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Humans are by nature creative
beings, but not by nature logical,
structured-thinking beings. Those are skills
you have to learn. One of the things that
makes people more eective is if you can do
both ... If you’re great on both attributes, you’ll
have a lot more options. LaszLo Bock 12
today • thursday 1 May 2014
W
ith the recent highlight of
mental illness in our society,
we need to start asking if we
are doing enough to understand and
treat mental illness in Singapore. Per-
haps the first step would be to address
the stigma against mental illness.
With one in six people in Singapore
suering from some form of mental
illness, it is quite likely that patients
include our friends, colleagues or
family members. Yet, mental illness
is still stigmatised by prejudice, igno-
rance and fear. There are still some
within our society who view symp-
toms of psychopathology as threat-
ening and inappropriate, and these
attitudes foster stigma and discrimi-
nation towards people with mental ill-
ness. Numerous international studies
have suggested that stigmatising at-
titudes towards people with mental
health problems are widespread and
commonly held. As recognised by the
World Health Organization, the image
of mental illness is incorrectly associ-
ated with images of violence and lazi-
ness rather than with suering, mar-
ginalisation and denial of basic rights.
It is crucial to reduce the stigma
attached to mental illness. There are
numerous government organisations
and initiatives, such as the Silver
Ribbon Project, that address this by
portraying mentally ill individuals in
more positive light.
THE ILLS OF STIGMA
Stigmatising beliefs about individu-
als with mental illness are held by a
broad range of individuals. Surpris-
ingly, research has shown that this
is regardless of whether they know
someone with a mental illness, have a
family member with a mental illness,
or even have a good knowledge and
experience of mental illness. Mental
illness stigma is even present in the
medical profession, at least in part be-
cause it is given a low priority during
the primary training of physicians.
This stigma stretches across a pa-
tient’s lifespan. For adolescents with
mental illness, it is often in the form of
distrust and friendship losses. Adult
patients report stigma of fear, avoid-
ance and gossip, while older adults
with mental illness largely experience
discrimination in the form of pity and
an underestimation of their abilities.
Stigma includes both prejudicial
attitudes and discriminating behav-
iour towards individuals with mental
illness. A local study on help-seeking
behaviour among those with mental
illness indicated that only about half
of those with a severe mental disorder
had sought help in the past 12 months.
The reason in part is the stigma at-
tached. Critically, besides the treat-
ment gap caused by stigma, we often
see patients suer self-stigma.
Self-stigma, the internalising of
perceptions of discrimination, causes
patients to feel shameful and leads to
poorer treatment outcomes. Research
has also shown that patients who suf-
fer from self-stigma feel socially ex-
cluded and have low self-esteem.
In Singapore, several organisa-
tions, such as the Institute of Mental
Health and Singapore Association
for Mental Health, have programmes
to help those with mental illness
find work.
However, the mentally ill may face
discrimination and are fearful as they
have not worked for a long time. The
existing stigma also means that many
with mental illness are undecided as
to whether to declare their condition.
ERADICATING STIGMA
Acknowledging the existence of prej-
udice is an essential first step. A Sin-
gaporean study comparing views of
cardiac and psychiatric outpatients
indicated that the majority of psychi-
atric patients felt the additional burden
of stigma, while the cardiac patients
reported very little stigmatisation.
If your friend had a broken leg and
had just come out of the hospital af-
ter an operation, you probably would
not think twice about asking how they
were. Why do we console and empa-
thise with that friend, while poten-
tially shun another suffering from
schizophrenia? Mental health prob-
lems are common and normal. Most
people do not feel ashamed when
they come down with the flu, or when
their back is hurting. They try to sort
out the problem. We must recognise
that our emotional and psychologi-
cal health is just as important as our
physical health.
You do not have to be an expert to
talk about mental illness. Anyone can
experience a mental health problem, so
being able to talk about it is important.
Sometimes, little things such as asking
someone how he is, letting him know
you are still thinking about him, can
make a dierence to how he is feeling.
It is important also to remember
that having a mental health problem
is only one aspect of the persons over-
all health and well-being. Do not only
talk about mental health either. Peo-
ple do not want to be defined by their
mental illness. We should be mind-
ful to avoid cliches. Phrases such as
“Cheer up”, I’m sure it’ll pass” and
You’ll get over it” may not help. Try
to be open-minded and non-judgemen-
tal. You will not always understand
what is going on for the other person,
but lending a listening ear is the im-
portant part. Just spending time with
the person lets him know you care and
can help you understand what he is
going through.
Sociologist Erving Goman, cred-
ited for his theory of social stigma,
commented that the difference be-
tween a normal and a stigmatised per-
son is a question of perspective, not
reality. Just as much as our advance-
ment for assessment and treatment
into mental illness has developed, so
has the stigma towards it. It will take
time, but it is time to put an end to
mental health discrimination.
Dr Joel Yang
heads the
Master of
Counselling
programme at
SIM University,
and is a clinical
psychologist in
private practice.
Re-governing
China
T
his year’s China Development
Forum in Beijing revealed
the clearest vision yet of how
China’s leaders intend to deliver the
“Chinese Dream”, which President Xi
Jinping has described as “national re-
juvenation, improvement of people’s
livelihoods, prosperity, construction of
a better society and military strength-
ening”. The question is whether the
government can follow through on
its ambitious reform and develop-
ment plans.
Last November’s Third Plenum
of the 18th Central Committee of the
Chinese Communist Party produced
more than 330 major reforms in
60 areas for implementation by 2020
— a package of unprecedented scale,
depth and complexity. Orchestrating
China’s transformation from a manu-
facturing- and export-based economic
model to one driven by consumption
and services — and that is inclusive,
environmentally sustainable and cre-
ates more than 13 million jobs annual-
ly is a massive undertaking. Add to
it the challenge of upholding financial
and social stability and accomplish-
ing all of this while managing one of
the world’s largest bureaucracies
and the task ahead becomes truly
mind-boggling.
COMPLEX GOVERNANCE
ECOSYSTEM
Consider the eort last year to assess
the government’s financial condition.
The National Audit Oce had to mo-
bilise 55,400 stamembers to review
not only the central government’s ac-
counts, but also those of 31 provinces
and autonomous regions, five central
municipalities, 391 cities, 2,778 coun-
ties and 33,091 rural communities.
The investigation covered 62,215 gov-
ernment departments and agencies,
7,170 local-government financing ve-
hicles, 68,621 public finance-sup-
ported reporting units, 2,235 public
business units and 14,219 other en-
tities responsible, altogether, for
730,065 projects and 2,454,635 items
of debt.
deLivering the
chinese dreaM
CONTINUED ON PAGE 10
ANDREW SHENG
AND XIAO GENG
JOEL YANG
Mental
health stigma
stretches across
a patients
lifespan. For
adolescents, it
is often in the
form of distrust
and friendship
losses.
PHOTO: THINKSTOCK
Lets end
stigma
of mental
illness
reducing prejudice and fear