Advocates and patients fume after Singapore deems mental health services ‘nonessential’

Complaints have risen online over the classification of mental health as unessential during the coronavirus lockdown in Singapore, where such problems have a history of being neglected.

Dozens of netizens, including parliamentary member and mental health advocate Anthea Ong, have voiced objections to the government’s seeming lack of concern about the mental health needs of the public during the coronavirus pandemic. 

“I feel seeing your psychiatrist or psychologist is so important, especially when you are suffering from some traumatic experience or flashback and nobody will understand and is able to help,” Facebook user Leila B White wrote online last night. “People who are already seeking mental healthcare can’t be left alone especially during this difficult time.”

Conversations Singapore needs to have about mental health are happening on Instagram

Leila punched a hole in the rationale that allowing remote consultations, as the government has encouraged, is a sufficient substitute.

“There’s no point seeing or talking about it with another psychiatrist or going online. Because it will [be] difficult, imagine someone who is having trauma with the computer and you asking them to deal with it online,” she added.

To some, it is the latest evidence of how mental health issues are not taken seriously in Singapore, despite high suicide rates and studies finding such issues to be widespread.

Workplaces of businesses deemed noncritical, including counseling and psychology services, have been unable to operate for the past week as part of measures to contain the spread of COVID-19 in Singapore, which has infected at least 2,918 so far.

The Ministry of Trade and Industry created confusion after it initially listed counseling and psychology as essential services at the beginning of this month. 

But that was soon negated by the Health Ministry, which told The New Paper that most outpatient psychological services had to be done remotely, while face-to-face consultations should be reserved for those with critical issues or in danger of physical harm. A National Care Hotline (6202-6868) was set up three days into the virtual lockdown for those who need emotional support.

Ong, who is a nominated member of parliament, had cited the lack of awareness and education for why the government considered such treatments to be nonessential. It also did not make sense for the government to set up a mental health hotline while considering such services to be unimportant, she added. 

“Because a) it shows mental health is still not a national priority even in such a crisis when it should be; b) it means we don’t understand mental healthcare which must include psychotherapy and counselling support, and not just about taking psychiatric drugs,” she wrote in an April 8 post on Facebook. 

“And c) it does not synchronise with the setup of a national care hotline (if you know there will be mental distress from Covid-19 hence the hotline, it must mean psychological services are essential, no?). ESPECIALLY when getting a haircut is,” she added, suggesting that the government list psychological treatments as essential and let medical health professionals decide on whether the consultation can be done at home or face to face.

Singaporeans suffering mental health issues on Reddit have complained about difficulties getting proper treatment, with one complaining they did not know when a canceled appointment would be rescheduled. 

“This has been made more obvious to me in the past week.. My psych appt that was meant to happen tmr at the polyclinic was cancelled, and I haven’t been informed when it’ll be postponed to. From what I’ve heard, there’s no option of going online either. I went to seek counseling before [lockdown] as well and was told a social worker would come back to me in 2 weeks and have gotten radio silence since I went for my assessment,” Redditor Avoeggs said yesterday.

“Until there is a great generational change in our mentality and attitude toward this health crisis, I don’t see any positive change forthcoming for those in need of help. If you’re willing to wait until someone has thoughts of self-harm or worse… the problem would’ve compounded to a point where treatment is really, really challenged,” Reddit user Deoriginalone said today.

Others worry that the lockdown might trigger mental health issues in people with no history of them or worsen the state of those currently struggling with such issues if counseling and psychology services don’t resume. 

“In this kind of lock down and uncertainty of the future, many people might sink into depression and there is a very high probability that those ‘recovered’ depression patients will also suffer a relapse,” Facebook user Zam Soha said yesterday.

“And some of them might be facing family issue[s] in their home, home violence, and some depression patients might even be facing some mental torture by family members daily etc which no one knows … nobody can understand how it feels unless they experienced it! Think of people in need please!!!” another, named Kay Melanie Vettel pleaded. 

The Singapore Psychological Society yesterday published a list of tips on how to look after mental well-being during the public health crisis. They include advice on maintaining connection with colleagues, and ways to avoid burnout. 

If you or someone you know needs help for mental health-related issues, here are some helplines:

National Care Hotline: 6202-6868

Fei Yue’s Online Counselling Service: eC2.sg

Institute of Mental Health’s Mental Health Helpline: 6389-2222

Samaritans of Singapore (24-hour hotline): 1800-221-4444

Big Love Child Protection Specialist Centre: 6445-0400

Singapore Association for Mental Health helpline: 1800-283-7019

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