Raymond's letter to The New Paper: Mid- week break to procreate? Govt should give extra half-day off

My letter on the above matter is published today in The New Paper, Monday 20^th August 2012, page 20.

Former Minister Mentor Lee Kuan Yew recently expressed concern that Singapore’s low fertility rate can lead to enormous problems.

While the Government can put in place material and economic measures to motivate couples to get married, the general feeling is that many of our younger workers, including professionals just do not have time on their hands to enter the bonds of marriage, let alone make babies. 

With the present fast-paced working life, many of our workers are stressed out from their demanding jobs which sees them putting in at least 10 hours a day to meet pressing deadlines.

Under some circumstances, it will be difficult to get people to see the importance of marriage and starting families.

To encourage young people to embrace marriage and produce children, I suggest that the civil service implement a half-day off in the middle of the week.

This will allow our young people sufficient time to relax and recharge, paving the way for marriage and procreation.

Productivity and efficiency of public service will not be compromised if flexible arrangements are made with some staff taking half a day off on Wednesday afternoon and the other half on Thursday morning and commencing work at 2pm.

Taking the lead

If the Government takes the lead in implementing the proposed mid-week half-day off, the private sector will mostly likely follow suit, or at least can be encouraged to do likewise. 

The other important aspect in encouraging young couples to tie the knot is for healthy marriages to be promoted by the Government and the local media.  

Marriage must be viewed as an essential institution for a successful society, bringing the blessing of children into our lives.

RAYMOND ANTHONY FERNANDO

The mentally ill and their caregivers need all the help they can get

I AGREE with Mr Chen Sen Lenn that it is best left to the attending physicians to decide if psychiatric patients are fit to roam the streets ("Mental patients in public: It's a doctor's decision"; Wednesday).

The task of caring for the mentally ill is extremely challenging, more so when there is widespread prejudice against mental illness. Very few people will understand how arduous the journey is until they are in the same predicament themselves.

There are many stories of psychiatric patients who sought treatment with support from family members and some sectors of society, and went on to lead perfectly normal lives.

Unlike for physical illnesses, medication for psychiatric illness takes time to settle in and patients need to reintegrate into society so that full recovery is possible.

Let us also not forget that caregivers have to go out and work to earn money to pay for treatment for their loved ones seeking psychiatric care. So it is not possible for them to watch over their mentally ill kin 24/7.

I often meet a 70-year-old man living in a condominium opposite my flat, and he tells me that he makes it a point to go out every day to meet friends and socialise, or he would go "crazy" sitting alone at home when his children are at work.

If people who are clearly lucid can feel this way, what about mental patients who are confined within four walls?

Those finding it hard to cope with mental illness need all the support they can get.
Raymond Anthony Fernando

It's also avaiblable here on this link:
http://www.straitstimes.com/premium/forum-letters/story/the-mentally-ill-and-their-caregivers-need-all-the-help-they-can-get

'Visiting consultants' to ease doctor shortage?

Many of our restructured hospitals are facing a shortage of specialists, as a number have left the public service.

At Tan Tock Seng Hospital (TTSH) for instance, patients in its Rheumatology, Allergy & Immunology and Orthopaedic departments have to wait for long periods to be treated. Some are even directed to the A&E department and still have to wait for hours.

As a regular at TTSH, I know that a patient could also wait for as long as six to eight months for a knee operation, which could worsen their condition. Such delays are not in keeping with an efficient healthcare system.

Given that many of our seniors are facing knee and arthritis problems or other ageing issues, the hospitals should bring back specialists from the private sector as visiting consultants.

This is being done at TTSH's eye clinic and should be adopted where needed. Visiting consultants would help to reduce the heavy workload the current pool of full-time specialists are facing now and will continue to face in the years ahead.
Raymond Anthony Fernando

Click here to see the link: http://www.todayonline.com/Voices/EDC120803-0000188/Visiting-consultants-to-ease-doctor-shortage?

Peer specialists needed to help caregivers of the mentally ill

I refer to the report, “Living with my daughter’s meltdowns” (The New Paper, July 22).

It is a stark reality that caregivers face a great deal of stress in taking care of their loved ones suffering from mental illness.

I relate very well to Madam Cheng’s emotional pain in trying to manage her 30-year-old daughter’s bipolar condition because I myself have witnessed how mental illness can destroy lives – especially when there is no support whatsoever.

If caregivers in this group do not get the vital support that is urgently needed, more and more caregivers will also fall into depression and find life meaningless.

As an experienced caregiver, I have been helping patients and family members cope with the mental illness, sometimes in person or through Facebook. After my story was told in MediaCorp’s TV show EVERYDAY HEROES, I received more patients and family members seeking my help on how to manage mental illness. And some of them are suicidal.

While I am willing to help, I have constraints as my privacy is sometimes invaded.

In America, the National Alliance on Mental Illness (NAMI) provides excellent support for both psychiatric patients and their caregivers. NAMI is the nation’s largest non-profit grassroots mental health education, advocacy and support organisation.

NAMI has a Peer Specialist scheme in place in which experience caregivers are paid an allowance to impart their skills and knowledge to caregivers of the mentally ill.

