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Elderly self-harm a growing concern; SOS sees slight increase in crisis calls over past year

Observers believe that self-harm among the elderly is being under-reported. Ahead of Mental Health Day on Oct 10, CNA looks at recent developments.

04:10 Min
More seniors are seeking help for mental health issues, according to figures from Samaritans of Singapore. Although government agencies could not provide statistics on elderly self-harm, experts believe such cases could be under-reported. Lauren Ong with more.

SINGAPORE: Almost every night, as he lay on his bed hoping to fall asleep, he would struggle with thoughts of dying alone in his one-bedroom flat.

Attempts to ignore the disturbing noise in his head were futile, recalled 69-year-old Mr Wong (not his real name). A prescription of one-and-a-half sleeping pills daily did not work. Neither did taking three pills at once, or even six.

It was a daily tussle for weeks, until one night when Mr Wong decided to take all the pills he had. He counted some 50 tablets and swallowed them.

“That time I thought, this is painless, swallow them and have a good sleep. Don’t wake up already,” the senior said in Mandarin, as he remembered that night almost five years ago.

“But I couldn’t sleep. Instead, I felt nauseous and kept vomiting.”

Mr Wong’s case is not uncommon, said social workers from non-profit organisation O’Joy. They see about a hundred other clients with mental health issues, some of whom turn to self-harm.

Although agencies, including the Ministry of Social and Family Development, Ministry of Health (MOH) and the Institute of Mental Health (IMH), were unable to provide figures on elderly self-harm, experts believe such cases could be under-reported.


Self-harm, by definition, is injuring oneself on purpose but not with the intent of committing suicide, said Dr Yao Fengyuan, senior consultant and chief of the Geriatric Psychiatry Department at IMH.

The main reasons behind of elderly self-harm, according to Dr Yao, include serious physical health issues, financial difficulties and coping with loss. Then, there are those who have to deal with social isolation and family tensions during the pandemic, he added.

Elderly self-harm cases are noticeably different from those reported by youth, an age group which has received increasing attention in recent years on the issue, he said.

According to Dr Yao, seniors tend to self-harm by overdosing on medication and cutting themselves.

“There are some seniors with mental illness but are unwilling to seek help. Because these mental illnesses are associated with poor awareness, such as psychosis and dementia,” said Dr Yao.

Also, some seniors may not be able to identify their psychosomatic symptoms.

Samaritans of Singapore (SOS) chief operating officer Phua Chun Yat said: “They are likely to tell the health professionals that they are experiencing chest pains but actually it’s psychological pain.”


More seniors are seeking help for mental health issues, going by figures from the SOS. The suicide prevention agency, which offers a 24-hour hotline for emotional support, received 6 per cent more calls from those aged 60 years old and above over the past year.

During the pandemic, seniors would call in to share their struggles grappling with the uncertainty, said Mr Phua. 

“A lot of them also experienced social struggles, as they are isolated and unable to meet up with loved ones. There's a general sense of loneliness,” he said.

The struggles, however, proved to be too much for some who ended up taking their lives.

For Ms Tricia Lee, head of communications at Caregivers Alliance, the suicide of her 92-year-old grandmother during the pandemic came as “an absolute shock”.

“She moved to Singapore from Malaysia just before COVID-19 hit, so it was a tough period of adjustment for her. She didn’t have her network of long-time neighbours and friends, and we were not able to bring her out much,” said Ms Lee.

“Although we knew she was unhappy, none of us saw it coming. It took me several months to fully process that she was gone.”


When elderly self-harm was brought up in Parliament in July this year, MOH said elderly care recipients who exhibit self-harm or aggressive behaviours can call the IMH helpline for help. Community intervention teams have also been set up to offer further care.

But these seniors may not get the assistance that they need, as more resources are moved online, experts said. 

“For those elderly who are not IT savvy, they are not used to videoconferencing. They actually prefer physical contact,” Dr Yao said.

Ms Jocelyn Toh, a senior social worker at AMKFSC Community Services’ COMNET Senior Service, shared the same view.

“Many older persons experience difficulties in keeping up with societies and struggle to use basic functions like Internet banking or using search engines,” she said.

Tell-tale signs are often less visible when dealing with seniors, she added. “Hence, it is important for us to observe carefully by listening closely to what they say and keeping track of their actions and emotions.”

Where to get help:

Samaritans of Singapore Hotline: 1767

Institute of Mental Health’s Helpline: 6389 2222

Singapore Association for Mental Health Helpline: 1800 283 7019

You can also find a list of international helplines here. If someone you know is at immediate risk, call 24-hour emergency medical services.

Source: CNA/ca


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