SINGAPORE: The Ministry of Education (MOE) and Ministry of Social and Family Development (MSF) are “very concerned” about the spike in the number of youth suicides this year, said the ministries in a joint statement.

“It is not yet a trend, but we must monitor this closely and take various measures to address it,” said spokespersons for the ministries in response to email queries from CNA.



The number of suicides in Singapore rose 10 per cent last year, with suicides among boys aged 10 to 19 at a record high, the Samaritans of Singapore (SOS) said last week.

A total of 94 people aged between 10 and 29 killed themselves last year, SOS said.

Among boys aged between 10 and 19 years old, there were 19 suicides last year – the highest since it began keeping records in 1991 and almost triple the seven cases recorded in 2017.





There were 397 reported suicides in 2018, compared with 361 the year before. This raised the suicide rate to 8.36 deaths per 100,000 Singapore residents, up from 7.74 in 2017.

Noting that the underlying causes of suicide are complex, the spokespersons said: “The objective is to build psychological resilience in youths, raise awareness on mental health issues, identify and support those at risk of suicide, and intervene in crisis situations where urgent help is needed.”



‘NEW CHALLENGES AND SOCIETAL PRESSURES’

Relationship issues, academic stress, peer pressure and uncertainties about their future are possible causes for suicidal thoughts in teens, said experts, and mental health conditions like anxiety and depression may intensify the problem.

Dr Ong Say How, senior consultant and chief of the department of developmental psychiatry at the Institute of Mental Health (IMH) said youths may think of suicide after facing severe distress and emotional pain from a major setback.

Since younger people have “limited problem-solving and self-help skills”, he said they might think of radical solutions for their problems, including suicide.

“Today’s youths are facing new challenges and societal pressures compared to times when life was simpler.”

Dr Adrian Wang, a consultant psychiatrist at Gleneagles Medical Centre believes academic and peer pressure play major roles.

He said: “Social media may unfortunately compound issues in a young person who is already feeling anxious or depressed. I have young patients telling me they feel lonely and marginalised because their friends have excluded them from a Whatsapp chat group, or unfollowed them on Instagram.

“Teenagers see their social media or digital presence as an extension of their personality. They need to feel accepted not only in real-life situations, but online as well.”

Education policy expert Professor Jason Tan said recent education reforms, such as not listing the top scorers in national exams, are good efforts to reduce academic pressure on youths.

But he noted that pressures also come from employers, parents and the wider society. “I think the important thing to emphasise is that the school is just one sphere of influence for young people.”

‘ASKING FOR HELP IS NOT A SIGN OF WEAKNESS’

Despite the spike, SOS noted that more young people are reaching out for help. Among those who wrote to them for emotional support last year, more than 78 per cent were between 10 and 29 years old. This was an increase of more than 56 per cent, it said.

Experts agreed that while this was an encouraging sign, more awareness of mental health issues among teachers, employers and society at large was necessary to eliminate the social stigma surrounding them.

Dr Cheryl Huang, senior clinical psychologist with the clinical and forensic psychology service at MSF, said: “More young people could be reaching out for support due to greater awareness and avenues to do so. They should not have to suffer in silence nor feel ashamed for asking for help.

“As a community, we could contribute by being supportive towards one another, understanding that asking for help is not a sign of weakness.”

Dr Wang highlighted that young adults who have just started work also often feel overwhelmed by job pressure, sleep problems and insecurities about their future, and stressed that employers need to be more supportive.

“I am sometimes contacted by a patient's HR department who sometimes have no idea of the concept of doctor-patient confidentiality, and want to know when their staff can get back to work, instead of asking what they can do to help,” he added.

But more young people reaching out for professional help could mean they still feel uncomfortable talking about it with their loved ones, said Mr Daniel Koh, a psychologist from Insights Mind Centre.

Some of them do not want to “be seen as a burden”, he said, and thus reach out to professionals, sometimes even in secret.

