we can to help speak out against the stigma against mental illness sufferers. Many mental illness sufferers are afraid to voice out their condition, you'll be surprised who may admit to you they are going through such a condition or know of someone close to them who does if you speak out and show acceptance for them.

5) Naturally, don't join in the bandwagon on calling mental illness sufferers as "siao", "psycho" or "crazy." It's rude, discriminating, insensitive and downright unkind.

Don't call those people who self-harm as attention seeking. Most people don't realise that self-mutilation for instance may be the person's way of coping, however dysfunctional others may see it.

And don't call those people who are considering, or attempted or commited suicide as "cowards."
Don't judge.

The kindest word in all the world is the unkind word, unsaid. ~Author Unknown

6) Have faith in them. Believe in them. Help them and help yourself understand that it is going to take time for them to recover, but they will (recover). Whatever they're going through, "It will pass in time." The important thing is, you must believe it yourself in your belief in them

"Treat a man as he appears to be and you make him worse. But treat a man as if he already were and what he potentially could be, and you make him what he should be." - Johann Wolfgang von Goethe

7) When they are slow in their recovery or in their signs of progress, or those who are grieving be patient with them. Don't rush them. Don't try to set datelines in saying/thinking that they have grieve/depressed enough. Let them move at their own pace.

Any frustration at their lack of progress stems from our own impatience. Work on our impatience instead and learn to be patient. Be patient with ourselves and be patient with them. Encourage them, don't give up on them.

"Patience makes lighter what sorrow may not heal." - Horace

8) There is a stigma against the male gender on that men shouldn't cry. If people are in pain and they wish to cry, let them, don't deny them that, male or female. The ability to cry is part of what makes us human

"But there was no need to be ashamed of tears, for tears bore witness that a man had the greatest of courage, the courage to suffer." - Victor E. Franklin

9) Don't say things like "they shouldn't feel this way."
Acknowledge their feelings. Do not invalidate their feelings.

Feelings are facts to the person experiencing them.

10) Don't give up. We are human beings, flawed in our own ways. We may make mistakes everyday in our effort to combat stigma or in reaching out to others. What matters is that we continue to learn from the mistakes we make.

Understanding and the art of listening can be learnt and acquired.

With every mistake, humility can be acquired. And with humility, the better understanding and empathy we can extend to others.

Be kind. Everyone you meet is fighting a hard battle - Plato

May 16, 2007

Straits Times Life! (15th May 2007) And TODAY's (14th May 2007) Review Of Off Centre

Life! - Life Arts

Off Centre is right on
Adeline Chia, ARTS REPORTER
432 words
15 May 2007
Straits Times
English
(c) 2007 Singapore Press Holdings Limited

OFF CENTRE The Necessary Stage Esplanade Theatre Studio Last Saturday

FIRST performed to rave reviews in 1993, Off Centre by The Necessary Stage (TNS) was lauded as a seminal play highlighting the plight of mental patients.

It has been revived by playwright Haresh Sharma this year to mark two milestones: the company's 20th anniversary, and the introduction of the play into the GCE O-level Literature syllabus.

Fourteen years on and with so many expectations riding on its back, this powerful work shows its 1990s vintage but remains fresh and compelling.

On one level, the story is a timeless one about the complex relationship between two sensitive individuals. Vinod (played by a mercurial Melvinder Kanth) is a straight-A junior college student and school debater who suffers from depression.

He meets Saloma (played sensitively and with much pathos by Mislina Mustaffa), a schizophrenic girl who graduated from a vocational institute.

And by sheer craft and sensitivity, the script is a gem which tackles serious issues with liberal doses of humour. Vinod's suggestion for a slow suicide, for instance, is to 'stay in Singapore'.

The darker elements haven't lost their ability to shock and to move either.

The way in which a clothes hanger featured in a brutal, humiliating episode during Vinod's national service and in the fate of mental patient Emily Gan (played superbly by Josephine Tan) drew gasps from the audience.

