Wednesday, November 27, 2013

Raymond Anthony Fernando's letter to The Straits Times: Start 'stigma busters' scheme to help the mentally ill

My letter on the above matter was published in The Straits Times on Wednesday 26th November 2013.

I appreciate the supportive role student Risa Tan Xuan Ying has played in lending a hand to patients with mental illnesses (“Fight bias against the mentally ill”; last Wednesday).

Many in society are still unable to accept people struggling with such conditions.

Patients and caregivers are the best people to educate the public on mental illness because they are “walking the journey”.

Policymakers who understand the difficulties psychiatric patients and their caregivers face can play an important supporting role.  We also need enlightened employers who are willing to give recovering patients a chance to turn their lives around.

Advocates can also help to combat stigma.  In the United States, the National Alliance on Mental Illness has come up with lots of programmes to help the mentally ill and their families reintegrate into society.

To combat stigma, it has a StigmaBusters network of advocates around the world whose role is to fight and correct inaccurate portrayals of mental illness.  They are committed to educating society on the reality of mental illness, in breaking down the barriers of ignorance.

The Ministry of Health, with the support of the Institute of Mental Health and its partners, should start such a scheme.  Our stigma busters can include those in the mental health-care industry, patients and caregivers, and anyone who feels passionately about mental illness.  They can make a big difference to the lives of those who have been ostracised by society.

Raymond Anthony Fernando



Tuesday, November 19, 2013

Raymond Anthony Fernando’s two letters to the press on improvements to healthcare & a safer environment

Two of my letters appear in the press today–one to MediaCorp’s TODAY Newspaper on how we can help maids and familes live in a safer environment; and the other on how we can improve or mental health care system. These are efforts to improve systems here and need to be taken in the right context.

Letter 1 - To prevent tragedy, provide better support for maids

The report, “Maid detained after teenager found dead in flat” (Nov 15), may signal a worrying trend, given that there have been several cases of maids implicated in harming their employers’ families.
We must do all we can to help maids, who leave their families behind to earn a living. If not, we would eventually be unable to bring them to our shores.
Also, members of a family who lose a loved one cruelly can fall into depression. It is not easy to cope with grief.

Many of our maids come from developing countries. They may be unable to adjust so quickly to our lifestyle and the demands of looking after our children, which many Singaporeans and foreigners depend on maids to do, as they work long, draining hours.

As a precautionary measure and to make our homes a safer place, maid agency staff should make periodic visits to see how the maid is coping. The staff must also be trained in basic mental healthcare, so that they are able to pick up warning signs that maids may display.

Maid agencies should also be given the telephone numbers of helplines, so domestic workers could secure help as and when needed.

Employers who are worried that their maids are distressed could be given the option to send them for counselling. This is to pre-empt any tragedy from taking place and help both maid and employer live in a safer environment. It should be taken in the right context.

Ultimately, let us strive to make Singapore the best home to live, work and play, not only for ourselves, but also those who give us the support we need.
Raymond Anthony Fernando

Often it is not that our citizens do not want to take care of their health, it is sometimes beyond their control, so we need to be sensitive to those with special needs. I have suggested in my letter to the press – given below, for collaborations between doctors. MOH could undertake this as a Quality Control Circle (QCC) or WIT (Working Improvement Team) project. Ultimately, if this proves successful, there can be improvements in the bed crunch, reduction of patient loads at clinics/hospitals, and the turnover rate for doctors and nurses will be reduced.  There can also be a reduction in costs ­–both on the part of Government spending on health care; and for the consumer.  Although it will take effort and resources to undertake these collaborations, I believe it’s a good investment and it should be taken positively.   We must look 5, 10 years down the road – more so with a rapid ageing population coming on-stream.

Recently, I’ve been having severe pain in my left arm – something like electric current running to this arm, and the doctor advised me to get it checked as I could be having nerve problems.

My wife is seeing a total of 7 doctors; has an average of 8 medical appointments in a month and takes 54.5 tablets a day, and I’m suffering from severe exhaustion.
As caregivers, we do our utmost to support our loved ones, but often we have to pay a heavy price. And it’s not that I have not been pleading for caregiver support. A good mental health care system must look into the welfare of caregivers who make huge sacrifices to support their charges. Do we have that here?

I’m also helping my twin brother who has a wife and a 3-year-old son. All have mental illness, and I’ve made this known to Dr Vivian Balakrishan. 

We need politicians –– ministers, MPs who feel for our marginalized citizens and show empathy.

I will never understand why it is so daunting to secure caregiver support. Yesterday, a teacher and her husband wrote to the Straits Times saying how they have bee struggling to take care of their two  autistic sons, and mentioned that her husband now has 4th stage cancer.

