Thanks Fitriah

I will now be going through a case study to illustrate mental health recovery using the 4 dimensions
that my teammates have elaborated on.

This is Alvin, he is currently a married man in his 50s and his marriage has lasted for 20 years.
However, Alvin was previously diagnosed with chronic schizophrenia first when he was in university.
The symptoms of psychosis came after he over-exerted himself in his year 3, which was a result of
attaining poor grades in his 2 nd year. The symptoms were that of delusions and possible
hallucinations, saying that he would, quote “see a painting come to life and staring angrily at him”
while his delusions would manifest as strong beliefs that people wanted to harm him. As a result,
Alvin was diagnosed with chronic schizophrenia and hospitalized into IMH by his parents for a few
weeks. He went through electro-convulsive therapy and was then discharged. After discharge, Alvin
did not have enough mental capacity to go back to university, hence his highest qualifications
remained at ‘A’ levels.

Now, thus far, this has been Alvin’s narrative of having been diagnosed with a mental health
condition, schizophrenia. However, he was able to achieve recovery, and we can see so in the
following ways.

Firstly, as we can see in the clinical recovery aspect:

 Although Alvin was not able to integrate back into school, he was able to find a suitable job
doing clerical work.
 After Alvin was discharged from IMH, he applied new coping skills and strategies to better
manage his symptoms such that he could integrate well back into a working environment.
 Alvin also continued seeing his psychiatrist years after discharge, not just for medication but
for psychotherapy as well.

Secondly, on the personal recovery aspect:

 Alvin had a positive outlook on his future despite him acknowledging that he, quote “may
not be as good as his fellow peers, who could be CEOs, doctors and lawyers”, but he is still
able to sustain work with a basic salary.
 In addition to this, Alvin importantly retains his self-identity separate from his mental health
condition, saying that he retains, quote “his thriftiness and frugality and hence positive
habits in saving up money for the future”

Thirdly, on the social recovery aspect:

 Alvin enhanced his existing social network, which was already strong in the form of his
Christian community, and met his now-wife through a Christian dating organization. His wife
was understanding and accepting of his mental health condition, when he brought her to his
psychiatrist to psycho-educate her on his schizophrenia diagnosis. He writes fondly about his
wife and clearly experiences satisfaction in such an intimate relationship.
Lastly, on functional recovery:

 Alvin’s parents previously had enough insight and rightly admitted him into IMH despite not
understanding his psychotic symptoms. This insight and intuition were later passed on to
Alvin. After discharge, Alvin had good insight into his mental health condition and he
understood that one of the biggest triggers for him was stress. Hence, he made the decision
to settle for a less high-flying but far more relaxed and hence more suitable job as a clerk, in
which he stabilized in.

Alvin is now a passionate mental health advocate and volunteers with community mental health
agencies in Singapore. If anyone would like to read Alvin’s story, you can scan this QR code.

As we can see, mental health recovery is multi-dimensional in nature – it is not just related to the
specific symptoms that people with mental health conditions experience, the context surrounding
each case is unique.

A very different picture of mental health recovery would be painted according to demographic
factors, that is, whether one is male or female and how old one is. Using the widely known lifespan
theory, for example, Erik Erikson’s stages of psychosocial development, mental health recovery can
look very different for, say, children and youths, whose goals are to achieve identity, versus the goals
of older youths and young adults, which are to achieve intimacy – to experience satisfying
emotionally intimate relationships, versus the goals of older adults and the elderly, whose goals
respectively are to achieve a sense of accomplishment and established legacy in life, and to achieve
the sense of having lived a full life with no regrets and no unfinished business.

We can also categorize the different initiatives into preventive, development and remedial in nature.
I would like to briefly explain and clarify these 3 categories as the issue of mental health recovery
seems very remedial in nature because the persons affected would have already been diagnosed
with a mental health condition.

When talking about preventive measures, we are not talking about measures that prevent people
from developing mental health issues. Instead, we are focusing on initiatives that can help prevent
people who are already diagnosed with mental health conditions, relapse and regress into a previous
state of instability, defined by a level of distress and dysfunction that they cannot cope with. As for
remedial measures, we are talking about measures that have been set in place as contingencies to
help people with mental health conditions, if and when they do experience a recurrent mental
health episode, so that they can quickly revert back to their recovered state. Lastly, for
developmental measures, we can focus on those more directed to society, such as public education
and awareness-raising campaigns.
With that, I’ll now go into the specific examples of the initiatives.

Firstly, I will briefly add on regarding peer-support-specialists in Singapore. The idea of peer support
is not a new one, and this form of support has started all the way back since the 1800s, coming from
a medical setting origin – it is not unique to mental health, and people with chronic or terminal
illnesses such as diabetes, heart diseases, cancer, HIV and AIDS also had, and do still have peer
support services. Referring back to the dimensions of mental health recovery, we can see that peer
support can strengthen one’s social recovery, due to the peer-support specialist being someone who
can be accepting and understanding of the mental health conditions, as they themselves were once
diagnosed with it, and still live with it. IMH Peer-support-specialists provide in-patient recovery
workshops, and outpatient peer-support groups, which aim to psychoeducate and provide
information to people with mental health conditions and their families. Peer support specialists
would play both a preventive and remedial role in mental health recovery.