There were also aspects of the play which were quaintly dated, although not alienating. Set in a time when batik T-shirts were in fashion, and before mobile phones were ubiquitous, the two friends chat over their land lines, sing to Boyz II Men and make radio dedications to each other over Class 95.

In a way, it was apt that director Alvin Tan kept these references, as a kind of a retrospective gesture to the company's performance history.

Off Centre still strikes a raw chord 14 years after it was first staged. Some of the reasons for Vinod and Saloma's breakdowns continue to sound familiar: a high-pressure society and uncomprehending and defensive family members.

It remains one of the play's piquant ironies that its relevance partially hangs upon malaises it seeks to address. The day that mental patients are treated with respect and sympathy is
the day of Off Centre's expiry date. That day may be a long time coming, even as Vinod and Saloma become familiar characters among O-level students.

chiahta@sph.com.sg


TODAY's review

Still Off after all these years

260 words
14 May 2007
TODAY (Singapore)
English
(c) 2007. MediaCorp Press Ltd.

IT SHOCKED 14 years ago, but the re-staged play Off Centre seems a tad
mild in today's context.

You can pick out what could have been taken as shocking for local theatre in 1993. Vinod, who suffers from depression, rants about God to Saloma, his schizophrenic girlfriend. He speaks of how Singaporeans avert their attention from what they are uncomfortable with - in this case, the idea of mental patients and their ability to live, and love.

The play sparked controversy when it was first staged due to what was deemed irreverent handling of a sensitive subject matter. The Ministry of Health, which commissioned it, took away its $30,000 funding after Haresh Sharma's script didn't suit their guidelines.

But this restaging reminds us of how much has changed since the early 90s; local plays now teem with such references to the Singapore psyche, mixing critique with humour in the way that Sharma did contentiously all those years ago.

Both Sharma and director Alvin Tan have chosen not to tamper with the original play so the references remain, from the use of Boyz II Men's End Of The Road, to the denim jeans and bandannas that served as fashion for NUS undergrads then.

It would have been interesting to see the play updated for our times, but its adamant retro-ness does underscore the fact that despite the years that have passed, some things remain the same. Off Centre is on until May 20, at the Esplanade Studio Theatre.

May 17, 2007

Photos From The Off Centre Play

All photos belong to and are credited to "The Necessary Stage"


Mislina plays Saloma in Off Centre.

Saloma: My social worker said I must come here. Rose. She always visit
me.


Melvinder Kanth plays Vinod and Mislina plays Saloma

Saloma [Narrator]: Saloma looked at Vinod and...and smiled. What else
could she do?
She liked him. He was crazy


Saloma: Must take. If not cannot become well. You take or not Vinod?


Mislina plays Saloma

Saloma: You can go back. I know you very busy. Got a lot of work to
do. So, you can go back


Alin Mosbit plays Mak (Saloma's mother) and Mislina plays

Saloma
Mak: Saloma, today is Friday. Today what we do? Asap rumah kan? See,
I put that
there OK? Dengar tak? Nak dekat Azan.


Mislina plays Saloma and Melvinder Kanth plays Vinod

Vinod: We are friends?

Mr Alvin was very gracious and kind to send me these nice photos of the play itself to post up.

All photos belong to and are credited to "The Necessary Stage"

May 21, 2007

Thoughts on Off Centre

This is just a personal entry so this isn't some official or unofficial review on the play.

I don't usually watch plays and I made this an exception due to the theme itself as I went to watch the play with my friend yesterday. I enjoyed the play a lot, the play lasted 1 hour 50 minutes, but I could have easily continued watching it for another 1 or 2 hours. Perhaps it's due to the fact that the theme is close to my heart, yet, without a realistic protrayal of the social situation and connection I could feel with the characters themselves, how would I have been able to enjoy it so.

