Jon: A Student's Perspective of Singapore Mental Health Conference 2016 (Part 2)

Continued from Part 1, which is Day 1 of the Singapore Mental Health Conference...
Note from SG Psych Stuff:  Photos displayed in this blog post are shared by Jonathan; please seek his permission, via his details below to re-use the photos. 
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Image Credit: http://www.smhc.com.sg/
Day 2:
Plenary 3:  Stigma towards People with Mental Disorders – A Singapore Perspective (Gretchen)
Speaker:  Adj Asst Prof Mythily Subramaniam

People roughly know what mental illnesses are but there will always be stigma about it.  Stigma is a mark of shame or disapproval that results in an individual being rejected and discriminated against.  A national study was conducted in Singapore to examine stigmatizing attitudes towards 5 disorders:  alcohol abuse, dementia, depression, schizophrenia and obsessive-compulsive disorder (OCD).  The results showed that Depression was more likely to be perceived as ‘Weak – not – Sick’, schizophrenia and alcohol abuse as more dangerous and unpredictable while dementia and OCD were perceived to be less dangerous.  This stigma leads to people with mental illness to have little intention to seek help from their friends and family especially for alcohol abuse.  People who hold these stigmas are usually those with a lower education and income status, however, those who have a close friend or family member would hold lesser stigmatization to mental illnesses.
I think that it is really important for the public to understand mental illness so that they would be able to help their friends or family who are in need in the future and they would not shun them away just because of a mental illness.  It is already difficult enough for a person going through it, but not getting the support that is needed from their friends and family would be tougher.  This session gave me a better understanding about the stigma that an individual with mental illness might face and how the public can change this by lending their support.

Plenary 4:  Recovery and Resilience: Family Resilience Training (Cho Ming Xiu)
Speakers:  Dr Lori Ashcraft, Mr Eugene Johnson

Mr Eugene and Dr Lori of Resilience Inc shared their expertise and experiences in setting up 53 programmes in 23 communities and 13 facilities in the United States to create a better future for individuals living with serious mental health issues.  Some of these programmes include:  crisis response services, peer support services, recovery education and supported employment for persons with mental illnesses.
Currently, they are in the midst of collaborating with Caregivers Alliance Limited (CAL) Singapore, to provide family resilience training and programme development for the staff, leaders and volunteers, so as to equip them with the necessary skills sets and knowledge to provide care and support for the clients.  Some of the trainings include:  recovery and resilience, facilitating skills, resilient leadership, family strengths bank, family resilience action plan and family mission statement for caregivers.
Personally, I think that family resilience training for caregivers is highly important, as highlighted in the theme for the Conference, “Mind matters, Family matters”.  As caregivers are better equipped with the appropriate resources to help their family members whom are suffering from mental illnesses, they would be in a better position and are able to make more informed choices in their daily battles with challenges from taking care of someone with mental illness.

Breakout Session 9:  Panel Discussion - Promoting Mental Health Advocacy: The Voices of Experience Perspective (Cho Ming Xiu)
Speakers:  Mr Wong Kim Hoh, A/Prof Marcus Yu-Lung Chiu, Miss Poon Lye Yin, Mdn Junainah Eusope, Mr Jared Goh
Moderators:  Adj. A/Prof Chua Hong Choon, Ms Chan Lishan

This was the most engaging and interactive panel discussion throughout the conference!  It was opened to students from various junior colleges, polytechnics, universities, healthcare professionals, social service professionals, educators, media, caregivers and persons in recovery.  Some of the topics discussed were the stigma that persons with mental illnesses faced, the struggles of being a caregiver, the work of a mental healthcare professional, the media’s portrayal of mental health in Singapore and how do we as a society help destigmatize and raise mental health awareness in Singapore.
Some of the key highlights were the sharing by Mdm Junainah, a mental health advocate with IMH since 2012.  She shared her personal struggles with major depressive disorder and how she has used her recovery story to touch others, and encourage them to seek treatment for mental health issues.  Mr Jared Goh also shared his personal story as a caregiver to his sister whom has major depression and anxiety disorder, and the importance of the role of the family and caregiver in the road to recovery for a person with mental illness.  Mr Wong Kim Hoh, a senior writer with the Straits Times also gave an interesting account of how the media should take on a more humanistic approach in journalism, in particular to news related to persons with mental health instead of having the main intention of creating headlines.
I felt that the panel discussion was insightful and engaging, as the audience had the opportunity to participate in the discussion though a real-time online polling system to gather our thoughts.  It was also heartening to see many youths rising up and voicing out their thoughts and aspirations for the mental health community in Singapore!  

