Fighting and understanding the woodbridge stigma

A well written article in the below link about the nature of the Woodbridge Hospital (now known as the Institute of Mental Health) stigma by a local undergrad.

http://www.singaporeangle.com/2007/02/fighting_and_understanding_the.html

There is a stigma to IMH/woodbridge even among those who's mentally ill. Mention to some of them that they have to get hospitalised there, and you can just see how terrified they can get.

Make a difference

Here's a beautiful clip that a good friend of mine forwarded through email.

I hope that everyone takes the time to watch the clip, it will be worth your while

http://www.teachermovie.com

and a quote here from Mother Teresa to go along with it for us to think abt.

We can do no great things, only small things with great love. ~Mother Teresa

Best/Worst things to say to someone who is depressed

A list of the best/worst things to say to someone who is depressed.
http://www.thewellspring.com/Journal/JWT/worstbestdepressed.html

I would say that the list applies to all those who has to go through mental illnesses, grief or just feeling plain down.

Push for mental-health 'parity' continues

United Press International®
News. Analysis. Insight.™
Health Business - Briefing
Published: May 2, 2007 at 7:48 PM

Push for mental-health 'parity' continues

WASHINGTON, May 2 (UPI) -- Mental-health parity advocates set up
camp at the U.S. Capitol Wednesday to demand equal insurance coverage for
mental illness.

After an outdoor news conference with Reps. Patrick Kennedy, D-R.I.,
and Jim Ramstad, R-Minn., sponsors of a bill that would require health
insurers to cover mental illness in the same way as physical illness,
advocates set up a headquarters in a Senate office building from which
they organized lobbying visits and phone calls.

The Paul Wellstone Mental Health and Addiction Equity Act would
prohibit insurers from imposing higher co-payments and deductibles on
beneficiaries for mental healthcare.

The bill is named after the late Sen. Paul Wellstone of Minnesota who
was the bill's original sponsor.

"This is a public health crisis that in some way impacts every family
in America. It's time to break down the barriers to good mental health
and addiction treatment," Kennedy said.

Study guide for local play (Off Centre)

Mr Alvin is kind enough to forward this article to me.

Life! Arts
The Straits Times
Thursday, May 3, 2007
Pg 12

Study guide for local play

A former lead actor in the play Off Centre, which is a GCE O-level
literature text, has written a guidebook to it

Adeline Chia
ARTS REPORTER

YOU could say Abdulattif Abdullah is the perfect man for the job.

The 39-year old English and literature head in Bukit Batok Secondary
School, who played lead character Vinod in Off Centre when it was first
staged in 1993, has written a student’s guidebook to the play.

He had married a fellow cast member, Sakinah Dollah, who played the
female lead, the following year. The study guide was written because
the work by playwright Haresh Sharma of The Necessary Stage (TNS) has
been selected as a GCE O-level literature text this year.

The seminal work about mental illness is the first Singaporean play to
become an O-level text. Not all schools have to study it as they can
use another play on the syllabus, but 13 schools are doing so this
year.

The play is about the friendship between Vinod, a top debater in school
who has a mental breakdown, and a 19-year old, schizophrenic called
Saloma. It is best remembered for bringing the plight of mental
patients to the public’s attention.

For the past six months, Abdulattif and colleague Ruth Tan, 28, have
been writing a 40-page guidebook, which includes sections on
characterization, plot, themes and sample essays.

“It has a lot more details than your typical Cliff Notes
guidebook,” he
says. They are still looking for a publisher but hope to have the book
ready by July in time for the school exams in September.

He says his involvement in the play more than a decade ago gave him
unique insights.

Together with Sharma and TNS artistic director Alvin Tan, he spent
months researching and interviewing mental patients and working out the
roles in workshops.

Also, having played Vinod gave him a deeper understanding of the
character’s motivations which he hopes to share with students.

“If anything else, I can talk to my wife about it,” he says with a
laugh. He has three children with Sakina, 34, who now runs a
pre-school.

