#SESSION 1 - State of Youth Mental Health

Preliminary findings from nationwide study sheds light on common mental health symptoms and vulnerable age groups.

IN a young life, the ages 14 through 16 are critical years. Parents and teachers should pay special attention to teenagers in this age group, who are more likely to have symptoms of anxiety and depression than those younger or older, revealed the nation’s first comprehensive study on youth mental health.

Some 3,300 respondents aged 11 to 18, were asked in Singapore’s Youth Epidemiology and Resilience Study if they worried a lot, felt unloved, as well as on resilience factors such as positive thinking, flexibility and positive self-image, among other questions.

The endeavour, by the National University of Singapore (NUS), in collaboration with the Ministry of Education and the Institute of Mental Health, began in April 2019, and found that about one in three youths reported symptoms of sadness, anxiety and loneliness.

These preliminary findings signal points of concern, said Senior Consultant Psychiatrist John Wong, the study’s principal investigator and panellist at the Temasek Shophouse Conversations on Youth Mental Health on May 20.

Associate Professor Wong, who works at NUH’s Mind Science Centre, noted that the load of these symptoms tended to peak at the ages of 14, 15 and 16, noting that children aged 11 were mentally better off as they were “just starting life”.

Concerns were echoed by the event’s guest-of-honour, Manpower Minister Tan See Leng, who noted in his keynote address that the pandemic had precipitated and coincided with a global surge in mental health challenges among youths here.

He highlighted data from the National Youth Council, which found that over 40% of youths who had not struggled before the pandemic reported that their mental wellbeing had worsened.

To tackle the issue, he said action is needed nationwide, across schools and workplaces, by industry partners, as well as the community. “Each and every individual has a part to play. We can start by showing empathy, such as understanding that the issues faced by our youths are real, listening to their needs and giving them support.”

Challenges in Access to and Provision of Interventions

With the slew of online and in-person mental health programmes, applications and services at their disposal, the Republic’s youth should — technically, at least — be faring better. What gives?

Panellist Dr Sharon Sung, Assistant Professor and Senior Clinical Psychologist at Duke-NUS Medical School’s Health Services and Systems Research said that despite the swathe of assistance schemes and tailored care available, stigma, in addition to systemic and structural issues, impede access.

Citing studies, Dr Sung said delays in seeking care range from a year to two for young people with depression or anxiety, and up to 11 years for those with Obsessive Compulsive Disorder. Mental health services might also be costly and hard to access despite an increase in the number of providers, she added.

Her fellow speakers suggested improvements such as a more flexible system, and better coordination across the board. To further move the needle, we need to move beyond awareness — simply knowing about a condition — to literacy, which is applying the right response to it.

As a start, Dr Daniel Fung, Chief Executive Officer of the Institute of Mental Health, suggested shedding labels.

“We tend to over-medicalise things… If we could take away the labels and just identify distress and what you can do with distress, we’ll create a flexible system,” he said. “Can we have a flatter system where people can access help as they need it, in the places where they exist? For young people, it’s the schools and the community. Are these available? Do we have a variety rather than a very rigid way of referral systems?”

He also called for mental health literacy via training programmes for all Singaporeans.

“Too much awareness is not good. Awareness itself just creates the mystique of mental health. What you want is literacy. It is actually intentional training, and then with literacy, participation. Look out for people who need help, listen to them, and link them to resources. But all that requires us as a community to say: ‘okay, everyone has to go for training.’”

Dr Priyanka Rajendram, Assistant Director of Integrated Health Promotion at the Ministry of Health’s Office for Healthcare Transformation, said better coordination of the array of mental health tools and offerings is needed, cheering the formation of the nation’s first inter-agency task force in August 2021 to oversee national efforts.

She welcomed the cohesive approach with governance frameworks, adding that it would help to normalise conversations.

"It sends an important message to Singaporeans that this is a shared care and responsibility, and that we all have a vested interest in this.”

For Dr Sung, it is about rallying the community to address gaps in the system.

Treatments are readily available to help people get back on track and build wonderful lives, she said. “One of the benefits of the pandemic is that it has allowed us to start talking about these things and recognising that mental health is health, and that we will all need to take care of ourselves and take care of each other.”