Other initiatives that have been setup include online counselling services, mental health hotlines like
such as fei yue’s online counselling services via text for youths, silver ribbon’s counselling centre,
TOUCHLine by TOUCH Community Services, and the belle helpbot chat and text support hosted by
beyond the label.

The employee assistance programme is a scheme in Singapore implemented by the Ministry of

manpower, engaging various counselling centres as vendors for staff with mental health conditions,
or personal issues to go for counselling; and the fees are partially or fully subsidized while the staff
can be given time off during work hours to go for the counselling. There is also a private version of
this initiative where corporates can engage other independent mental health service provider
vendors to care for and consult on their staff’s mental wellbeing. An example is this entity named
Acceset; You can scan the QR code here to find out more about Acceset. These are initiatives that
play a preventive role for employees with mental health conditions in any workplace settings.

Secondly, developmental strategies would include public education and awareness raising initiatives.
Some examples of these include singapore’s Annual Mental Health Awareness month, occurring in
May, represented by a green ribbon, and online webseries and public sharing media platforms like
‘Our Grandfather Stories’ and ‘Can ask meh?’. For anyone interested in the ‘Can ask meh?’ video
interviewing people with mental health conditions, you can scan the QR code here to watch the
video. The sharing platform ‘Our Grandfather Story’ later also posted other videos interviewing
people on more specific mental health conditions like Bipolar, dementia, eating disorders and
interviewing caretakers of persons with mental health conditions.

From the overseas education front, Taiwan’s education system incorporates a psychology and
mental well-being module for their elementary and secondary school curriculum, teaching and
normalizing mental health conditions in mainstream schools for students from a young age. This
psychology and mental health subject is normalized to the extent of it being like how Singapore has
civic and moral education as a subject they teach from primary to secondary school, or sex
education, home economics etc.

And yet another awareness raising solution could be borrowed from the LGBTQ community’s
Pinkdot Parade idea, that is to say, raising awareness of mental health issues by having a mental
health parade or march. Speaking of which, there is a fundraising mental health run event in
Singapore called ‘I run for hope’, by an organization called ‘The Limitless’, and the funds go into
supporting youth mental health programmes in Singapore. However, this is still primarily a
fundraising event and does not have the main objective to raise awareness. Instead, something
more akin to another mental health running event, done in the United States, called ‘Still I run’
would be something more meaningful and more aligned to the objective of raising the public’s
awareness – being a call-to-action for the public to be involved in advocating for and supporting
persons with mental health conditions. All these examples would constitute as developmental
strategies for mental health recovery, as the de-stigmatization would allow for a more inclusive and
less judgemental society. It is only through the nurturing environment that a more understanding
and accepting society creates, that would allow persons with mental health conditions to recover in
the sense that they regain their confidence, hope for the future and sense of self-efficacy to achieve
their goals.

Thirdly, there are also many community resources supporting people with mental health conditions
who have recovered and have integrated well back into the community. Some examples of these are
private practice counselling centres and workshops equipping people with various therapeutic
coping skills. For example, Brahm centre has an extensive selection of mindfulness courses and even
certifications, which could be a useful coping skill for persons with mental health conditions to be
equipped with. There are other interventions like groupwork provided by various organisations like
samh’s mobile support team, care and counselling centre and TOUCH mental wellness. There are
also the community intervention teams, known as COMIT, who aim to support persons with mental
health in the community, and this service is hosted by various organisations including AIC, Singapore
Aglican Community Services, Fei Yue and St Luke’s hospital.

Along this line of thought, it may also be useful to wonder if there could be self-help mental health
support groups in Singapore, which other countries have. For example, the alcoholics anonymous
group follow a 12-step program to help cope with alcohol addiction. Of course, this would differ a lot
from a self-help group consisting of persons with mental health conditions. However, the idea is not
new at least in the global context. For example, there is actually an international ‘depressed
anonymous’ group that holds online meetings for people from all over the world. That being said,
the face-to-face meetings are only conducted in a handful of countries excluding Singapore, mainly
based in the United states and other countries like Iran, Poland, Russia, Ukraine and UK. It might be
helpful to have similar groups like these in Singapore, but modified to suit our local context. For
example, having self-help groups for specific mental health conditions highly prevalent in Singapore,
like having an obsessive compulsive anonymous, schizophrenia anonymous, depression and anxiety
anonymous and so on and so forth.
In conclusion, the resources and potentials that I’ve elaborated on can help persons with mental
health conditions achieve mental health recovery, be it in the clinical, personal, social or functional
sense. All in all, there is much hope for people with mental health conditions to enhance their
quality of life and subjective well-being, regain a sense of hope, form aspirations and future goals,
have a more positive outlook in the future to create new, positive auto-biographical narratives about
their mental health condition and life story.

Here is one more story about a Singaporean peer-support-specialist’s journey with mental health
recovery – you can read it by scanning the QR code here. With that, we end our presentation, thank
you!