Off Centre joins two other Singaporean texts in the O-level curriculum.
They are Heartland, a novel written in 1999 by lawyer Darren Shiau,
and Island Voices, a 2007 anthology of Singapore short stories
commissioned by the Education Ministry.

The ministry said the play was included because it satisfied the
criteria for literature texts, which include To Kill A Mockingbird by
Harper Lee and A Midsummer Night’s Dream.

“Off Centre explores a wider range of themes such as marginalisation,
friendship, and societal and familial pressures. The play has good
characterisation, dramatic potential and accessibility,” said a
ministry spokesman.

The play has been restaged thrice since its debut in 1993. The most
recent revival was in Malay, called Otak Tak Centre in Kuala Lumpur two
years ago.

Over the past 14 years, Off Centre has also been made into an
experimental feature film and adapted into a television movie, both
with the same title. It has also been given a full reading in Britain
and taught at the International Islamic University Malaysia in Kuala
Lumpur.

Sharma, 41, has been giving talks to teachers since it was announced
the play would become a school text, and even had a webchat with
students on it.

“I feel like a mini-literary celebrity,” he jokes.

And for an entire generation of students who had missed the first run,
TNS is restaging the play this month.

Alvin Tan, 44, who directs the play, says Off Centre remains relevant
today because prejudice against mental health patients still exists.

“I still hear of people whose salaries get halved because employers
think that if you have mental health issues, you’re not so
productive,” he says.

He adds that Off Centre is also a timeless play about human
relationships, such as the friendship between the lead characters Vinod
and Saloma.

Playing Vinod this time is Melvinder Kanth, 34, an actor and
documentary film-maker. Saloma is played by Mislina Mustaffa, 36.

And reprising her 1993 role as Saloma’s mother is actress Alin
Mosbit, 33.

Alin says she is now closer to the actual age of her character, who is
in her late 40s. In the first Off Centre production, she was only 19.

She adds: “The character is more curt and much harsher – she has a
darker streak this time.”

chiahta@sph.com.sg

Off Centre will be staged at the Esplanade Theatre Studio from May 9
to 20 with 3pm shows on May 9, 12 and 13, and from May 16 to 20; 8pm
shows on May 9 to 12, May 18 and 19.

Tickets at $30 from Sistic (www.sistic.com.sg, tel: 6348-5555).

Mentally Ill Kids Face Widespread Stigma

This news report came from the US.

By Randy Dotinga
HealthDay Reporter Mon Apr 30, 7:01 PM ET

MONDAY, April 30 (HealthDay News) -- Children with mental illness may face a double burden -- the condition itself, and discrimination and stigma at school and elsewhere, a new survey shows.


Almost half of U.S. adults polled expected that children undergoing mental health treatment would be rejected at school, and half anticipate that these youngsters will also suffer problems later in life.

At the same time, almost nine out of 10 Americans believe that doctors overmedicate kids with behavior problems.

"It's pretty clear that there's a lot of prejudice and discrimination about children's mental health problems in American culture," said lead researcher Bernice Pescosolido, professor of sociology at Indiana University. "These attitudes and beliefs are very powerful in terms of what happens to kids and their families."

Pescosolido said she and colleagues began examining attitudes about mental illness after reading news reports that stigma had begun to disappear. These came alongside what she called an "extraordinary tidal wave of [media] response" that was largely critical of changes in the treatment of mentally ill children.

Drugs are being prescribed more often to kids, and psychiatrists are diagnosing illnesses at much younger ages, Pescosolido said. Indeed, there are reports of kids being diagnosed when they are little more than babies.

For this study, her team examined the results of a 2002 survey of almost 1,400 adults; the margin of error was plus or minus four percentage points. The findings are published in the May 2007 issue of the journal Psychiatric Services.

Forty-five percent of those surveyed believed that kids who were undergoing mental health treatment would be rejected by their classmates at school, and 43 percent said that stigma around mental health issues would create problems for them in adulthood.

"No matter what that person attains later in life, this will follow them around," Pescosolido said. "This is classic stigma, when someone is marked and seen as less than (others)."

But stigma also could prevent people from getting the treatment they need, Pescosolido said.

