Jon: A Student's Perspective of Singapore Mental Health Conference 2016 (Part 1)

The Singapore Mental Health Conference 2016 happened over 27 and 28 May, with the theme of Mind Matters, Family Matters, at Singapore Expo.  This was wonderfully covered by Jonathan Kuek (who also covered the SPS Psychweek 2016 with me!) and his friends!!  Thank you Jon and friends!!

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Image Credit: http://www.smhc.com.sg/

Hello everyone!  It’s me again and this time I brought a couple friends with me, Ming Xiu, Gretchen, and Hakim (can’t cover the entire conference on my own).  We are excited to share with you our experiences at the Singapore Mental Health Conference 2016 (a 2 day event consisting of 4 plenary sessions, 14 breakout sessions, and 2 workshops).  Sadly we couldn’t cover all the breakout sessions because there were just too many for the 4 of us!  This year’s theme was Mind Matters, Family Matters.  This meant the emphasis was on how we can bring mental health services to the society at large and involving the community, instead of waiting for people to approach mental health services which quite frankly does not happen soon enough until it’s too late.  This is going to be a really long post so sit back, relax and enjoy the conference without having to attend it!

Note from SG Psych Stuff: This post will be broken up into two posts. Photos displayed in this blog post are shared by Jonathan; please seek his permission, via his details below to re-use the photos. 

Day 1:  Opening Address: (Jon)

Speakers:  Adj. A/Prof Chua Hong Choon, Mr Tan Chuan Jin

The conference kicked off with Adj. A/Prof Chua Hong Choon, CEO of the Institute of Mental Health thanking the various agencies involved in the planning and execution of the conference and introducing the main theme of the conference and a basic rundown of the topics that would be covered.  Following which, Minister for Social and Family Development, Mr Tan Chuan-Jin graced the event with the opening keynote speech which focused heavily on the importance of family support from our biological and “extended families” (community and workplaces) in shaping a mentally-resilient and inclusive society.  This was really heart-warming as it signified an effort to provide more support to various sectors such as caregivers, or people working in social work and other welfare organizations that work with people who are mentally ill or at risk.

Plenary 1:  Uncovering Mindfulness and Well-being (Jon)

Speaker:  Dr Daniel Racey

The first plenary session was by Dr Daniel Racey, a psychiatrist who specializes in mindfulness-based interventions.  It started off with a short mindfulness activity (particularly useful for me because I was sitting by the door and people were talking a lot outside) to help us redirect our attention to the present in preparation for his talk.  He then introduced research which showed how people with wandering minds tended to be unhappy, and how people who practiced meditation frequently were happier than those who did not.  A key concept he shared that I found particular interesting and felt was the biggest take away is that of the “second arrow” phenomenon.

The story goes something like this:  

An individual being shot by an arrow, would often fire a second invisible arrow that causes as much or if not even more pain than the first physical arrow.  

So how does someone to fire an arrow at themselves?  Well, to put it simply, the first arrow often comes from some kind of distressing event, but the second arrow comes from what we choose to make of it. Pretty simple right?  This imaginary second arrow often times leads us to believe that things are worse than they actually are, and the worst part is that it can all be avoided through the conscious effort to not fire it, which is basically what mindfulness teaches (acceptance of the situation while not letting it take over and to live in the present rather than worry about the past or future).  Perhaps we could all consider if we want to fire this second arrow in the future now that we know about it.

Plenary 2:  Mental Health and The Elderly: The impact of Dementia (Jon)

Speaker:  Dr Ng Li-Ling

Dr Ng Li-Ling, a senior consultant from Changi General Hospital was the second speaker of the day and her topic was one that reflects the changing demographics in Singapore.  As the number of elderly people increases, so has the number of dementia cases.  Additionally, this is not a situation isolated to Singapore;  globally the costs of dementia has risen from US$ 604 billion in 2010 to US$ 818 billion in 2015, a scary number right?  With our increasing life span, this number is estimated to increase even further.

The main point she was trying to put across in sharing these numbers is the scary reality of being in this time and age, you get elderly people in their 90s with dementia being taken care of their kids who are in their 60s.  This highlights an urgent need for more to be done to provide support for people with dementia that involves not just the medical professionals, caregivers and social workers (because let’s face it, there’s just not that many of them to go round), but the community at large.  If you’re reading this, why not consider getting more involved too?