Breakout Session 10:  Resilience in Youth and the Elderly (Abstract Information from Programme Book)
Speakers:  Dr Grace Lee, Mr Sean Kong, Dr Tam Wai Jia

Mental well-being relates to our ability to positively experience life and make a meaningful contribution within our community.  Building resilience is an essential step to enhancing our mental well-being.  Resilience helps us to deal with challenges, solve problems, achieve our goals, and also reduces our vulnerability to mental health difficulties.  In this session, latest research in resilience was discussed and sharing on programmes and services targeted at different populations were showcased.

Breakout Session 11:  Challenging Mood Disorders in Youths and Interventions (Jon)
Speakers:  Dr Teng Jia Ying, Dr Johnson Fam, Miss Terri Chen, Mr Lee Seng Meng 

This particular breakout session was interesting as it gave us a better understanding of what is being done to better help youths with mood disorders.  The first speaker Dr. Teng Jia Ying from the National University Hospital, Singapore, shared on the importance of developing more effective screening procedures for youths.  This is mostly due to the high number of youths that are not getting treatment for their problems earlier.  She also shared a clinical workflow utilized by the hospital in determining when to screen and what to do if people were tested positive for mood disorders.

This flowchart has been found to also been quite successful in detecting various mood disorders, which is promising as early detection can often lead to better outcomes in treating these mood disorders.  Hopefully more hospitals can start up similar initiatives and fine tune them to get the best outcomes for the patients.
The second speaker Dr. Johnson Fam from the National University Hospital, Singapore, talked about a shift away from the traditional pharmacological treatments to a more neuropsychiatric methods such as Transcranial Magnetic Stimulation.  This involves sending low level of electric currents into the brain, and works to generate more neuronal activity in areas where there is a lack of it, while reducing neuronal activity in areas that are hyperactive.  Now I want to point out at this point in time that such treatments are not like what you would see on the television and are safe, and in most cases even beneficial for the patients.  Additionally, most studies have found few side effects which is promising as anti-depressants have been known to have many unwanted side effects such as weight gain or sweaty palms.  Perhaps in the next few years we will see more of such treatments being used as the literature grows and it becomes more empirically supported.
The third speaker Miss Terri Chen from the National University Hospital, Singapore, shared on her work with group therapies for youths with mood disorders.  In particular, how they have recently started a form a group therapy based on concepts within Dialectical Behaviour Therapy which is the gold standard and most used treatment for Borderline Personality Disorders.  For those who do not know what it is, Dialectical Behaviour Therapy is a modified form of Cognitive Behavioural Therapy and is designed to change patterns of behaviour that are not helpful (e.g., self-harm).  Miss Chen has found that through her group therapy sessions, she was able to greatly reduce the amount of self-harm in the youths that she was working with.  This is a really good sign because group therapy is more cost effective than individual therapy, and with the widening patient to therapist ratio in Singapore, such forms of therapy could offer an alternative form of treatment that has a wider reach but similar effectiveness.
The final speaker Mr Lee Seng Meng from Student Care Services, believed strongly that we should be empowering our youths and promoting positive mental health rather than just preventing it.  His take was that instead of being content with having no mental disorders, we should be giving youths tools that will help them overcome any challenges they may face.  To that end, his programme on positive youth development (see below) aims to teach youths various core aspects of mental resilience such as regulation of emotions and understanding how to navigate social norms amongst others.  By doing so, we can achieve more than a mental disorder free youth population, but have youths that are mentally resilient and able to take on adversities in the future.  I personally believe this initiative is extremely good as we need youths to be proactive members of society, and to contribute actively as part of it instead of just not being a burden to society.  I do hope that more schools will follow in his footsteps and have such programmes for their youths as well.