While watching the show, I dare say a tinge of sadness and pain was felt because I know for myself how true and real the prejudices and the emotional and mental confilcts, and more importantly the struggles and fears that the characters face, for in the 2 characters Vinod and Saloma, I also see in them the cries and faces of some people that I know.

Vinod protrayed just how what depression supposedly is, "anger turned inward." His anger and frustrations, hidden in his fears. The seemingly stable but yet more fragile than the very girl he tried to befriend

Saloma on the other hand outwardly looks mentally and emotionally frail, yet in her, I see the courage and strength that she has deep down. Just like a friend of mine that I know who also suffers from schizophrenia coincidentally.

Emily, Saloma's friend in the play, despite how the character's manner of talking is understandably funny to most public, it brings about a sense of sadness again knowing that people like Emily truly do believe what they say and think. Delusions of grandeur.. bipolar disorder if im not mistaken.

There are several other characters I enjoyed watching in the play, among them would be Vinod's platoon seargant (not the captain mind you) who protrayed just how their fellow peers are also in a state of helplessness themselves, unable to rise against those above them in rank in the army, and not knowing how to truly help people like Vinod.

It thoroughly annoyed my friend and I that some people in the audience were constantly laughing, annoyed in the sense that I feel sad for these people in the audience who despite seeing the play, is clearly completely out of touch and unable to connect with the depth of pain and struggles the characters are going through.

I saw and recognised in the play, the loving yet denial state and lack of understanding parents some mental illness sufferers had to face, the harshness of NS which so often lacks a human heart, the fears and struggles mental illness sufferers go through, the fear and prejudice of the majority public, and the co-dependent but genuine friendship that Vinod and Saloma share. In their friendship, I saw the neediness of both, and in the progress, the abandonment and fearful feelings that Vinod must have felt.

At the end of the play, Saloma sitting there, to me protrayed the aloneness that mental illness sufferers face, and how we could all so easily take the time not to judge and be there with them and that alone could have helped and meant so much to them. We are all too busy as Saloma puts it, too busy with our lives, unable to spend a moment to care. I sat there with my friend watching the audience depart at the end of the play with Saloma sitting there waving goodbye, and I wonder, just how much did the audience truly understand what Vinod and Saloma (and all the other mental illness sufferers out there) had to go through.

June 11, 2007

Long-Stay Mental Patients Strain IMH

(the article is taken from Pg 4 Straits Times 11th June 2007)

Hospital constantly in the red; 300 patients have been ther 10 years or more.

By Carolyn Quek

In North-Eastern Singapore lies a hospital where three-quarters of the 1,600 patients have been tehre for at least three months.

In fact, 300 of them have been there for 10 years or more.

The Institute of Mental Health (IMH) is where they have been dumped by family and relatives who want little to do with them.

The cost of caring for these usually subsidised C-class patients has probably contributed to IMH being in the red by between $1 million and $5 milion a year from 2002 to 2005.

This, despite an infusion of an average of $9.3 million in government funding over that same period, and the hospital hving its own endowment fund.

But the number of thsee "long-stayers' also points to the strain that caregivers in these families can no longer take. And it shows how mental illness is still a dark secret their families and society would rather forget.

Mr Teo Twa Lau was a typical long-stayer. When he died two months ago, he had been a patient there for 49 years. A search by the police for his kin turned up nothing. Soon, as with most unclaimed bodies, he will be cremated, and his ashes stored at the Mandai Crematorium. If no one claims them in three years, his ashes will be scattered at sea, said the National Environment Agency.

This is the fate that awaits IMH's long-stayers - who now occupy 10 of its 54 wards.

Some will be discharged and re-admitted; others never leave, a spokesman told the Straits Times.

The low number of discharged patients is not a good sign, say social workers and psychiatrists.

Dr Ang Yong Guan, who heads the Action Group for Mental illness, said people were still uncomfortable about living with the mentally ill. "many have the misconception that they are aggressive and unpredictable. hence, the less to do with them, the better."