Meanwhile, most of those polled were "very negative about the use of any kind of psychoactive medication for children's mental problems," she said. In fact, 85 percent of people surveyed said kids are already overmedicated for common behavioral problems, and over half (52 percent) felt that psychiatric medication "turns kids into zombies."

Could they be right about kids taking too many medications? "I'm sure there are some [cases], but how much do anecdotal stories really match the reality? I don't think the science is there" to provide answers, Pescosolido said.

She added that there are big differences in how people view the use of drugs to treat physical illness and mental illness. "If your child had diabetes, and you needed insulin, would you wring your hands over that?" the researcher said.

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Schneider Children's Hospital in New York City, said he encounters bias against the use of psychiatric drugs every day.

"There's a disconnect," he said. "The public is generally looking to embrace evidence-based treatments (for other conditions) yet rejecting pharmaceutical interventions when data suggest it works."

What to do? Pescosolido called for a better mental health care system and more discussion about prejudice and discrimination that targets mentally ill kids.

Taken from
http://news.yahoo.com/s/hsn/20070430/hl_hsn/mentallyillkidsfacewidespreadstigma;_ylt=AvO5ewSo7iupjffLVBMh3WrVJRIF

Listening

This is posted in my first entry of this blog which I will refer to again

"When we honestly ask ourselves
Which person in our lives means the most to us,
we often find that it is those who,
instead of giving too much advice, solutions or cures,
have chosen rather to share our pain
and touch our wounds with a gentle and tender hand.
The friend who can be silent with us in a moment of despair or confusion,
who can stay with us in an hour of grief or bereavement,
who can tolerate not knowing, not curing, not healing,
and face us with the reality of our powerlessness,
that is a friend who cares.
- Henri J. M. Nouwen "Out of Solitude;Three Meditations on the Christian Life"

My thoughts.

I'm sure most if not all of us desire to be understood by others. And we have at one point or other in our lives needed that listening ear to listen to us, perhaps we had a bad day at work or in school, perhaps we just had our hearts broken or rejected by others, perhaps we are grieving over a loss, or perhaps, we are struggling to carry on in life, trying to find that courage to carry on and just simply needed an outlet for someone to listen to our struggles.

Often, many people tries to console others not realising that their perceived good intentions have a very adverse effect on those whom we try to comfort.

We are often quick to attempt to solve other people's problems, giving them advice, solutions, believing that answers, solutions is what others are asking of us when they approach us.

Lines like "What should I do?" "Why did this happen to me?" tug at our heartstrings making us think that if we can give them an answer to their questions we will solve their problems. But it is not always answers they seek when they say that, often, what they need is to know that we are there with them and to acknowledge that it's a terrible time and period that they are going through.

A crying "why?" from someone in pain is not always an invitation to start giving them what we think is the truth or the answer in the world. The truth hurts but it is the truth, or so some people might claim. The "truth" however, when inappropriately said is most unkind and cruel to say the least to the individual whos in pain. It is a lack of understanding and sensitivity to the feelings of the person we address. It is shoving our opinions and perspectives down their throat without a care or thought of how they feel. It is thoughtlessness at its worst.

One might wonder, is that "why?" not a question to be answered? To a grieving widow, a broken-hearted teenager, a person who has lost everything, the answer to the why (why did this happen, why did it happen to me, why did he/she leave...) often simply doesn't matter. It cease to matter because at that point in time, it is their pain that matter to them, for it is their pain that overwhelms them so completely. They are in such terrible pain emotionally and mentally that any answer, no matter how good an answer we might think it is, is of small and cold comfort.

We are not here to take away their confusion, their pain. We are here to be a friend, to let them know we know they're hurting and in pain and we want to be with them, to let them know that they're not completely alone. We are with them, stay with them when they are down, not in front of them so impatiently trying to drag them back up for whatever intentions we think we have.

