Wednesday, November 30, 2011

Cat dumped in rubbish bin- Set up website so we can assess mental health

Raymond’s letter to The New Paper is published today on page 21, Wed 30th November 2011.

I refer to the report, “He’s still responsible” (The New Paper, Nov 26).

I’m not at all surprised at the way cat lovers and netizens on forums like Stomp have demanded that Madam Hamidah’s husband, Mr Michael who suffered a relapse of his bipolar condition, be taken to task for his actions.

But some of the comments on Stomp are far from kind. What is the point of showing love to animals, when we are so unkind to a human being who has fallen ill with a mental disorder that is so unpredictable?  Bear in mind that the couple do love cats - otherwise they would not have adopted four cats, would they?

Given the findings of a study by the Institute of Mental Health which reveal that one person in 10 will suffer from some form of mental illness, it is imperative that we cast out nets wider to reach out to everyone in our society.

The key to tackling mental health issues is to secure a better understanding of the illnesses.

One way would be to set up a public funded website for people to do a  self-assessment for potential mental health  problems. 


Make the exercise confidential and available in the four main languages.

The questions asked can be designed to review one’s situation with regard to some of the more common mental health issues including, post-traumatic stress disorder, depression, anxiety, addiction and so on.

Such a screening will not provide a diagnosis, will but will give guidance as to where help can be sought.

It can be managed by experts who should be able to help the person doing the tests decide whether to go for treatment or not.

Grassroots leaders and the Community Development Councils should reach out to the lonely elderly, the vulnerable groups and those who do not have access to computers and carry out face-to-face assessment of residents.

For this, grassroots leaders should be trained in mental health. 

There should also be a system in place to ensure that patients under psychiatric care do not default on treatment and medications.

Madam Hamidah is going to go through some challenging times, so let’s learn to rally around her, instead of giving her more stress.


Monday, November 21, 2011

Anonymous mental health screenings? -Raymond's letter to the press- TODAY Newspaper

The findings of the mental health study conducted by the Institute of Mental Health (IMH), reported in "I am not mad" (Nov 19), are cause for concern.

With a global financial crisis looming and as stress levels in our fast-paced society increase, there is a need to find quick and sustainable solutions to meet the challenges ahead. One of the biggest hurdles preventing people from seeking treatment for their mental health is stigma.

But as it is important to do so, I suggest that the Ministry of Health (MOH) set up an online site where people could do a voluntary, anonymous self-assessment of potential mental health or addiction problems.

The online questions could be designed to review one's situation with regard to the more common mental health issues such as post-traumatic stress disorder, depression, anxiety and alcoholism
The screening would not provide a diagnosis but give guidance as to where help could be sought. It would inform the person concerned whether or not he/she has symptoms consistent with a condition that would benefit from further evaluation or treatment.

Available in the four main languages, such confidential self-assessment exercises should be managed by professionals.

To further encourage treatment to be sought, perhaps MOH could consider giving heavily subsidised or even free treatment for the first two consultations, be it at public hospitals or by general practitioners who have been trained in basic mental healthcare.

Grassroots leaders and the Community Development Councils could reach out to the lonely elderly, vulnerable groups and those who are unable to access a computer, by carrying out face-to-face assessments with residents.

Any medical certificate issued by IMH should also not bear its name, as there are few enlightened employers. It would be better if such MCs have the National Healthcare Group's endorsement.

Raymond Anthony Fernando

Saturday, November 19, 2011

Do you have a history of mental illness?

“Twenty years from now you will be more disappointed by the things you didn’t do than by the ones you did do.  So throw off the bowlines.  Sail away from the safe harbour.  Catch the trade winds in your sails.  Explore.  Dream.  Discover.”

- Mark Twain -

The captioned words above of Mark Twain had long ago set me thinking as to whether I should  take the road less travelled and become a voice for the thousands out there who are struggling with the stresses of life.  I brushed away this thought, only to see it resurrected again during my journey as a caregiver to my wife, Doris who had to struggle with mental illness amongst other health ailments.