This is confirmed by the fact that long-stayers have no visitors, including in the case of Mr Teo.

The hospital, delving into its records, turned up little on him. He was admitted to the then Woodbridge Hospital in 1958 with no identification or relatives.

Patients like him end up at the hospital after relatives - unable to cope with looking after them - bring them in, or when they are abandoned and the authorities do the same. Many have no identification and some do not even know who they are.

Dr Ang said most long-term patients are part of a case backlog from the 1950s, when treatment of mental illness was not as advanced and drugs not as effective.

Ms Rachel Goh who heads community services for the Singapore Association for Mental Health, noted the inadequate support given to caregivers and said it was common for them to get burnt out.

"When they can no longer handle it, they end up dumping the patient at IMH," she said.

The state and the hospital also bear the cost of care for these patients. Last year, $10.2 million out of the $40.5 million given out under Medifund went to the IMh.

The hospital has beeen the largest recipent of this fund which helps need Signaporeans meet their hospital bills - since the fund's inception in 1993.

The hospital also has its own Woodbridge Hospital Endowment Fund, which covers non-core medical and therapy programmes, and provides financial aid to needy patients. Yet, the IMH lost between $1 million and $2 million in 2004 and 2005, said its spokesman.

Mental health workers want more "step-down care" facilities and more support for caregivers.

The hospital has moved 700 long-stayers to welfare homes in the past five years after determinating that they do not need hospitalisation. This has freed up nurses for actutely ill patients.

But more pressing is the need for public education to wipe out the stigma of mental illness here.

Ms Goh said;"The stigma comes from a lack of understanding. this is caused by a lack of knowledge. So if we know how to manage the stigma, the rejection rate won't be so high.

carolynsph.com.sg

June 12, 2007

The Dark Secret Families Prefer to Forget

(taken from Straits Times Home Pg 1 and 2 dated 11th June 2007. A continuation of my previous entry of the article from the Straits Times)

Among the Institute of Mental Health's 54 wards are 10 set aside for long-staying patients, where a typical day is marked by a routine of meals, shower, nap, medication and, for some, light chores. Carolyn Quek spent some time with patients and stuff to file this report with photos by Ng Sor Luan.

A large airy room on the sixth floor of the building is where the patients have their meals and spend a better part of their day.

The room has rows of chairs and some tables. A lone television set is mounted on the wall. A pantry and toilet are off to one side.

An occasional wail is heard echoing from the wards.

The smell of antiseptic mingles with the faint odour of urine from the inconteinent among the patients.

The walls are whitewashed, and the floors scrubbed clean.The dark brown window grille is where some patients press their faces for a glimpse of what goes on in the wide world outside.

Some stare blankly at the walls, muttering. Others walk around in circles.

It is after the dinner hour, and one patient, an 88 year old mute Chinese woman, is busy with her "duty" for the day - wiping down the bed frames in one of the wards.

The diminutive woman, clad in the hospital-issue fblue floral top and blue pyjama bottoms, has been a patient for 30 years, after she was picked off the streets. she does not even have a name. She is simply referred to as "Unknown."

Over at the men's ward is Mr Tan Siew Kiat, which is not his real name.

At 69, he is at the Institute of Mental Health's longest-staying patient, having been admitted by his brother-in-law in 1953 as a deaf and mute teenager prone to violent and destructive behaviour.

He has ventured beyond the hospital walls only once - and even then only in a bus - when the hospital moved in 1993 from its old Woodbridge site in Yio Chu Kang to its current premises at Buangkok Green.

Now stoud and balding, he is no longer a hot-headed youth. He sits out his days quietly, and sometimes helps the nurses to arrange the chairs in the ward.

Soon, he may move to the psycho-geriatric ward for male patients aged 65 and up as he is on the waiting list for a spot there.

His family has never visited in all these years. Attempts by the hospital's medical social workers to locate his relatives have been unsuccessful.

Many long-stayers are like him - the dark secret families prefer to forget.

