I remember the day I sought help for my mental health. It was in the army.
It’s 12 midnight, and most of the lights are off in the clinic. There is a faint smell of antiseptic in the air.
Walking into the doctor’s room, I happen to see his adjacent screen. The page?
Wikipedia.
The title? “How to make a mental health assessment”.
Telling him about my suicidal ideation makes him worried enough to send me to IMH. I remember the state of despair when that happened.
I try to convince him otherwise, that all I need is someone to talk to.
He sends me anyway. I remember sitting in the army ambulance, and thinking,
“Gosh. What have I gotten myself into?”
That night, at 1 am, I find myself in IMH. I’ve been waiting for 1 hour for the doctor to see me. I feel stifled.
I want some fresh air.
Walking towards the exit, the door doesn’t open. I look for a button to press. Then the receptionist calls out from the counter.
“You can’t go out.”
The Mental Jail I Now Found Myself In
That was when I first realised that seeking mental health treatment had not just left me physically locked up, but also mentally jailed. Sat in this mental jail, I could only look out of the bars, feeling that I would not be accepted for having been treated for mental health.
The day after my visit to IMH, I remember calling IMH to ask them how long my records would be kept.
I wanted those records to disappear, thinking my ‘clean’ record, and consequently, my future, were now ruined.
I had to lie when filling up employment forms asking if I had mental health conditions before. As much as we can say that we have moved ‘beyond the label’, would an employer really take someone with a mental health condition, when he had someone ‘normal’ to choose from?
Even insurers didn’t want to insure me.
The Missing Conversation
Much of our conversation today focuses on raising awareness of mental health conditions and getting sufferers to seek help.
And much of the work so far is deserving of praise.
But mere focus on awareness and encouraging people to seek help misses the mark of what happens after someone gets help.
Among the interviewees I spoke to, they tended to split their lives into two portions. BC, and AD. Before Crisis, which was what led them to initially seek help; and After Diagnosis, which has confronted them with the realities of living with a mental health diagnosis.
This is the experience of 2 patients who have spent time in the psychiatric units of Singapore’s hospitals.
Mere focus on awareness and encouraging people to seek help misses the mark of what happens after someone gets help.
The Cost On One’s Employment
Nadera remembers her worst experience at the Institute of Mental Health, Singapore’s only psychiatric hospital.
In that Class C ward, she spent days with 40 others in the ‘day area’. I thought I heard wrongly.
Forty, or fourteen?
Forty.
The day area is where patients spend their days. There are simply chairs and tables in the room. Their phones are kept from them. Often, not many programmes are organised for them. She saw a diversity of patients there, including one who removed her diapers to defecate on the floor. Another one started stripping off her clothes. Others were screaming.
There, toilets cannot be locked. Anyone can enter the toilet.
She was traumatised by that experience and found herself feeling worse after being discharged.
Nadera has lost count of the number of times she has been hospitalised at IMH. But she continues to go whenever she doesn’t feel safe, despite previous negative experiences.
Nadera agrees that there have been consequences of her diagnosis, especially in job hunts.
I know friends who have lied about their mental health conditions when filling up employment applications. For me, there are times when I haven’t heard back after declaring.
I’ve learnt to not declare it first, but talk about it during the interview. I don’t want employers to make conclusions without even meeting me.
It seems that the emotional cost of one’s mental health, also has a dollar sign attached.
When the Cost Outweighs the Cause
Lishan has been hospitalised 5 times between 2018 and 2021, when she actively sought help.
But she had to stop because it got too draining on her finances.
I’ve spent $70,000 on psychiatric treatment. And I didn’t feel I was getting better.
Every time I saw a psychiatrist, they would say the same thing. There’s no cure for your condition.
Lishan was diagnosed with bipolar disorder.
She felt something had to change.
I almost felt like sometimes I was playing this role of being a patient. For those 3 years, I just wanted someone to care for me.
I weaned myself off my medication.
Since January 2022, Lishan took on a full-time job as a yoga teacher. There is clearly something different about her today, compared to when I first met her in 2019.
