Mental health 'key priority' in national agenda; 900 more GP clinics to be added to community care network

SINGAPORE: The government will make "significant moves" to improve Singaporeans' mental health and well-being, as Deputy Prime Minister Lawrence Wong on Wednesday (Feb 7) called for a more inclusive "Singapore Dream" and a mindset change on what constitutes success.

Weighing in on a parliamentary motion on advancing mental health, Mr Wong announced a raft of measures. These include:

• Increasing capacity at the Institute of Mental Health (IMH) and the redeveloped Alexandra Hospital.
• Ramping up the number of public sector psychiatrists and psychologists by 30 per cent and 40 per cent respectively.
• Training an additional 28,000 frontline personnel and volunteers.
• Introducing mental health services at all polyclinics and 900 more GP clinics.

The government aims to implement these measures by 2030 or earlier. 

Mr Wong stressed that the government is making mental health and well-being a “key priority” in the national agenda and called on Singaporeans who are passionate about the issue to join in this national movement. 

“We have lots to do and a full agenda ahead of us. The government has set out clear plans and deliverables. But the issues are complex and we do not have all the answers,” he said. 

“We want everyone on board, so that we can learn together, and continue to fine-tune our strategies based on your feedback and ideas, and our shared experiences and insights.”

CHANGING DEFINITION OF SUCCESS

While attitudes towards mental health issues are shifting, Mr Wong acknowledged that the stigma remains. And this “reduces a complex and difficult problem into unhelpful labels and stereotypes”, he said.

“It opens people struggling with mental health to discrimination, such as in the job market. It may cause them to be socially ostracised. It makes them feel ashamed, isolated, and stops them from seeking treatment.” 

Improving overall mental health also means mindsets have to be changed over what is considered success, said Mr Wong on the second day of the debate.

He pointed out that this was, in fact, one of the key points from the Forward SG engagements, where the majority of Singaporeans had said they wish to see a "more inclusive Singapore Dream". 

The dream was defined as “one where we are not pressured to conform to narrow definitions of success; where we embrace excellence and talents across many areas, and find meaning and purpose in what we do”, he added. 

Mr Wong, who chaired the Forward SG exercise, noted that the government is making policy moves by reviewing the education system, narrowing wage gaps and strengthening safety nets. But he reminded the House that “we cannot make this happen through policy alone”. 

Instead, attitudes and mindsets must also change and align with aspirations for a “refreshed” dream.

WIDE SUITE OF SOLUTIONS 

The national mental health and well-being strategy, which was launched in October last year, aims to provide more tailored care for different needs across the spectrum.

On Wednesday, Mr Wong reiterated the need to appreciate and understand the “full range of mental health issues”. 

On one end, mental health conditions like bipolar disorder and schizophrenia can be “debilitating”, while issues like anxiety and stress on the other end of the spectrum may not typically require medicalisation. But it does not mean the latter should be taken lightly, he noted. 

As mental health issues exist on a spectrum, there is a need for “a broad suite of solutions”. 

While the government will hire more psychiatrists and build more capacity at IMH, this solution is not the be-all and end-all. 

“We also need to strengthen capabilities across our entire spectrum of care, including at our polyclinics and GPs, and also across other settings like schools, workplaces, and in the community, so that more timely support can be rendered to those in need,” said Mr Wong. 

To that end, the government has specific targets that it aims to achieve by 2030 or earlier. 

First, it will increase capacity at IMH and the redeveloped Alexandra Hospital for those who need specialist care. Capacity at long-term care facilities will also be increased to provide “step-down care” for those who need it.

Second, it will increase the number of public sector psychiatrists and psychologists by about 30 per cent and 40 per cent respectively.

Third, it will introduce mental health services to all polyclinics and 900 more GP clinics, bringing such services closer to the community. 

Fourth, it will equip and train 28,000 more frontline personnel and volunteers who serve at various community and social service touchpoints. This will help them “identify people struggling with mental health and offer early assistance”. 

The government will also “redouble” existing efforts, added Mr Wong. 

The Education Ministry is on track to achieving its target of deploying more than 1,000 teacher-counsellors across schools. This is in addition to the basic counselling skills that all teachers will be trained in, as well as the one to two counsellors that every school will have to support students with “more challenging social and emotional needs”. 

Parents will also be provided with resources to help them support their children’s mental health and well-being needs. 

There will also be more peer support networks established in the community, such as in schools, institutes of higher learning (IHLs), workplaces and among national servicemen. Such networks will have “trained peer leaders” who can provide a “first line of response” to friends and colleagues who need help. 

INSURANCE COVERAGE, WORKPLACE STIGMA 

Addressing concerns raised by MPs on Tuesday about better insurance coverage for mental health conditions, Mr Wong pointed out that life insurers in Singapore have offered coverage to people with mental health conditions.

“But the underwriting of such persons can be a complex matter, as our own data is limited, and insurers here typically reference the underwriting guidelines of global life reinsurers,” he said. 

The government will nonetheless review how the coverage can be improved and ensure that financial institutions deal fairly with all their customers, including those with mental health conditions, he added.

In the workplace, the government is also taking steps to help companies better understand employees’ mental well-being. 

It will launch iWorkHealth Lite, which is a “dipstick survey” that can be completed in five minutes and is for companies to gauge their employees’ work stress and burnout, announced Minister of State for Manpower Gan Siow Huang in parliament on Wednesday. 

The iWorkHealth Lite comes under the Ministry of Manpower’s iWorkHealth assessment tool – a free online, company-administered tool that employers can currently use to gain insight into their employees’ mental well-being, including workplace stressors they may be facing. 

The shortened survey was the result of feedback from companies to use iWorkHealth as a “pulse survey” to monitor the mental well-being of staff more frequently. 

Echoing sentiment among MPs about eradicating stigma, Ms Gan pointed to the upcoming Workplace Fairness Legislation, which “sends a strong signal that there is no place for discrimination against employees and jobseekers with mental health conditions”. 

Employees should be treated fairly and based on merit even if they have chosen to disclose their mental health conditions, she said. 

In his closing speech, Dr Wan Rizal (PAP-Jalan Besar), who had filed the motion along with four other MPs, also highlighted the common concern among those who spoke over the two-day debate: Stigma. 

Stigma is “not just a societal issue”, he reminded the House. 

“It's profoundly personal, affecting individuals and families in every corner of our community. The stigma mutes voices that need to be heard. It isolates those who feel alone in their struggle and deepens the wounds of those silently suffering.” 

As such, cultivating an environment where people are not afraid to seek help or talk openly is a mission that spans “every facet” of society, he said. 

The motion on advancing mental health care was unanimously passed in parliament on Wednesday afternoon.