For more than 3 decades, I have witnessed the blatant discrimination that sufferers of mental illness face every day in their lonely lives.  Out of my compassion for psychiatric patients and their caregivers, I decided in 2004 to bring to light the plight of these marginalised citizens through advocacy.  It is never easy being a mental health activist – it is a thankless job that many would not do.  There is also an uneasiness that deters people from speaking out on social issues.  In the case of mental illness, this uneasiness is even greater.  Patients and caregivers would rather suffer in silence than speak out openly about their struggles.  They do not want to be identified with the illness that carries a nagging social stigma.

Whilst many people support my advocacy work, I know there are some people who are “uncomfortable” when I raised mental issues in the press or on television and radio.  Some have unkindly resorted to name calling in an attempt to demoralize and humiliate me.

But given the growing number of people - both foreigners and Singaporeans who have lost the will to live and are struggling to cope with mental illness, I fervently believe that we cannot sweep the problems of mental health issues and suicides under the carpet. And I remain committed to being a voice for the “voiceless.”

Passing of champion for disabled

I am shocked and deeply saddened to read in the Straits Times that Miss Nancy Chia, 60 who was the former President and most recently, the honorary secretary of the Handicaps Welfare Association (HWA) was found dead in her car on Wednesday- 16th November 2011 (“Champion for disabled found dead in her car”, ST Nov 18).  I know Nancy did a lot of hard work because my wife is a member of HWA and I’ve spoken to her a few times.  Nancy had a lot of passion in her work, and my wife and I would like to express our deepest condolences to her family. 

Serious social problems

There have been many reports in the press about people losing their tempers, the most recent ones being (a) the case in which a local banker was beaten up by a Caucasian over a booking of a taxi.  (b) In another TNP (The New Paper) report, (“They wanted to beat us,” Nov 17), another case of anger erupts.  We read of the “high drama after a road collision resulted in 20 people chasing occupants of a car involved.”

Neighbours are quarreling and cannot get along with each other- two of one whom ended up in a fight and got arrested by the police (TNP, Nov 18- “Fighting over potted plants”).

People here are not able to manage their anger, divorces are going up and poor boy-girl relationships are causing a lot of problems with some hitting out at each other on social media platforms. Financial calamity is hitting many as gambling and money issues become another real problem.  As crowds on the MRT and public places swell, people are becoming agitated and losing their cool easily.

Media’s role

The media has to raise social issues so that policy makers sit down and fine tune their policies that can help everyone on this tiny island to live, work and play in a happy, cohesive and conducive environment.

Noise pollution

There has been much unhappiness over noise pollution affecting the lives of many Singaporeans. Couple of months ago, several people voiced their displeasure over the endless noise that were affecting their rest. One suggestion from a Straits Times reader made a lot of sense. He said we should follow the Hong Kong method and only allow construction work or renovation to be carried out from morning at around 9am and end off at 12noon or 1pm. It is a practical suggestion, and I fully support his idea.

I now reproduce the letter which I wrote to the press on noise pollution.

“S'pore's becoming too noisy”

The most serious problem created by sound pollution is the impact on our health

Letter from Raymond Anthony Fernando

(TODAY Newspaper on Monday 21st Jan 2011)

I REFER to the letter, "Can't sleep for the MRT clatter (Jan 27), and share Tan Lye Chye's sentiments.

In our fast-paced lives, our homes should be a place where we can relax and have peace of mind. Yet, this is not possible in the estate where we live in Ang Mo Kio because all the year round, there is noise pollution almost seven days a week.

Before residents can fully recover from two years of noise from the Lift Upgrading Programme, we will now have to bear with more noise pollution and inconvenience from the impending upgrading inside our flats, with the changing of pipes, doors and toilets.

I will then have to search for alternative accommodation as my wife, who is coping with schizophrenia, cannot bear excessive noise. Her mobility is also severely impaired because of arthritis.

Shouldn't the HDB show some empathy and provide us with affordable alternative accommodation if they insist on carrying out such works? Should not there be consideration shown to the sick and those who are convalescing at home?