Breakout Session 12:  The Emerging Role of Caregivers (Abstract Information from Programme Book)
Speakers:  Dr Lori Ashcraft, Mr Chris Martin, Dr Sally Thio, Ms Rita Haque, Ms Dawn Kor, A/Prof Kalyani Mehta, Dr Tan Jit Seng

This training symposium was based on the highly valued role of caregivers and the important part they can play in improving the services available to those who suffer from mental health issues.  The caregiver movement in Singapore has grown rapidly over the past few years and caregivers have spread the message that recovery and resilience is possible.  Yet, too often caregivers are not given meaningful roles to play in the healing process.  They have a valuable contribution to make and must be given opportunities to contribute more broadly and deeply to the delivery of services.  Through this training, caregiver support groups will learn how to form their own direction and how best to support the growth of members of such groups.  Additionally, ways to overcome conflicts and use problems to build resilience and strengthen this movement towards more caregivers being trained and supported were shared.  Furthermore, perspectives from current caregivers were shared at the second session of this talk which shed light on the various factors that could play a role in the journey of a caregiver.

Breakout Session 13:  The Next Phase of Primary Care: Managing Mental Health Patients (Abstract Information from Programme Book)
Speakers:  Dr Mok Yee Ming, Dr Eng Soo Kiang, Dr Jared Ng, Dr Terence Yow

Primary care for mental health is a key component of any well-functioning health system. For an effective and efficient system, primary care for mental health must be complemented by additional level of care. It includes secondary care components, which primary care professionals can turn to for supervision, referrals and support. Links to informal and community-based services are also necessary. It is crucial to understand appreciate the relationships, and to learn the role of integrated primary mental health care within the context of the overall health system. Through this session, general practitioners and allied health community partners were invited to share their experiences in the management of patients in the community with physical and mental health needs. Mental health is an integral part of primary care services and with improved accessibility, mental health needs of the community are more likely to be identified and treated together with the co-morbid physical condition, contributing to a more holistic care.

Breakout Session 14:  Paradigm Shift in Mental Health Services: A Peer-Driven Approach (Cho Ming Xiu)
Speakers:  Mr Eugene Johnson, Dr Eu Pui Wai, Mr Anjan Ghosh, Ms Rosalind Pek, Ms Nicole Kay

It is really exciting to know that the mental health services in Singapore is taking a whole new paradigm shift towards a more peer-driven and recovery oriented approach, where persons with mental health issues are involved in the design and implementation of services.  In the bid to break down stigma associated with mental illnesses and strengthen the support for persons suffering from mental health issues, the Institute of Mental Health (IMH), National Council of Social Services (NCSS) and Voluntary Welfare Organizations (VWOs) are co-developing this initiative, where a pool of former patients may be peer specialists to share their personal experiences and offer advice to patients as part of a new national framework.  Dr Eu of IMH and Mr Anjan of NCSS have stated that the two organizations are currently working with VWOs such as the Singapore Association for Mental Health (SAMH) in rolling this initiative out, where these peer specialists will be hired on a full-time basis to work in IMH, NCSS or the VWOs.
Rosalind Pek, one of the first few pioneering peer specialists from SAMH shared that the beauty of being a peer specialist is to see the lives of the persons in recovery being transformed through mutual experiences.  She was elated to see one of her clients whom was previously aimless in life, now motivated to strive towards in becoming a peer specialist to encourage fellow peers whom are also suffering from mental illnesses.  She believes that through shared lived experiences, it will empower fellow persons with mental illness to rise up and change their lives.
Personally, I feel that this is a game changer in building a support community for persons in recovery and those whom have successfully recovered.  Through common lived experiences, they share a common bond and aspire to help one another to live purposeful lives, which is in essence the greatest gift to those whom are suffering silently with mental illnesses.