Peer Specialists are mental health consumers who have completed specific training that enables them to enhance a person’s wellness and recovery by providing peer support. Peer Specialists work in a variety of locations, such as peer support centers, crisis stabilization units, respite programs, psychosocial rehabilitation programs, and in psychiatric hospitals. Peer support can be a one-on-one experience or a group of people sharing together.

Singapore should introduce this scheme as part of its mental health service programmes. As mental health providers lack funds, the Ministry of Health (MOH) can providing the funding for the proposed Peer Specialist scheme which currently does not exist.

Most certainly the MOH and its partners needs to play a bigger supporting role in helping to alleviate the emotional, physical and financial pain which caregivers in this group have to endure almost every day in their isolated and lonely lives.

Raymond Anthony Fernando

Proposed Medishield enhancements: Raymond's letter to the press

The Ministry of Health's (MOH) proposed MediShield enhancements will benefit many patients, especially the elderly sick and those suffering from chronic illnesses.

It is also heartening that newly diagnosed patients who require inpatient psychiatric treatment will gain from the enhanced coverage. This would indeed encourage more Singaporeans who require treatment to seek it early.

But many long-term psychiatric patients are also worried about rising medical costs. A lot of them are unemployed for long periods and have limited Medisave contributions.

Their caregivers often must give up their jobs to provide round-the-clock supervision, as mental illness can be unpredictable, placing a financial burden on both parties.

Patients such as my wife, who is at risk of falls due to her advanced arthritis, are advised to be admitted to the Institute of Mental Health's medical ward when they have a relapse - in her case, of schizophrenia - to be monitored closely, to prevent falls.

The fees are not cheap. Ward charges are about $1,200 a month, or $40 a day. With costs for medication and treatment such as blood tests, X-rays and electro convulsive therapy, I would have to pay about $4,000 a month.

My wife and I have not benefited from paying MediShield premiums every year. In addition, no insurance company will cover her for any of her physical chronic illnesses because she has mental illness. The psychiatric community needs more support from MOH.
Raymond Anthony Fernando

Appoint block leaders to help residents cope with mental illness

By Raymond Anthony Fernando, Advocate for the mentally ill

I refer to the report in The New Paper(TNP), “He looked like he was possessed” (The New Paper, July 4).

Misconceptions about mental illness are pervasive, and the lack of understanding can have serious consequences on psychiatric patients who often are shunned and left to fend for themselves. It is happening here in our heartlands.

One of the misconceptions of mental illness is that people believe that the sufferers are possessed.  Dispelling these misconceptions through on-going public education and getting patients the support they so badly need is a powerful step towards eradicating the stigma and allaying the fears surrounding brain disorders. 

Next comes support for their family members who will undoubtedly be groping in the dark in trying to cope with a loved one stricken with mental illness.

There has been a surge in the number of people grappling with mental illness in our heartlands and these need to be put in check, otherwise we will create enclaves in our society, leaving the mentally ill and the caregivers ostracized from society.

A couple of weeks ago, there were two TNP reports of men stripping themselves naked in public areas.  These are obviously clear signs that the mind is deeply troubled.  I’m sure there are ways to help these stressed-out individuals cope.

The Institute of Mental Health(IMH) already have their hands full and are doing their part to treat patients who are willing to come forward for treatment. So we need the community to do their share in helping people cope with the stresses of life.

Besides on-going public education on mental illness, I suggest that the government  through their respective Members of Parliament (MP) appoint block leaders in their respective constituencies to help residents cope with the onslaught of mental illness.

If need be, the block leaders can be paid an allowance and they can serve a couple of blocks where residents can touch base with them if and when they discover that anyone is behaving in a less than normal way.  Needless to say, the block leaders must be trained in basic mental health care. 

Block leaders can be either grassroots leaders or activists serving the MPs.  Once every MP in Singapore has compiled a list of these block leaders, they can send their names to IMH or the Singapore Mental Health Association so that these mental health providers are fully aware that the appointed block leaders are there to partner them in helping to encourage treatment. 

RAYMOND ANTHONY FERNANDO

Thursday 19th July 2012- “EVERYDAY HEROES”, Channel 5, 9pm

Thursday 19th July 2012- “EVERYDAY HEROES”, Channel 5, 9pm just before the English News

A new TV local production that highlights people who make a difference. People who want to save lives and give love and support & understanding to those who badly need it.
In this particular episode, my wife, Doris & I speak candidly about her struggles with schizophrenia & depression for 40 years, her advanced arthritis condition, and the power of unconditional love that is helping my wife to cope.

 An insightful peak into an illness (schizophrenia) that is often not talked about, we share candid true accounts of what goes through her troubled mind and mine when Doris falls into a relapse. The journey of a caregiver for 37 years; counting that will encourage caregiving to be taken to a higher level. How I have helped my wife to become an author of 7 books.

 A programme that will create more awareness of mental illness and how I am helping others to cope with depression and other types of mental disorders.
Catch it - Thursday 19th July, Channel 5, 9pm - just before the English News at 9.30pm! Thanks.
Sincerely,
Raymond Anthony Fernando
View it here:
http://video.xin.msn.com/watch/video/episode-9/1dkv7c6yb