There’s a sparkle in her eyes, a spring in her step, and she even breaks into song when a familiar tune comes on in the cafe.
What has changed? Is there truly life after a mental health crisis? How have these patients found life again, from such dire circumstances?
Is There Life After Crisis?
Nadera acknowledges that there are still gaps in post-crisis treatment today.
There’s been more focus on preventative, youth mental health today.
But we shouldn’t forget the work IMH does in treating people in crisis, or helping them after crisis.
When I was in IMH, I used to spend day after day sat in the day room, with nothing to do except chatting to other patients, and waiting for the meals to arrive. There were no activities.
After I was discharged, there was an IMH Job Club, and basic activities like sewing and baking, but these were really more suitable for people who were in more severe conditions.
There’s a lack of resources in expanding the work IMH does.
Can More Be Done For Life After Seeking Help?
Nothing is perfect, and if we poke holes in our mental health post-recovery system, there will definitely be gaps.
But it’s not because the government, professionals, or the community haven’t tried hard enough.
In August 2021, the Government’s set up the Inter-Agency Taskforce on Mental Health and Well-being. In their public consultation between May to August 2022, they shared their preliminary recommendations, one of which was to build a wider ecosystem of support in workplaces, to support persons with mental health conditions.
It’s a recognition that recovery from mental health is no longer just about the individual, but the wider workplace where the person can contribute.
Professionals spoken to shared about the very real bed crunch faced in IMH, and the manpower issues that prevail in a medical speciality that seems to have little financial reward for the difficulties involved in caring for patients.
The community has stepped in too. Organizations like Club Heal, have a Community Intervention Team (COMIT) to support life in the community after psychiatric treatment.
Building a wider ecosystem of support in the community, and in the workforce, are certainly steps in the right direction.
The Individual Effort Matters Too
But for both Lishan and Nadera, their community of friends and their personal drive to improve their situation have made things better.
Life after diagnosis is really expensive. $150 for one session of therapy is a lot. If I was feeling rich, maybe I would go more times a month.
But I really can’t afford it.
Nadera pauses for a long time when I ask her how she would encourage those facing mental health crises now.
I’m struggling to answer because there are so many times when I don’t want to go back to IMH. But I don’t know where else I can go.
I can hear the pain in her voice.
But I also see the tenacity of hope. Nadera recently lost her father.
Yet she continues to fight, together with countless others, to make life after crisis, possible.
The Importance of Community
The Singapore Mental Health Study (SMHS) in 2016 found that 1 in 7 has experienced a mental disorder in their lives. But 6 in 7 haven’t, and may not ever experience one.
If you’re one of the 6 who may never face a mental health crisis, you still play an important role in being the relationship that matters, when it feels like everything else in the patient’s life has crumbled.
In 2018, I volunteered in Xi’An, with a charity serving children with disabilities, who were often found abandoned in street corners, rubbish dumps, and doorsteps.
One afternoon, walking home with a teen with a mild intellectual disability, I asked stupidly,
Do you miss Mummy?
No I don’t.
I thought I heard wrongly.
I asked again, more firmly this time.
No I don’t. I have friends and aunty here.
Later when I went to his room, all he had was a teddy bear on his bed, and a suitcase under his bed. In the eyes of the world, he had nothing.
But in his eyes, he had everything.
Because he had friends and family.
Nadera concludes,
Going into IMH can be a scary experience. You don’t know anybody, you could be waiting in A&E for 4 hours, with people screaming around you.
It can be a very lonely experience.
Ultimately, people make the journey easier, and the recovery matter.
If COVID has taught us something, it’s that however user-friendly and accessible our technologies can be in making our experiences better, nothing can ever replace our deep yearning for relationships.
John Lim was trained as a social worker in the U.K. before moving back to work at a family service centre for 2 years. He currently writes and speaks on building better workplaces for Gen Zs at liveyoungandwell.com
This is an invited opinion piece. The opinions expressed are those of the author. If you would like to have your work featured on Regardless, please write to us at hello@regardless.sg