"Most of the patients here have come to treat the hospital as their home," said senior nurse manager Koh Siow Eng.

Medical social workers at the hospital do their best to help trace family members of the "unknowns". This sometimes entails bringing the patients back to the place where they were found to look for people in the area who might recognise them.

Four "unknowns" were admitted last year, of which two were eventualy identified.

Sometimes, even when patients' next of kin are found, these patients' next of kin are found, these patients still do not get visitors. For example, a son of Madam Lim Ah Hee (not her real name) who was tracked down 2 years ago still does not visit her.

She was brought to the hospital at the age of 25 in 1960 by her relatives after her fishmonger husband abandoned her and their four young children.

Each day passes placidly.

A team of three nurses, with added support from health-cares assistants, oversees each 40-pateint ward.

morning call is at 7am, after which the patients take their shower.

Then they go to that large airy room for their meals and to spend their day.

Breakfast and morning medication are followed by about two hours of "activities", which include "reminiscence therapy" with the nurses to jog their memory.

Then it is lunch time. Another round of medication is handed out. After a two-hour post-lunch nap, the patients are up for more activities - such as phyysiotherapy and "reality orientation" exercises - till dinner is served at about 5pm.

After their nightly drink of Ovaltine at 9pm and medication, the patients return to their beds.

The cycle is repeated the nextr day.

Volunteers from religious organisations and schools come in weekly to conduct sing-along sessions or just bring the pateints' their favourite food.

Birthday parties are a monthly affair. Those who do not know their birthday are randomly assigned a month by the nurses.

The more stable long-stayers are taken out once in a while to places like the Zoo, Orchard Road and the Esplanade.

Like the mute 88 year old female patient, some patients help out with simple chores, like helping fellow inmates into wheelchairs or clearing the table after meals.

Nurse manager Mazlan Hassan said:"The idea of getting patients to do these chores is so that they do not remain idle and be too dependent on the staff. We encourage independent living and we do nto want them to deteriorate physically."

An IMH spokesman said that, as much as the hospital has programmes and activies for these patients, some simply cannot respond or take part because of their mental state or because they cannot walk.

But the nurses do not give up.

Ms Mazlan said" Even though some patients don't communicate, we still talk to them. For example, when we wake them up, we say,' Good morning, come take your bath.'

This helps build good rapport between nurses and long-stayers, she said.

She added "We take care of them like they are our family. To us, they are very lovable. We treat them with dignity and respect. So they do the same for us.

carolynq@sph.com.sg


My thoughts/feelings

My heart aches for them.

June 17, 2007

Pentagon may drop mental health question

Pentagon may drop mental health question

By PAULINE JELINEK and ROBERT BURNS, Associated Press Writers 1 hour, 59 minutes ago

WASHINGTON - U.S. troops would no longer be asked to reveal previous mental health treatment when applying for security clearances under a proposal being considered by the
Pentagon.

The idea stems from the finding that service members avoid needed counseling because they believe that getting it — and acknowledging it — could cost them their clearance as well as do other harm to their careers, The Associated Press has learned.

"This is just one of several items under review by the
Department of Defense and the services in an effort to remove the stigma associated with mental health issues," said Air Force Maj. Patrick Ryder.

The proposal is to omit a question regarding mental health treatment that appears on a form required by the Office of Personnel Management, the agency that does the majority of investigations for granting clearances to military and civilian workers in the federal government.

Currently, the questionnaire asks applicants whether they have consulted a mental health professional in the last seven years. If so, they are asked to list the names, addresses and dates they saw the doctor or therapist.

The Pentagon has been working for some time to end the stigma of counseling. Studies indicate that soldiers most in need of post-combat health care are the least likely to get it because they fear that others will have less confidence in them, that it will threaten career advancement and that it could result in loss of their security clearance and possibly removal from their unit.