Breakout Session 1:  Person-Centered Approach to Eldercare in the Primary and Community Setting (Abstract Information from Programme Book)

Speakers:  Dr Chris Tsoi Tung, Dr Ng Wai Chong, Ms Chong Ying Ying

With Singapore’s ageing population, the well-being of the Singapore elderly study found that the prevalence of dementia was 10 per cent in the elderly population (people aged above 60 years).  To cater to the needs of this growing and ageing population, capacity of the primary care and community based sectors have to be scaled up to meet this upcoming needs in dementia, a disease identified under the Chronic Disease Management Programme.  Speakers shared on their experience of diagnosing and managing patients with dementia in a polyclinic setting, individualization of assessment and behavioural interventions, and possible ways to increase social interactions between patients with dementia and their caregivers.

Breakout Session 2:  Wellness and Resilience (Jon)

Speakers:  Ms Angie Chew, Dr Chan Keen Loong

The first half of the session was presented by Ms Angie Chew from the Brahm Centre who shared on mindful speech and communication.  How often do you find yourself offending others without realizing?  Or have said something in a fit of anger?  A really cool quote that was shared highlighted how emotions will pass, but words spoken and the damage they do can sometimes stay long after the emotions have gone.  Don’t worry though, I’ll share with you 4 things to ask yourself before speaking, which perhaps you could use in the future to be a more mindful and effective communicator:

Step 1: Is it true?Step 2: Is it beneficial? (Why say something that is not going to help others and potentially put you in a bad situation? Unless of course your intention is to offend or cause harm in which case you probably should get some help.)
Step 3: Is this the RIGHT time and place? (Often times we say things with well intentions but when and where we say it can often cause the words to have an opposite effect. For example, pointing out a teacher’s mistake in front of the class can often have negative consequences, as I have good cause to know)
Step 4: Choice of tone and words (This may seem like common sense but if we’re not mindful of it, there are times we may not notice the tone and choice of words we use and it may come out differently from how we think it to be)

The next part of the session by Dr Chan Keen Loong from Khoo Teck Puat Hospital was really funny and interesting, but yet informative.  He shared on an indirect approach to communicating with youths.  So what is this indirect approach?  Basically it involves a less directive approach (e.g. "You should be doing this" or "Don’t do this"), and allows the youths to process for themselves what you are trying to tell them.  By doing so, the youths will become less defensive and yet be able to see things from your point of view.  I will now share an analogy he shared that I think really stood out to me and is a good example of how this indirect approach can work wonders if used properly.

In dealing with a depressed male who had been dumped by his girlfriend, and who kept ruminating (rethinking negative thoughts over and over again) on how his ex-girlfriend could not see any good in him; instead of what most adults/peers would tell him to do, like “just get over her”, or “she is not good enough for you”.  Dr. Chan shared an analogy with him instead:

A story about a farmer who found a rock with a huge piece of jade within, but this rock looked like a rock on the outside but being the experienced farmer, he knew it was something precious.  This farmer wanted to give this precious piece of rock to the emperor of China.  One day as the emperor was making his rounds in the city the farmer stood by the road side and offered this piece of rock to the emperor.  Upon seeing it, the emperor was furious and order the farmers left leg be chopped off for insulting the emperor of China.  However, the man did not give up and still wanted to give the rock to the emperor, so the following year, he appeared at the same spot and hobbling on his right leg, offered the rock to the emperor again.  The emperor got angry once again and ordered the man’s right leg be chopped off this time.  It should be noted this was a time of war and this emperor was replaced with a new one that same year.  Not wanting to give up, for the third time the man decided to offer his rock to the new emperor as he was making his rounds (how the man with no legs managed to reach the road is beyond me).  This new emperor looked at the rock for a moment and took up his sword and swung it at the man.  Instead of striking the man like the previous emperor probably would have, the sword struck the rock which split open, revealing the most beautiful piece of jade that had ever been discovered which the emperor gladly received and carved into the imperial seal of China and gave a handsome reward to the farmer.

When Dr Chan had finished, the depressed male thought about it for a moment before realizing what Dr Chan was talking about, but eventually was able to see things from a different perspective and move on with his life.  This analogy really showed me a new way of communicating and perhaps an even more effective way.  No one likes being directed so maybe putting your point across in such a way could really work wonders especially for youths who are in their “rebel” phase of life.

Breakout Session 3:  Starting a Family: A New Mother’s Perspective (Gretchen)

Speaker:  Dr Cornelia Chee, Ms Jasmine Yeo and Ms Alicia Lim

It was rather odd for me to go for this talk as I was not a new mother or even close to getting married anytime soon.  However, I always wondered what mothers go through before and during their pregnancy.  The talk started off with Dr Chee introducing perinatal anxiety such as panic disorder and obsessive-compulsive disorder (OCD) and how mothers have repeated thoughts of things happening to their baby.  This perinatal anxiety would affect the bonding that the mother would have with the baby such as the mother having regrets on being pregnant which is irreversible but with therapy, the mother would be able to have more confidence in themselves to provide for the baby and have more stability in their mental health.