Many are uncomfortable with people wallowing in self-pity, we want them to snap out of it, pull themselves together, we tell them there's so many other more unfortunate people than them, we want to tell them that they aren't the only ones with problems. We mean well, what we are trying to tell them is that things aren't actually as bad as they perceive but we fail to see just how hurtful and cruel such comments are to them, we fail in making them feel heard or understood and invalidate how they feel in the process. We are too busy in telling them what we think and feel using the almighty good intentions as a reason to justify what we say, rather than truly sit with them and feel and try to understand what they feel.

We are uncomfortable at times with some of the questions they ask. Who are "they"? "They" can be our spouse, our friends, our family, the mentally ill, the people who are grieving, the people who are down, broken-hearted, the list goes on, the common factor is that they want a listening ear, they want to feel heard, to feel understood. We seem to expect ourselves to must have the answers to their questions but it's okay not to have the answers. It is okay to be powerless. To understand that is to go one step in understanding the feelings of hopelessness and helplessness that those who are in depression and in grief feels.

When we tell them that they shouldn't feel that way, they shouldn't feel sad because..., they shouldn't feel angry because.... etc, we are invalidating how they feel. Why should they not have a right to feel what they feel? Why should we deny them what it means to be human?

Would we ever truly understand how they truly feel? Personally I don't think so. We can come close by putting ourselves in their shoes but we're not them. And it is this fact that we have to realise that we are not the ones going through their pain. And that pain is very real and very painful to them.

When they are silent, can we sit with them and stay quiet too? Many of us aren't comfortable with silence. We feel an urge to fill the silence. It is however not words that they want to hear from us, silence is a gift at times. It is a gift of listening, a gift of letting them dwell and explore what they feel.

At the end of the day, the question we have to ask ourselves for those who truly wish to give a listening ear or to be a friend to those in need, have we truly make them feel heard and understood? Have we given them the gift of kindness and understanding, accepting them for who they are. Have we given them the gift of listening?

Mediacorp's Radio Interview with Off Centre's director Alvin Tan

An interview done by Mediacorp Radio with Off centre's (refer to the last blog entry for more information) director Alvin Tan about their journey and research that went into this play.

Read the interview here
http://www.rsi.sg/english/artsarena/view/20070426170427/1/.html


My thoughts.

I had the opportunity and privilege to hear and speak to Mr Alvin personally a couple of days ago spoke about his own experiences and story regarding his brother and his family. I won't go into details but it was heartwarming to hear from him his brother's route to recovery and will to live, as well as the support and patience his brother has received from their parents. I could see that it couldn't have been easy all these while for their family and I truly wish them well and hope that the play would help spread more awareness of mental illness.

Thank you Mr Alvin for sharing with me.

Off Centre

Off Centre



First staged in 1993 to critical acclaim, Off Centre is recognised as a
landmark play in the history of Singapore theatre, best remembered for
bringing mental illness and its patients’ plight to the attention of
the media and general public in Singapore. The play traces the
friendship of Saloma and Vinod and the hurdles they have to overcome,
including social stigmas, prejudices and personal conflicts.


Off Centre has also been selected by the Ministry of Education as the
first Singapore play to be offered as a GCE ‘O’ Level literature text
from 2007, and has been republished by The Necessary Stage.


9, 12 – 13, 16 – 20 May 2007, 3pm
9 – 12 May, 18 – 19 May 2007, 8pm

$30 | $21* (Excludes $2 SISTIC ticketing fee)
* Concessions for students, NSF & senior citizens

Get your tickets from 1 Mar 2007 at all SISTIC authorised agents,
online at www.sistic.com or via the SISTIC hotline at 6348 5555.

For more information or for school and corporate bookings, please
contact us at Tel: 6440 8115 or email: admin@necessary.org

Medisave liberalised further from May 1

Medisave liberalised further from May 1
By Hasnita A Majid, Channel NewsAsia | Posted: 29 April 2007 1926 hrs

SINGAPORE: From Tuesday, CPF members who are hospitalised or who go for day surgery can use more of their Medisave to pay for their bills.

The Health Ministry announced two months ago it would be raising the Medisave withdrawal limit to benefit more patients.

From May 1, the withdrawal cap for inpatient stay at hospitals will go up by $50 to $450 per day.