PEER SUPPORT AND BUILDING RESILIENCE

For youths and teens, experts stressed the importance of having programmes that build resilience and allow them to discuss the challenges they face.

Dr Ong said: “It is important to educate young children that failures and setbacks in life are to be expected and are acceptable.

Allowing children to face challenges/obstacles, make mistakes and subsequently overcome them, helps them develop a sense of responsibility, mastery, and confidence.”

He added that this would mentally prepare adolescents for challenges they meet when they grow up, that they would otherwise feel are “catastrophic”.

“Peer support can also be helpful, where youths are taught how to provide a listening ear to their friends who are feeling troubled, and also how to alert and link their friends to receive additional help,” said Dr Huang.

MSF said it “pays special attention to vulnerable youths”, such as those who have been abused or ill-treated, and screens them to detect mental health concerns and self-harm risks.

“MSF psychologists also work closely with case managers and caregivers to develop case plans and interventions that take into account the particular circumstances of the individual, including his or her age and gender, as well as risk and protective factors,” it said.

In schools, an “individualised approach” is adopted for each student at risk, said MOE.

“At the same time, school personnel look out for risk factors and issues more uniquely associated to each gender to provide specific support. Schools also work closely with parents to encourage a nurturing and supportive home environment,” the spokesman added, noting that every school has a trained counsellor.

“Our teachers seek to build positive relationships with their students, and look out for those displaying signs of distress.

“Schools also encourage students to look out for and support one another, as well as point peers in distress to seek help from trusted adults, including parents, teachers, and counsellors.”

"To foster a caring school culture", most schools have rolled out peer support programmes, MOE said.

One such school is Fairfield Methodist Secondary School (FMSS). Ms Clarissa Koh, year head for upper secondary and officer-in-charge for peer support at the school told CNA that student response to peer support has been "very positive".



Efforts to educate students on how to look out for and support friends in distress have been paying off, said Ms Koh, with student peer support leaders alerting teachers whenever they notice those who may be struggling.



"The peer support leaders have the most direct contact with their peers and are able to listen out and watch out for signs of distress such as sudden mood swings, change in habits and appetite, unusual activities and so on," she added.



FMSS' student peer support group comprises 73 students who have undergone a peer support training camp to learn about different mental wellness issues, what signs to look out for and how to provide support.

Once a term, the six student leaders in the group share mental wellness tips with the student body, reminding them of what to do and who to look for if they are having difficulties coping with stress.

The peer support group also organises two major mental wellness events every year. For example, mental wellness week teaches students how to cope with stress and how to de-stress, and the activities have seen strong participation from students from all levels, Ms Koh said.



PROVIDE A LISTENING EAR



Jeremy Tan, a secondary 4 student in FMSS who also serves as head of the peer support board said classmates are more open to sharing their worries with each other because they feel more comfortable.



Recounting an incident where a friend "poured his heart out" about family issues at home and some other problems at school, Jeremy said: "I listened to his worries and empathised with him. He felt better after that.

"I felt that all he needed was just a listening ear and to know he had the support of his friends."



While it can be unsettling to hear that someone you care for is feeling suicidal, experts encouraged they be given support and encouraged to seek help.

Dr Ong said individuals who have experienced episodes of anxiety or depression, a significant loss like a break-up or death, a personal crisis, or a loss of social support are vulnerable.

The first step should be to provide a listening ear for those affected to talk about their feelings, said Dr Huang. “Help to monitor and keep this person safe.”

Dr Wang said: “You don't have to give solutions to their problems immediately. Just listen and validate their feelings. Sit and be with them until that feeling of despair fades. Then follow-up the next day, and the following day. Encourage them to speak with a counselor or a doctor.

“Small steps can help in a big way.”



Where to get help: Samaritans of Singapore operates a 24-hour hotline at 1800 221 4444, or you can email pat@sos.org.sg. You can also find a list of international helplines here. If someone you know is at immediate risk, call 24-hour emergency medical services.