Ms Yeo then touched on parent-infant interventions using the circle of security approach.  The key for parents is to be strong and kind while knowing when to encourage their child to go out and explore the world, and to be available to welcome them back into their hands when they are in times of needs.  Parents should ask themselves what their child’s behaviour is telling them, as a need for attention would mean a need for emotional connection.  Children feel secure in their emotional connectedness with their parents.

Ms Lim talked about the Touchpoint approach where the goal of this approach was to have optimal child development, healthy and functional families, and strong communities.  Development consists of regressions, bursts and pauses where regression in a child’s behaviour would cause disorganization for parents.  However it should not be taken negatively as disorganization would provide an opportunity for providers to connect with the parents.  Touchpoints are the predictions of periods of regression and disorganizations that occur before bursts in a child’s development.

Through this session, I learnt that there is so much more to know about becoming a parent more than just having a child and bringing them up.  The approaches mentioned are aimed to educate parents and intervene when parent-infant interaction is at risk of derailment.

Breakout Session 4:  Creating an Inclusive Workplace (Cho Ming Xiu)

Speakers:  Mr Kent Teo, Mr Vincent Budiharjo, Mr Tan Wen Xiang, Ms Low Wan Ve

The highlight of this session was to know that the social service sector and employers of major companies in Singapore are taking active steps in making the workplace a more inclusive environment for people with mental illnesses.  MINDSET Learning Hub, which is a new initiative by the Singapore Association for Mental Health (SAMH) and Jardine Matheson Group of companies will be up and running in July 2016.  This new centre will provide customised vocational training in the cleaning, hospitality, healthcare support, retail, and food & beverage industries for clients with mental health illnesses.  Mr Tan mentioned that the clients will be taught soft skills such as resume writing, managing job interviews and work etiquette.  Graduates from the vocational training stint will go on to take up internships lasting three to six months at companies in the respective industries.  Those who perform competently will then be hired.

Mr Budihardjo mentioned that employment is a key part of the re-integration process back into the community.  It also gives the clients a sense of purpose and confidence as they perform in their work environment.  Mr Teo also stated that this new move will create more job opportunities in the employment market for persons with mental illness.  However, he said that most of the jobs that were available for the clients were for blue collar workers.  He hopes that in the future, as the initiative gains more traction, people with mental illnesses would also be able to take on white collar jobs as they attain higher educational qualifications.

Personally, as a social work student, I am heartened to know that social service organizations and employers are churning out great programmes such as the MINDSET Learning Hub in creating job opportunities for people with mental illnesses.  It is definitely one step closer in helping the clients to reintegrate back into the community and creating an inclusive workplace in Singapore!

Breakout Session 5:  Importance of an Integrated Care Community (Abstract Information from Programme Book)

Speakers:  Dr Kelvin Ng, Ms Hannah Lew

This session features an innovative approach in bringing all stakeholders together to explore and co-create solutions in order to support people with mental health issues in the community.  While some live well with good community support, there are those whose symptoms go undetected and others who are at risk of developing issues.  With a more network-centric approach which showcases the various roles of partners, the community hopes to raise awareness, promote early detection and recognition of mental health conditions, as well as provide necessary support for the affected individuals and their families.  This network also emphasises on the collaboration and integration of both the social and healthcare sectors.  Speakers in this session shared their experience in attempting to build an inclusive society through strengthening community support and improving information flow.  Additionally, ways to develop successful networks and cultures that enabled people with mental health conditions to stay connected and live well within the community were also shared.

Breakout Session 6:  Arts in Mental Health (Gretchen)

Speakers:  Ms Ong Chui Ngoh (Art Therapist), Mrs Sharmini Winslow (Experiential Therapist), Ms Deborah Chen (Art Therapist) and Mr Tan Choon Heng

This session was really interesting because it touched on how art is a form of therapy to an individual.  When words are unable to describe how they feel, art forms such as drawing or acting it out would enable individuals to express themselves.  The therapeutic alliance allows the art therapist to take a peek into the client’s world.  Art is a creative tool that helps them to explore and their art work contain many difficult feelings experienced.  During the session, volunteers acted out a drama of a troubled man, and through that drama, the participant sees whatever has happened to him from an outside point of view and those acting together would be able to relate to him.  Mr Tan, who has been in art therapy since 2011 shared with us how pointillism helped him with his mental illness.  Pointillism is dotting to create an artwork and each dot represents mindfulness.  Mr Tan also showed pictures of his own artwork (shown below).  I enjoyed this session a lot as there were a lot of interaction with the audience and it gives people different options for therapy.