The change is expected to benefit about 112,000 bills.

With the increase in withdrawal limit, Medisave will on average cover 82% of each B1-class bill, up from 76% currently, and 66% of each A-class or private hospital ward bill, compared to 57% respectively.

With the existing withdrawal limit, more than 90% of all Class B2/C bills are already fully covered without the need for any cash outlay.

The Health Ministry says the change is to help middle-income earners reduce the cash outlay when they are hospitalised.

For patients undergoing day surgery, the Medisave withdrawal limit is raised to $300 from the current $200.

With the revision, 84 percent of all subsidised day surgery bills will be fully covered by Medisave, compared to 77 percent now.

This translates to greater coverage for about another 30,000 day surgery episodes.

The Ministry hopes this will encourage more patients to opt for day surgery if they do not need to be hospitalised.

This will not only save them money and time but also free up valuable bed space for other patients.

For those needing inpatient psychiatric treatment, the annual Medisave withdrawal limit will be increased from $3,500 to $5,000.

This change, also effective from May 1, will ensure greater coverage of hospital bills of up to 82 percent of a Class B2/C bill, compared to about 68 percent currently.

About 1,200 patients who stay long term, especially in Institute of Mental Health (IMH) wards, will stand to benefit from the change. - CNA/ir

For the article, refer to below
http://www.channelnewsasia.com/stories/singaporelocalnews/view/273247/1/.html

=============================
My thoughts :

This news would come as an added help. The change means an additional $125 per month allowed to be withdrawn from medisave for those needing psychiatric treatment.

Stigma worsens mental illness

A newspaper (MindYourBody) article from a few months (Jan 2007) back. My own views are placed below of the article.

========================================================
Stigma worsens mental illness

By Shefali Srinivas -
The Straits Times

A steady, simple job and acceptance from people are top of the wishlist for patients recovering from mental illnesses. But these very things are in short supply and have significant impact on whether the road to recovery is rocky or smooth.

Even though mental illness can strike any one at any age - people with these conditions face fear, hostility and disapproval rather than compassion, support and understanding.

This stigma and the role it plays in mental illness was the subject of a recently concluded study at Institute of Mental Health (IMH) in Singapore.

Nurse educator Poh Chee Lien, who was involved in the study, said the aim was to find out the extent to which patients encountered stigma and if they had any strategies to deal with it.

While the study results are yet to be published, it was conducted by nurses who looked specifically at schizophrenia and the stigma that recovering schizophrenics face.

For the full article, refer to the link below
Stigma worsens mental illness

======================================================

In one of the last few lines of the article, Prof Chong said "'You can gauge how civilised a society is by the way they treat their mentally ill." I would say, we can gauge how gracious and how kind/unkind a society is by the way they treat the mentally ill.

Those who go through mental illnesses are treated as outcasts. Yet I find myself seeing that their discrimination comes from their fears of what they do not understand. For a society like Singapore, it can be rather difficult to accept that we actually are still so ignorant, filled with so much misperceptions and intolerance. Yet as mentioned, in all honest truth, can we blame them? I don't think we can or should. For it is all too human for us to fear the unknown. What then can be done to fight the stigma? What can we do more to spread understanding and awareness.

How much are we all as part of society doing our part in listening?

I hope to see the day where mental illness sufferers here can be treated with more kindness, understanding and acceptance.

Depression May Be Early Sign of Parkinson's Disease

By Jeffrey Perkel
HealthDay Reporter Fri Apr 27, 11:47 PM ET

FRIDAY, April 27 (HealthDay News) -- In some cases, depression can be an early manifestation of Parkinson's disease, new research suggests.

Researchers at the Harvard School of Public Health compared antidepressant use among more than 1,000 individuals with Parkinson's disease to more than 6,600 age- and gender-matched individuals without the degenerative neurological illness.

They found that people currently on antidepressants had an 80 percent higher risk of developing Parkinson's disease than those who had never taken antidepressants. This was true for both men and women, regardless of age or the class of antidepressant used.