Thank you.


Raymond Anthony Fernando

(2) Letter to The Straits Times:  Help those who cannot help being sick

My letter to The Straits Times on the above matter is published in the Straits Times, today, Tuesday 19th November 2013.

Although some chronic illnesses can be prevented with a healthy diet and exercise, there will always be people who cannot prevent illnesses from disrupting their lives.

Studies have revealed that the prevalence of diabetes and its risk factors is much higher among patients with serious mental illnesses.

Schizophrenia and some other mental disorders, such as bipolar disorder and depression, arise when there are chemical imbalances in the brain.

Research also reveals that the cause of some mental disorders like schizophrenia is genetic.  If the condition does not affect one generation, it may hit the next. This is the case with my wife, whose parents did not have schizophrenia but her grandmother did.

It is also a known fact that all medication have side effects.

During my wife’s visits to the polyclinic and Tan Tock Seng Hospital, the doctors discovered that her sodium level was low, leaving her at risk of getting fits.  According to the doctors, this was caused by some of the psychiatric drugs she has to take every day.

Yet, my wife has no choice but to consume her medication.

The solution is for the Ministry of Health to intensify research and get specialists, general practitioners and psychiatrists to collaborate better, so that those with illnesses they have no control over will not have to see more doctors than necessary.

If this proves successful, it would help ease the current bed crunch and patient load at clinics and hospitals.

We must remember that no one chooses to stay unhealthy.

Raymond Anthony Fernando

This is also an interesting letter from another ST reader –Ms Li Dan Yue, who responded to my earlier letter to the press where I asked for grants to be given to patients and caregivers to tell their stories. It’s some consolation that my message is getting across to some kind souls who feel for us.  This is what makes for an inclusive society.

New perspective of the mentally ill
This letter on the above matter was published in The Straits Times on Tuesday 19th November 2013.
I read with interest Mr Raymond Anthony Fernando's letter ("Help the mentally ill tell their stories"; Forum Online, last Tuesday).
In 2009, I worked for a year as an advice and welfare services volunteer in London, helping people to fill in welfare benefits forms.
Among my clients were those with bipolar disorder. Whenever I had to work with them, the staff would tell me to sit close to their cubicles so I could run and call for help if necessary. Hence, I thought these people were dangerous. How wrong I was.
I once met a woman with the condition. At first glance, she did not seem different from any other person and sat through a three-hour interview with me and answered half the questionnaire in a logical and clear manner.
Later, she revealed she had bipolar disorder that was controlled by medication. She said that when the effects wore off, she would have to take a new dose or isolate herself so she did not hurt her five-year-old son or other people.
She said people would usually stare at her strangely when they saw her taking her medication.
At the end of the interview, she expressed her gratitude towards me for not treating her differently.
Mental illness is still very much a taboo subject in our society today. I admit that I used to judge people with mental illness, but my year of working as a volunteer has given me a whole new perspective of them.
Li Dan Yue (Ms)


Thursday, November 14, 2013

Letter to The Straits Times: Help the mentally ill tell their stories

Professor Chong Siow Ann, Vice-Chairman of the IMH Medical Board (research) wrote an interesting commentary on schizophrenia last Friday, and I applaud him for the effort. Indeed, psychiatric patients struggle to come to terms with mental illness and grapple with the side-effects of the medications.  

I have the utmost respect for patients who have the courage and conviction to tell their stories; and more should be done to this end.  I am working on a novel – a caregiver handbook – about 150 pages that will give family members a step-by-step direction on how to look after a loved one suffering from schizophrenia based on my wealth of experience in taking care of my wife.  It will give insightful peeks into her illness and how I pick her up each time she falls ill.  I will have to fund the book myself as its so difficult getting grants. But I fervently believe it will be a useful resource for caregivers who often grope in the dark when trying to help a loved one with schizophrenia. This is my calling, my mission.

My press letter to the Straits Times published today is in respond to that insightful and frank commentary by Prof Chong. Thank you.


Raymond Anthony Fernando

Letter to The Straits Times: Help the mentally ill tell their stories

My letter on the above matter was published in the online section of The Straits Times on Tuesday 12th November 20013.

Last Friday’s commentary (“Shedding light on those with schizophrenia”) provides an insightful peek into what goes through the mind of a patient with schizophrenia.

An effective way to raise more awareness of mental illness is to write compelling stories about how psychiatric patients and their caregivers struggle with mental disorders.

This is part and parcel of advocacy and should be encouraged. Most certainly, people with mental illness should in no way be “imprisoned” by their conditions.

Both my wife and I have benefited from telling our stories because it not only raises more awareness of schizophrenia, but also offers us the opportunity to chart new directions in life and gives my wife a sense of self-worth.