Funeral wakes are carried out almost every month opposite our block and the chanting can last as late as 11pm over three to four days. Every week, the irritating noise of the blower used to remove the cut grass disrupts the quiet we so badly need at the close of the week.

There is also excessive noise when clan associations regularly carry out their activities late in the night, and this sometimes stretches for a week. In the middle of the night, the beating of the drums does not allow anyone a wink of sleep.

Karaoke singing in HDB flats should not be encouraged. To my left, a couple sings at the top at their voices every weekend, sometimes past 1am. Above my flat, another family also engages in this activity with total disregard for residents.

The most serious problem created by sound pollution is the impact it has on our health. Besides disrupting sleep, noise pollution has also been linked with stress, heart disease, high blood pressure and stroke.

As I have to write for a living, I have no choice but work in the wee hours. Doesn't a caregiver also need rest? Little wonder I have suffered burnout countless times.

Raymond Anthony Fernando

While it is necessary to upgrade and redesign our landscape and city, let us be mindful that our citizens need to have sufficient rest; given that many work long and taxing hours. They also need to spend quality time with their families.

All these issues need to be addressed and tackled - swiftly.

Mental illness declaration

Just go take a look at any Government job application form and you will find a clause there which requires the applicant to declare if he/she has a history of mental illness.   Why is this requirement still in place? This clause handed down since the colonial time is clearly outdated, and has to be removed if we want to give equal opportunity for all Singaporeans to secure jobs and to encourage treatment if a person is going through depression or other types of mental illness, because the illness is treatable.  If the Government takes the lead, the private sector will most likely follow suit. I have raised this matter in the press, but no one wants to give a reply.

In The New Paper (TNP) on Thursday, 17th November 2011, a maid plunged 15 storeys from her employers flat because she was depressed. Her employers tried to save her, but could not do so because she was out of control.

This begs the question:  Are foreigners who come to work in Singapore screened for mental health issues?

Whether we like it or not, mental illness is becoming a BIG problem. We cannot avoid it, but we must find quick and sustainable solutions to tackle suicides, mental illness and stress related problems.


I urge the Government to consider the following:

( a) Set up a task force at a national level to tackle suicide, mental illness issues and stress –related problems. I am emphasizing national level because all these problems are happening in the heartlands. So the CDCs must also play an active role and come on board this recommended national task force committee. 

(b) Members of Parliament (MPs) need to raise the plight of the mentally ill and their caregivers in parliament.  A few years ago, I wrote to several MPs, pleading with them raise our plight, but none, including those in the opposition wanted to take this matter up. One told me, “Oh, I will have to think about it,” and she never did anything.” Another told me, “I am too stressed.” Others choose to ignore my plea.   Yet aren’t MPs elected by the people, supposed to serve the people - ALL people.

( c ) Reach out far and wide to get people to better understand mental health issues. Even doctors outside IMH need to learn about mental health because a fragile mind needs extra care and support.  A troubled mind can easily snap if circumstances are not conducive.  And I can give clear insights into this.

Why is mental illness such a taboo subject that it does not merit serious discussion and debate?  In 2006, I wrote a letter to the Straits Times and cautioned that depression was going to become a major cause of disability- worldwide. How many people believed me?  Look at the situation today.

Shouldn’t we be proactive instead of reactive?
Raymond Anthony Fernando

The writer is an advocate for the mentally ill and runs a website & 2 blogs –

 He is also the author of 13 books. His wife, Doris who has battled schizophrenia for 40 years is also an author – 6 books to her name.  
The article is also available on The Online Citizen

Wednesday, November 9, 2011

“Suicides in Singapore: Address it, not shun it”

“I expect to pass through this life but once.  Therefore, if there be any kindness I can show, or good things I can do for another human being, let me do it now, for I shall not pass this way again.
- William Penn -

William Penn’s well known quote that motivates us to show kindness to everyone is worth practising given that we are living in an unpredictable world.  An unpredictable world calls for us to prepare ourselves for uncertainties and become more predictable.  To help our brothers and sisters who are finding it so hard to cope. 

The recent spate of suicides at Bedok Reservoir and the growing number of people, including the lonely elderly, who have lost the will to value life, has prompted me to pen this article.    