For the full article refer to the below link
Depression may be early sign of Parkinson's disease

Six-fold increase in eating disorders among teenagers since 2002

Six-fold increase in eating disorders among teenagers since 2002
By Janice Ng and Julia Ng, Channel NewsAsia | Posted: 20 February 2007 2019 hrs


Photos 1 of 2
SINGAPORE: The number of teenagers with eating disorder has increased six-fold since 2002.

The Singapore General Hospital said 140 new cases are reported every year.

But only 10 to 20 percent of them are seeking treatment.

A study of some 1,000 girls across Asia, aged between 15 and 17, shows teenage girls suffer from a severe lack of confidence.

In Singapore, more than eight in ten want to change the way they look, while six in ten feel bad about themselves because of looks or weight.

Read more here
http://www.channelnewsasia.com/stories/singaporelocalnews/view/259641/1/.html

Mad Medusa Mum

Mad Medusa mum

By Judith Tan - Apr 4, 2007
The Straits Times

Looking at my three-year-old, people say I'm a great mother and that my daughter, Victoria, is clever and well-adjusted.

But they would be surprised if they knew this: In the first few months of her life, I entertained graphic thoughts of picking her up, opening the window of my flat and throwing her out of it.

I was going through post-partum depression.

I can laugh now, but at that time it was no laughing matter. I didn't realise what was happening. I just felt overwhelmed by this little person who didn't like to sleep.

I guess I had really set myself up for deep disappointment.

I got pregnant when I was 26 and I wanted to go the natural way. I looked for a gynaecologist who believed in it, and I even went on radio to tell listeners that I wouldn't have an epidural.

When my friend, a mother of three, heard the show, she called to say I was mad to have such high expectations of myself.

She was right. It turned out to be a difficult birth and I ended up going through an emergency C-section.

I also thought that, after the birth, the nurse would clean the baby, put her in my arms and my husband would take a snapshot which would be picture perfect - like we see on TV.

It was nothing like that.

When I looked at the photo, I was dishevelled and my face like kena bus langah (like a bus had hit me).

When I went home with Victoria, I had to cope with my C-section wound, a crying and non-sleeping baby, and bleeding nipples.

All these little things added up - making me feel like a loser. It was no wonder I went into depression.

Read the full article below
http://justwoman.asiaone.com.sg/motherhood/stories/20070404_001.html

The gift of listening

Friend

"When we honestly ask ourselves
Which person in our lives means the most to us,
we often find that it is those who,
instead of giving too much advice, solutions or cures,
have chosen rather to share our pain
and touch our wounds with a gentle and tender hand.
The friend who can be silent with us in a moment of despair or confusion,
who can stay with us in an hour of grief or bereavement,
who can tolerate not knowing, not curing, not healing,
and face us with the reality of our powerlessness,
that is a friend who cares.
- Henri J. M. Nouwen "Out of Solitude;Three Meditations on the Christian Life"

Listen

When I ask you to listen to me,
and you start giving advice,
you have not done what I asked.

When I ask you to listen to me,
and you begin to tell me why I shouln't feel that way,
you are trampling on my feelings.

When I ask you to listen to me,
and you feel you have to do something to solve my problems,
you have failed me, strange as that may seem.

Listen! All I asked was that you listen.
Not talk or do -- just hear me.

Advice is cheap;
a quarter will get you both Dear Abby and Billy Graham in the same newspaper.

And I can do for myself;
I'm not helpless.
Maybe discouraged and faltering, but not helpless.

When you do something for me that I can and need to do for myself,
you contribute to my fear and weakness.

But when you accept as a simple fact that I do feel what I feel, no matter how irrational, then I quit trying to convince you and get about the business of understanding what's behind this irrational feeling. And when that's clear, the answers are obvious and I don't need advice.

Irrational feelings make sense when we understand what's behind them.

Perhaps that's why prayer works sometimes for some people -- because God is mute, and He doesn't give advice or try to fix things. He may just listen and let you work it out for yourself.

So, please listen and just hear me -- and, if you want to talk,
wait a minute for your turn; and I will listen to you.

Anonymous