May 7, 2008

Community Mental Health in action!

At Singapore, i had the opportunity to attend a public forum, organized by Silver Ribbon, Singapore - to reduce stigma regarding mental illness, and to promote mental health.

[Here's a report of that program “Emerging Trends in Psychiatry and Successful Recovery” - with title "I have Mental Illness, SO WHAT", happened on 26th April 2008].

I have mental illness, SO WHAT? was the bold title of the first Community Mental Health related program I could attend after coming from India to Singapore. This public forum, free for all interested public, started exactly at the time announced, 2.00 pm at Punggol room, near Toa Payoh Mass Rapid Transport (MRT) Station, (Train-station) in a centrally located area in Singapore. The hall with seating capacity of 100 people was completely full before the program started with the program announcer’s comments. A spokesperson of Janssen-Cilag, a pharmaceutical company cum the sponsor of this program, gave his address first.

Ms. Porsche Poh, the Executive Director of Silver Ribbon, Singapore came next. Her pleasant & informal style put the whole audience at ease, and she quickly gave background information of why and what of this forum, and described the efforts of Silver Ribbon’s team members to reduce stigma associated with mental illnesses. Ms. Poh then explained how this stigma is one of the biggest challenges faced by not only the mentally ill patients, but it spills over to their caregivers & family members as well. Stigma acts as a block, when it comes to seeking treatment, difficulties in gaining employment honestly, financial problems & even as a cause for quitting medication. She ended her talk by pointing out that everyone has a role to play and the need to strive towards positive mental health.

Dr. Fatimah Lateef, Member of Parliament, Singapore, who is also Consultant at Dept of Emergency Medicine, Singapore General Hospital, was the next speaker. ‘Touch one life – Make a difference’, the title of her presentation itself was welcomed with applause all around. Dr. Lateef gave statistical information regarding prevalence of mental illnesses in Singapore, which together with Depression (5.6%) , Anxiety (3.4%) & schizophrenia (1%) accounts for 10% of the population, and dementia affects 5.2% of elderly. Results of studies also pointed out the impact of stigma & lack of awareness as only 49.1% had sought assistance to treat their mental illness.

Dr. Fatimah then went on to show the various govt. Interventions that had taken place since 1995, which have induced more patients to seek treatment, as well as to reduce duration of hospitalization. She also briefly showed various schemes ongoing and in the pipeline. Especially encouraging were the positive results of Psychological Outreach Program or POP as its commonly known, in dealing with depression & caregiver burden. She also described a pilot project to deal with primary school children, where by a stick figure ‘Zippy’ is introduced to them for sharing emotional issues & for psycho-educational purposes.

Dr. Rita Goh, presented the next session, “Back from the brink of insanity”; a sharing session, as Dr. Goh had suffered from paranoid schizophrenia 4 year ago. When she pointed out that 45 thousand Singaporeans are diagnosed with schizophrenia, the enormity of that figure it sunk in, as for a country with 4.5 million population, its a huge figure. She further stunned the audience with objective description of her symptoms very openly. Dr. Rita then pointed out how early treatment, effective counseling, support from others & self helped her. Further, she pointed out the negative impact of stigma in detail, through her presentation slides. Photo of an elderly inmate in a hospital, who has not received a single visitor in his 49 years long stay, suffering from mental illness was a symbolic example of stigma & existing misconceptions regarding people with mental illness.

Currently, majority of mentally ill patients are youngsters (teenagers & below), and other revealing information followed through. She pointed out that recent efforts like a play depicting mental illness ‘off center’, and celebrity admissions regarding their depression etc. have been helping to increase public awareness & reduce stigma. She encouraged more people to open up about their mental illness, as self-stigma is something they can immediately work on. This followed by a tea & snack break around 3.20 pm.

I was already itching to move around and be part of the coordination process of this event, as this wonderful mental health initiative brought back memories of countless public programs organized by IPH (Institute for Psychological Health) in Thane, India. In those events, I have always been an active organizing member, and am not used to sitting at one place and taking notes. During the tea break I got an opportunity to move around and talk to various people. Mr Ng Choon Peng, the Country Manager of Janssen-Cilag was a refreshingly different & deeply involved in the whole proceeding & volunteered his assistance in many ways during the program itself. I also could talk a little with Ms. Porsche Poh, though we met for the first time, through Ms. Gayathri Ramprasad, we were already introduced. But obviously she was very busy as a main coordinator of the whole program.

In about 20 minutes the post tea session started. As Ms. Porsche had pointed out to me, majority of Singapore audience don’t stay back after tea break... but here surprisingly most people gathered in quietly again, and the hall filled in no time. Though the dreariness of afternoon time was setting in and I was wondering, how will this speech be, as Mr. Harris NG, the next speaker walked in to talk on “Back to society”. But Mr. Harris with his informal & affectionate style warmed up the audience. Through his story telling way he shared his 16 years of fight with mental illness, hospitalizations, quitting medicines, subsequent relapses and path to recovery. Applause and laughter freely flowed along with these stories and a truly community spirit fully gathered around again.

Harris discussed about 2 types of stigma. One is external – which is pointed out the most, but the other type, internal also needs to be tackled. He quoted that, “Our own shame & guilt about mental illness needs to be overcome by openly accepting it & sharing it”. He further indicated that, there definitely has been more awareness & less stigma than 20 years ago, but we still have a long way ahead, and though patients are now called as clients, but they need to be called as ‘consumers’, as and the caregivers/family members as well. He elaborated by comparing consumer rights movement with movement of rights for mentally ill.

Mr. Harris also shared through his stories, the strength & insights he received due to the rapport with his counselor, which help to stay in the path of recovery. His urged all consumers to compare medicines with a pedestal, which help you to stand higher up, rather than as a trouble, and was greeted with much applause. He then introduced his life partner, his wife as speaker for next presentation, titled “For good..... and even better times: A life partner’s view”.

Mrs. Violet Ng, wife of Mr. Harris Ng, started by saying this was her first ever public speech in all these years, and the supportive audience began to cheer even more. The positive attitude and sparkling spirit of Mrs. Violet was very evident throughout her sharing. She emphasized that, it is possible to have a purposeful, satisfactory life despite having a mental illness... What else can be called normal?” She questioned. She also expressed her gratitude for all those who helped in a touchingly emotional way to end her speech.

Next was a short Q & A session due to time constraint. Here also Ms. Porsche Poh’s informality & charm sparkled through, and helped everyone to be interactive. As the session ended, I could see many people rapidly completing Silver Ribbon (Singapore) membership forms, obviously inspired to take up the cause & go ‘towards positive mental health’.

(Report by Venkatesh Iyer, Psychologist from India, who attended the program as an invitee).

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