Workshop 1:  Psychiatry Residents Symposium – Heart to Heart: Conversations about Real Life Ethical Dilemmas (Gretchen)
Speakers:  Dr Calvin Fones, Dr Yap Hwa Ling

This session was supposedly for psychiatry residents but it was still open to anyone who wanted to sit in to listen.  Additionally, its aim was to generate awareness on the multitude of ethical issues surrounding mental health care.  Clinical ethics skills in psychiatric practice is the ability to recognize one’s internal discomfort as a signal of potential ethical conflicts and seek resources that will help in approaching these ethical issues.  We did 4 case studies of different ethical dilemmas and the psychiatry residents gave their opinions.  Furthermore, people from the social service sectors also gave their point of views.  It was interesting to hear the different opinions about the ethical dilemmas.  Ethical dilemmas do not necessarily have a correct and straightforward answer.  Dr Fones ended off the session by saying:
“You come in here thinking you will get a direct answer, but when this session finishes, you are more confused”
Workshop 2:  Workshop, Recovery and Resilience (II): Wellness in Action (Hakim)
Speakers:  Dr Lori Ashcraft, Mr Eugene Johnson

The session was a continuation of the session conducted in Plenary 4, Recovery and Resilience (I):  Family Resilience Training that was focused on how the dynamics and support of family members could have a significant impact on the recovery journey of a person with mental challenges.  This session on the other hand focused more on how a recovering individual could benefit from adding more resilience into his/her recovery journey.  This is because some of us, may find comfort in staying in that area of safe recovery which results in possibly limiting our full recovery potential.
 In my opinion, it is simple yet amazing how by being resilient, an individual who for example expresses 'hope' in recovering would find it a lot more manageable if they are resilient in being optimistic with the goals being set.  Also, at a cultural level, promoting the recovery culture would bring forth a community of wellness through the act of being resilient in every individual in the community.
In exploring the dimensions of wellness, Dr Ashcraft mentioned the Eight Dimensions of Wellness, namely Intellectual, Emotional, Spiritual, Occupational, Social, Financial, Physical and Environmental, are where each individual's choice may vary depending on how they prioritize one factor from the other based on their beliefs, personality, well-being, etc.  These were further explored through interacting and sharing of views amongst the different groups.
I find that the session gave a new refreshing take on things that would definitely benefit anyone and everyone, not just for individuals working in the mental health sector.

Closing Plenary:  Finding Inspiration in Mental Health (Jon)
Speaker:  Mayor Denise Phua

The last plenary session was presented by Mayor Denise Phua.  For those who did not previously know, Mayor Denise has struggled with having to raise a child with special needs, and I can’t even begin to say that I know what she’s been through, and is still going through.  I can only imagine the pain she must have been through, yet here she stands in front of us sharing her story of how she turned adversity into success.  Through this talk, she shared with us the struggles she faced such as ostracism from others and the general stigma of having a child with special needs.  But she never gave up and instead wanted to give more support to help people with special needs.  To that end, she set up Pathlight (mainstream school for children with special needs) and has been very active in volunteering.  I think by being so giving by nature, she has touched many lives and have helped changed things for the better.  Lastly, she ends off with sharing how despite her best efforts, without the community supporting her, none of this could be possible.

Finally, we have reached the end of the conference and if you’re still reading this at this point in time, thank you for joining us through this wonderful journey.  Seeing all that has been done and will be done has really rejuvenated us on our quest to really give back to society and to hopefully make a difference in the lives of others one day.  Speaking for all of us who have brought you this post, I hope we have allowed you to walk away from this post with the mind set of how I can better contribute to society.  With that, I would like to thank SGPsychStud for allowing us to post such a lengthy post and we hope that anyone who reads this will find new inspiration in your life journey of helping others!

Thank you for reading the posts!!!
From left to right: Joanne Gan (Nursing Student), Jonathan Kuek - Post Contributor (James Cook University, Singapore), Gretchen Lim - Post Contributor (James Cook University, Singapore), Cho Ming Xiu - Post Contributor (Singapore Institute of Management University)
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.

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