Often people who lose the will to live and commit suicide have struggled with depression or one of the other types of depressive illnesses, and have not sought professional treatment.  It is sad that although depression is the most treatable of all types of mental illness, 50% of persons with depression and anxiety disorders do not seek help here in Singapore.  This is the same as the estimated 50 -60% in most developed countries.  A person who has depression feels hopeless and often does not look forward to a brand new day.  Some sleep most of the time to forget their worries.

People who suffer from depression are in dire need of support.  They need friends because loneliness and a feeling of being uncared for will make them feel that life is not worth living. 

Poor relationships, be it in the office or in personal life is also a cause for depression.  Sometimes, it is not work that will “kill you”, but people.

Highlight cases of suicide in the media

Straits Times reader Lim Wei Jan wrote in on 28 October this year appealing to the media to cease sensationalizing suicide cases as it could create a copycat syndrome.

While media stories about suicides may be newsworthy and can cause harm, the media being a powerful tool for communication can play an important role by highlighting suicide prevention and stories of people who have overcome adversities.   It would also be useful to seek the views of experts on this topic.

The media, if it needs to report on suicide cases could also focus on :

(a)   Trends in suicide rates

(b)   Recent advanced treatments

     ( c )  Individual stories of how treatment was life - saving

(d)   Stories of people who despair without resorting to suicide

But I’m glad that some newspapers like The New Paper have highlighted stories of people who are overcoming adversities.  It is a step in the right direction.

Real people, real stories

Sometimes it is necessary to raise issues on suicide because it creates more awareness for policy makers to understand the needs of those who are going through the stresses of life and who are in dire need of support.   Just like mental illness that is affecting many in schools, in our offices, in homes, in churches, and in the heartlands, these social problems should not be swept under the carpet.  Rather, we must talk about it, discuss it and find quick solutions. 

I survived a suicide in 1995 and I really regret giving up on life.  I can’t imagine the damage it could have done to my family if I had not survived.  The doctor’s advice to me after he saved me still lingers fresh in my mind: “Don’t ever do such a thing again, Mr. Fernando because there is always a way out.”   And that is the key message I would like to convey to anyone who feels that life is not worth living – There is always a way out.

I encourage people who are severely distressed and want to give up on life to seek treatment - immediately.  Believe me it helps!

 Warning signs of depression

Having gone through depression for a few years, I would like to share with you some of the warning signs that you need to look out for when coping with depression.  These are:

1.    Excessive fatigue or disturbed sleep

2.    Weight loss

3.    Losing interest in everything

4.    Difficulty concentrating

5.    Failing memory

6.    Diminishing sexual interest

7.    Inability to experience pleasure, even in situations that are normally pleasurable

8.    Feeling worthless - that life is meaningless

9.    Having thoughts of suicide

For ladies, depression sometimes comes right before their menstrual period.  Some women expect to feel depressed, even making a habit of it.  There is a way to fight it.  First of all, take your mind off it.  Do things that you enjoy doing, like dancing, listening to music and watching comical movies.  Engaging in happy things makes you feel happy and also makes you look confident.

 Note: Any change, serious loss or stress - e.g a divorce, the death of a loved one, the loss of a job, or move to a new home can trigger depression, usually temporary, but sometimes requiring treatment.

Research has revealed that a combination of antidepressant medication along with psychotherapy - otherwise known as talk therapy is the quickest, most effective treatment for treating depression.  Sometimes those suffering from depression just need a listening ear.  Let us find the time to rally around them during their difficult moments.

Schizophrenia: Look out for the warnings signs!

After caring for my wife, Doris for thirty-seven years, I am now more alert to the warning signs of schizophrenia.  These are some of the symptoms that she displays when she falls into a relapse.

-                     She complains of headaches

-                     She cannot sleep at night

-                     She becomes very nervous

-                     Many thoughts run through her troubled mind

-                     She is restless

-                     She becomes confused

-                     She is deep in thought

-                     She has overwhelming sadness

-                     She has difficulty concentrating

-                     She starts recalling unpleasant memories

-                     She has a loss of appetite

-                     She believes that people are talking about her

-                     She becomes fearful, suspicious and argumentative 

-                     Dandruff starts appearing on her forehead and on her hair despite shampooing

-                     Finally, she has suicidal thoughts and at this stage, she must be warded.