For the full article, refer to
http://news.yahoo.com/s/ap/20070616/ap_on_go_ca_st_pe/pentagon_security_clearance


My thoughts ; I find this article interesting. The most powerful nation in the world, and their military is taking steps to fight the stigma of mental illness. Military agencies in general are at times perceived by some as rigid. Yet the US military itself is taking a huge step in fighting the stigma of mental illness. I find this very very encouraging. Can all other organizations and countries around the world follow their lead?

June 20, 2007

Mental Health Advertisement.

Original link
http://www.youtube.com/watch?v=oljqb1FjSrA


My thoughts :

The advertisement is absolutely brilliant! I had a very good laugh when I watched the advertisement. All employers in Singapore should watch this advertisement.

September 17, 2007

Masterplan to tackle mental illness

Salma Khalik, Health Correspondent
17 September 2007
Straits Times
English
(c) 2007 Singapore Press Holdings Limited

Multi-ministry panel to map out 5-year blueprint to curb growing problem

ONE in six people here suffers from some form of mental illness, and if Singapore follows the trend in other developed countries, the numbers are set to go up.

A top-level multi-ministry committee - headed by Health Ministry Permanent Secretary Yong Ying-I - has been convened to tackle this growing problem.

Her committee will map out a five-year blueprint to look at how Singapore needs to beef up everything from manpower to education to cope with the issue.

Health Minister Khaw Boon Wan told The Straits Times: 'We need to size up the potential problem and prepare for building up such capabilities.'

Citing previous studies, Associate Professor Chong Siow Ann of the Institute of Mental Health (IMH) said that between 16 and 18 per cent of people here have some form of mental health problem.

This could range from mild anxiety and depression to severe manifestations like psychosis, substance and alcohol abuse and dementia.

Even mild mental illnesses can affect work performance. Workers may be absent more often or be less productive at work, said Prof Chong.

Still, the rate of mental illness here is relatively low compared to those in other developed countries like the United States, where 26 per cent of its people suffer from such ailments in any given year.

Already, the US government estimates that the cost of mental illness there exceeds the combined cost of all cancers in the country.

The World Health Organisation has also classed mental illness as a major health issue that is likely to drain the coffers of many countries.

Estimates from the WHO in 2002 showed that 154 million people globally suffer from depression and 25 million from schizophrenia; 91 million people are affected by alcohol use disorders and 15 million by drug abuse.

A more recent report found that 50 million people suffer from epilepsy and 24 million from dementia.

In Singapore, the IMH treated close to 33,000 patients for mental illness in its outpatient clinics last year.

Based on the global trends, Mr Khaw expects the problem here to grow.

He said: 'I am almost certain that we are short of many kinds of supportive allied health workers like psychologists, counsellors and medical social workers to help the psychiatrists manage the entire range of mental conditions.

'We need to size up the potential problem and prepare for building up such capabilities.'

Singapore has done well so far in handling mental health issues, he said, 'but I believe we have new ground to cover and new capabilities to acquire and expand'.

Singapore knows how to deal with traditional drug addiction problems, he said, but there are new synthetic drugs and other addictions to consider.

Gambling, for instance, can form the basis of another form of addiction.

Singapore opens its integrated resorts in 2009 and 2010, housing the country's first legalised casinos.

Plus, the stigma still associated with mental illness is a real problem here, he said.

In the US, people will seek psychiatric help to deal with their stress and estranged couples will get counselling.

Such an attitude helps destigmatise mental illness and fosters early treatment.

'Asians tend to sweep such problems under the carpet and pretend that they do not exist. But they won't go away,' Mr Khaw said.

The Singapore committee, which includes officers from the Education, Manpower and Home Affairs ministries, is not looking at only manpower issues but also how mental health teams can work in communities, research and public education.

And education could make people more aware of the benefits of early intervention.

As a special report by this paper on Saturday showed, young schizophrenia patients who are aggressively treated are able to lead fairly normal lives, holding down jobs, attending school and having friends.

salma@sph.com.sg

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