However, publishing a book does not come cheap.  It can cost anything from $4,000 to $6,000 to print 500 copies. On many occasions, my wife and I have had to dip into our savings to fund the books that we wrote.

Some people who face adversities in life, be it through mental illness or other challenges, have approached me on how to go about writing their stories, but are concerned about the publishing cost.

To this end, I urge the National Arts Council to offer special grants to psychiatric patients and their caregivers.

After which, the council can help them keep the royalties from book sales and, with the collaboration of the Institute of Mental Health, assist the writers to promote their books effectively.

Raymond Anthony Fernando





Friday, November 8, 2013

Concessions for mentally ill patients and caregivers? Advocate for the mentaly ill extraordinary ,Raymond Anthony Fernando writes to the press

Advocacy must be part & parcel of a good mental health care system, its the practice in well developed countries like Hong Kong , Australia  & America.  We have a long way to go as far as mental health support is concerned.

Check out my letter to the Straits Times.

Letter to ST: Concessions for mentally ill patients and caregivers?

My letter on the above matter was published in The Straits Times on Friday 8th November 2013.

I welcome the proposal by the Fare Review Mechanism Committee to provide subsidised public transport fares to disabled people (“Fare concessions for more commuters: Panel”; Wednesday).

Taking care of loved ones with chronic illnesses can be draining for caregivers, more so with the rising cost of living. Many caregivers are retired or have given up their jobs to focus on caring for their loved ones.

A major concern for them is the transport expenses incurred when they take their loved ones to hospitals and polyclinics for regular medical appointments. On average, I take my wife, who is battling schizophrenia, for at least eight medical appointments a month.

The committee has recommended concessions for people with disabilities. But what about individuals with “hidden” disabilities such as mental illness?

They may have difficulty finding work because of the stigma attached to their conditions, and need to travel on public transport to search for jobs.

So I urge the Government to consider this group and their caregivers as well when approving fare concessions. To prevent abuse, a special concession card with a photo of the caregiver could be issued by the transport operators. The same could be applied for mentally ill patients, who would need a supporting letter from a psychiatrist.

Mr Raymond Anthony Fernando



Thursday, November 7, 2013

Airport sculpture incident: More compassion needed- Raymond A Fernando's letter to the press

As I read the report “Police arrest woman who damaged sculpture at airport” (Nov 4), I could not help but wonder if the woman who risked life and limb could be suffering from psychological problems.

I commend the police for rescuing her in time; otherwise, she could have sustained serious injury or even a fatal injury. Our boys in blue did the right thing by arresting her under the Mental Health Act where she could be closely monitored by professionals and referred to specialists for treatment.
But I am disturbed by the insensitive online comments hurled at the woman, such as “crazy” and other demeaning names. At first glance, it appears that she had vandalised the sculpture, but there could more to it than meets the eye. Let us not be too quick to judge those going through the stresses of life — whether they are our own citizens or foreigners — and more so when we do not know much about the woman’s background.

The authorities should do all they can to help her. After all, she could be someone’s daughter, sister or wife. And every life must be valued and treasured.

In the meantime, perhaps the frontline staff can be trained to look out for symptoms of mental distress to better handle such situations. As an additional measure, those travelling alone should provide a next-of-kin contact number on their visitor arrival forms, to facilitate the rendering of assistance if and when it is needed.

Just as Singapore has achieved a first in many areas, let us also strive to be No 1 when it comes to kindness and compassion.

Raymond Anthony Fernando

Tuesday, November 5, 2013

Dating online portal Ashley Madison: Raymond A Fernando's letter to The New Paper: Reject any site that promotes infidelity

My letter on the above matter is published today – Tuesday 5th November 2013 in The New Paper,
 Page 7.

I refer to the recent articles about online dating portal Ashley Madison planning to set up operations in Singapore.  

Ashley Madison’s online slogan says that since life is short, it’s perfectly okay to have an affair. 

This mentality of enjoying oneself will only cause marriages to fail because the promotion of such a mission is destructive and selfish.

As it is, there has been an increase in the number of divorce cases, so we should reject outright the setting of any website that promotes infidelity.  

My belief is that if life is short, we must do whatever good we can – today.

We must do our best to nurture families to bring out the best in them.

Marriage can be compared to a sensitive plant.  It needs to be nurtured and cared for so that it can grow.  If the plant is neglected, it will wither and die.

Similarly, give a marriage the attention and care it needs, and it will grow. 

To promote successful marriages, I call on the  Ministry of Social and Family Development to invite couples who marriages have passed the test with flying colours to conduct motivational talks and workshops.

Most certainly, if we put our heart and soul into building a solid partnership, we will experience the depths of joy and happiness a fulfilling marriage can bring.