Finding solutions to suicide

With the financial crisis looming over our heads, it is crucial for all of us to play a part in helping to bring the suicide rate down.

Bring available supporting services right to the doorstep

Sometimes it is necessary for us to bring supporting services right to the doorstep of those who are in desperate need of  help.  People who attempt suicide are likely to do it again if they fall into depression at another period in their life.  When we read of stories in the media of people who are unable to cope with the stresses of life, we can help to highlight such cases to Members of Parliament, Government agencies, the CDCs and VWOs who are in the business of mental health care.  For a start, government agencies need to scan the newspapers everyday and pick up news of people struggling in life and then bring the supporting measures to the person concerned or to their family members because people suffering from depression or other types of mental illness are quite often in denial.

Grassroots leaders must also be trained and equipped to look out for warning signs of people struggling with mental illness as they are the “eyes and ears” of their respective MPs.   

Face-to-face contact

A friend of mine told me that in Australia if you are contemplating suicide and call the hotline, the professionals will come down onsite and talk you out of it. Even though it will involve resources and money, I feel this could help to lower the suicide rate because nothing beats face-to-face contact. 

Form a suicide prevention committee

To tackle head-on the problem of suicides, it would be useful for the Government to form a task force comprising of experts and even people who have overcome suicides, to brainstorm for ideas and find quick solutions to suicides.  We must not see it as “extra work” but do so with a keen sense of saving and reclaiming lives.

Form retiree clubs

Most workers who retire will lose key social support when they have left their jobs.  They become lonely when colleagues stay out of touch. Loneliness, as mentioned earlier can lead to depression. So a good way to ensure that retirees can still lead fruitful and meaningful lives after they are no longer in the work force is to form Retirees Clubs. Government agencies and private companies could initiate this suggestion for workers who hit 50 while they are still contributing in their respective ministries and companies.

Public education

We must intensify public education on depression and other types of mental illness, and coping skills in every part of Singapore – in schools, in the heartlands, in offices and in churches because mental illness is a hidden illness, a hidden disability that is affecting a large number of our population.

And as Christmas 2011 is just around the corner, I would like to wish one and all yuletide greetings with this poem which I penned, entitled “Christmas made in Singapore.”

Christmas made in Singapore

The annual light-up at Orchard Road

People in festive moods gathering by carloads

The Christmas lights that sparkle at night

Here the city comes alive and it is such a beautiful sight

Christians who congregate in churches to attend midnight mass

Start of the Christmas celebrations that for 12 days, will last

We see Christmas carols being sung in many places

We see goodwill being spread in many places

Children all excited decorating the Christmas tree

The smiles on their pretty faces are a sheer delight to see

“Santa Claus is coming tonight” all would say

For surely the gifts St. Nick brings will make their day

As in many cities, the Christmas feast in Singapore is an annual tradition

Family and friends tuck into meals prepared in mummy’s kitchen

Providing for the poor, sickly and less fortunate people in Singapore

Is a joyful event,  an annual affair

During Christmas, volunteers raise more funds because they care and share

The true meaning of Christmas is to give with our hearts

This for many will in the New Year, be a good start

So let’s uplift and comfort anyone who is finding it hard to cope

Give them the will to value life and embrace hope

A Merry Christmas and a Happy New Year to one and all

Spread  kindness and love and you will always stand tall


Raymond Anthony Fernando


Disclaimer:  Although this sharing tips mentioned in this article has worked very well for the author and his wife who has schizophrenia, readers should not regard the tips described as the only way to help in the healing of ALL patients suffering from depression and other types of mental illness as different people respond to different ways of treatment, rehabilitation and care.  Please consult a qualified doctor, counsellor or psychologist for more information.  

The writer is the recipient of the Model Caregiver Award 2007 and Mental Heath Champion 2010. He runs a website at :
This article is also available on The Online citizen: