Emotional first aid a viable first response to mental distress in Singapore, experts say

SINGAPORE: Demand for mental health services is on the rise in Singapore, with some clinics seeing a nearly 40 per cent spike in new clients since the start of the year.

The Ministry of Health has also reported an over 80 per cent jump in unique visitors to its online stress management platform, mindline, from 2022 to 2025.

But in moments of distress, people are more likely to turn to a friend or family member than a therapist, experts said - and this is where emotional first aid is emerging as a viable frontline response.

Emotional first aid is not about solving problems, but helping people regulate their emotions so they can respond to challenges in a more rational and effective way, noted counselling psychologist Karen Ho.

It can also help individuals to spot unhelpful thoughts, and re-frame them before they spiral.

Exercises such as tapping, breathwork or even journalling are some examples of emotional first aid tools.

They have helped Ms Ho deal with her own personal difficulties, she told CNA.

"There was a period of time where everything seemed to happen all at once. I was caring for young children, juggling my freelance work, studying and also preparing for a big family transition,” she recounted.

“I remember feeling very overwhelmed and stretched, like I couldn't hold everything together."

What helped her to cope was tapping - a method used to calm the mind by applying gentle taps on specific points on the body, such as under the eyes or on the collarbone.

“It helped my mind to settle down. When I was calmer, I was able to think more clearly and to respond to what was happening, instead of feeling frozen in the emotions,” Ms Ho said.

She added that she usually takes five to 10 minutes to tap, along with other breathing exercises, before facing her clients or family members.

“It helps me to ground myself, so I can help my mind to refocus (on) what I need to do, instead of thinking of worrying thoughts or scenarios that I have to cope with later.”

BREATHING THROUGH THE STRESS

While emotional first aid is a fairly modern concept, it is based on evidence-backed techniques in therapy and counselling, experts said.

Controlled breathing is one of the most researched and effective tools to help people feel calmer and more focused.

One example is box breathing, a technique used by United States Navy SEALs. To do this, breathe in, hold, breathe out, and pause, each for a count of four.

"When we breathe in, our heart starts pumping out. When we release the breath through the mouth, it calms, the heart rate goes down, blood pressure goes down. So you're working, teaching, equipping our own bodies to calm ourselves,” said family counselling psychologist Adrian Lim.

Virtual reality and biofeedback have also been used to help people learn these techniques.

Such technologies combine immersive environments with real-time feedback from heart rate or brainwave sensors, allowing users to practise calming techniques while monitoring their physiological responses on screen.

Yet, experts note that many emotional first aid techniques - such as breathwork - can be practised independently once learned.

DOES NOT REPLACE THERAPY

Emotional first aid is not a substitute for professional therapy, just as physical first aid does not replace medical care, experts said.

They stressed that first responders must also be aware of their own state of mind when helping others.

"When people are distressed, they don't pick up the call to call a psychologist. They will pick up a phone to call a friend and a family member. And you provide the first response there,” said Dr Matthew Lim, deputy director of the master's of psychology clinical programme at the National University of Singapore.

"I think of it like a container. You are providing space, a container for them to pour their distress into.”

But Dr Lim cautioned that this has its limitations, particularly for the person offering support. He said people should consider their own emotional capacity before stepping in, especially if they are already feeling stressed or overwhelmed.

“Your own cup is full. And if you want to be a first responder, you need to have space to contain the emotions of somebody,” he said.

Agreeing, principal registered psychologist Geraldine Tan added that psychological or emotional first aiders do not need to “resolve everything at that point in time”, but focus on de-escalating the emotions.

Once that initial support is given, it is vital to connect the person to professional help - such as a psychologist or psychiatrist - to ensure continued care, said Dr Tan.

She added that emotional first aid can help one to be prepared in moments of crisis.

“If, let's say, somebody is breaking down in front of you - you're not frightened, you're not running away, you're not succumbing to the fight, flight, freeze responses,” she said.

But she cautioned there is no one-size-fits-all response to people in distress.

“We have a toolbox. When you are hurt, there are different degrees of hurt. There's different tolerance levels also … so we pick and choose what is most suitable for ourselves,” Dr Tan added.