Breakout Session 7:  Roles and Perspectives of the Family in the Caregiving Journay and Mental Wellness - Building Bonds and Resilience in the Social Sector (Cho Ming Xiu)

Speakers: A/Prof Marcus Yu-Lung Chiu, Dr Vincent Ng, Mdn Hajjah Rehana

In this session, A/Prof Marcus Chiu shared his experience and wealth of knowledge in reaching out to more than 6000 caregivers through his Family Link Family Education programme in caregiving, and many whom have become active advocates in South Korea, Hong Kong, Malaysia, Taiwan and Thailand.  One of the key highlights that he shared was his involvement in the first city-wide stigma study on mental health and many related research studies in Hong Kong.

Dr Vincent Ng also highlighted the importance of the family in the caregiving journey and the impact of collaborative efforts to bridge social and health care issues in Singapore as he believes that such partnerships can create a positive and lasting social impact in our community.  

One of the major highlights of the session was the personal sharing by Mdm Rehana, 68.  Her powerful testimony as the main caregiver for her husband, whom is currently bed-bound due to a complex spinal injury sustained from an accident in 2010 has touched many of the audiences.  Mdm Rehana has been carrying out her husband’s wishes based on his Advance Care Plan and looking into his complex care needs.  She also reaches out to other caregivers who face similar plights through her involvement as a volunteer in caregiver support programmes at various hospitals.  Going the extra mile, this selfless lady does home visits to share her journey and offer fellow caregivers a shoulder to lean on.

Mdm Rehana’s personal testimony really moved me, and it has reminded me the resiliency of the human spirit and the selfless acts of sacrificing can be found in everyday heroes like herself.

Breakout Session 8:  Mental Wellness at the Workplaces - It can be done, and here’s the Proof! (Jon)

Speakers: Mr Michael Kuan, Ms Rachel Wong, Mr Frank Ong

The next session I attended was one on how workplaces can be more adaptive to try and suit the needs of their employees better.  It involved professional such as Mr Michael Kuan from ELITE translations, Ms Rachel Wong from Panduit Singapore, and Mr Frank Ong from the Institute of Mental Health.  They shared with us various practices that their companies have established to help create a more employee centric environment which caters to the individual needs and with a greater focus on the mental well-being of each employee.  For example, working from home or other special working arrangements that can be made to better suit an individual’s needs.  This actually helps the employee feel more empowered and that the company actually cares for them, which in turn allows them to achieve their greatest potential.  Indeed, in the fast paced life of the current Singaporean, I think that knowing there are companies out there who are paving the way for more of such programmes to be implemented is a great source of comfort.  Imagine being able to work from home, or being asked to go home to take care of your kids instead of coming in to work.  It seems like we could one day achieve a better work life balance if more companies follow their lead. 

To be continued in Part 2...

About the writers:

Jon is a 3rd year psychology student in James Cook University (Singapore).  Learning is his passion and he hopes to one day educate the next generation of psychology students.  He has interests in many fields of psychology, in particular social and clinical psychology.  In his free time, Jon volunteers at the Institute of Mental Health and is constantly looking for new volunteers to join him on his adventure to serve the mentally ill who are staying at the hospital.  Do contact him at jon211190@gmail.com if you would be interested in helping them too!

Gretchen is a 2nd year psychology student in James Cook University (Singapore).  She has interests in the field of counselling psychology and hopes to destigmatize mental illnesses in students.  In her spare time, she volunteers for Institute of Mental Health and enjoys travelling.  If you need to contact her, you can email her at GretchenLYC@gmail.com.

Ming Xiu is currently pursuing his Bachelor in Social Work under the Singapore Institute of Management University (UniSIM) Scholarship.  He is deeply passionate about mental health advocacy and believes in the power of peer empowerment in helping youths with mental health issues towards their road to recovery.  He has worked with youths-at-risk whom were under juvenile probation together with their families and believes that every youth can be a successful story.  He also volunteers with the Institute of Mental Health regularly with Jon and a group of like-minded individuals whom have the heart for persons with mental health issues.  If you need to contact him, you can email him at Mingxiu87@gmail.com. 

Hakim is a counsellor with ClubHeal, an organization set up by a group of like-minded individuals who have a strong passion in helping people with mental illness and their family members lead a fulfilling and stigma-free life.  ClubHeal runs a psychiatric rehabilitation day care service in which psycho-education and supportive counselling to persons with mental illness and their families are provided.  They also provide outreach programs to them and the general public.  To contact Hakim, you can email him at hakim@clubheal.org.sg.