The opening of a new nursing home for mentally unwell patients next month will not only raise the number of such homes to four but will also be especially welcome because it will be the largest of them. St Andrew's Nursing Home will help in meeting growing demand for mental health care in Singapore, where more than one in 10 people will have mental illness in their lifetime. That statistic, contained in the Singapore Mental Health Study of 2010, is projected to worsen as the population ages. An ageing society means also that cases of stroke and dementia, which affect mental capacity, will increase. For example, the number of dementia sufferers here in 2005, among those aged 65 and above, was 22,000. By 2050, the figure is projected to increase to a massive 187,000. With such numbers, Singapore must be ready for a rise in demand for mental health services.
An important part of that preparation is psychological. Studies have noted the nefarious effects of stigma in making mentally ill persons averse to treatment. Stigma can take the form of hurtful or even offensive public behaviour centred on avoiding mentally ill persons, and extend to abuses such as job discrimination that punish them financially. No less insidious is self-stigmatisation, where the patient accepts cruel social attitudes as normal, blames himself for his condition, and loses self-esteem. Recognising the need for changing public mindsets, the Singapore Association for Mental Health, a voluntary welfare organisation, focuses on reducing misconceptions that surround mental illness and the social stigma attached to it. Enlightened public attitudes, combined with alert and sympathetic family members, are necessary to encourage the unwell to seek treatment early.
The provision of core mental health services here has been developed under the National Mental Health Blueprint and the Community Mental Health Master Plan. Looking at both, the authorities are taking the right approach in seeking to ensure mental health care is not hospital-focused but includes a wide range of services in the community. Detection, intervention and psycho- social rehabilitation are often best done in the primary care setting and, in appropriate cases, in the home. Crucially, the network of mental health-care and support services must be closely integrated with each other and with the rest of the health-care system.
The new nursing home exemplifies the contribution of community organisations to the provision of long-term psychiatric care in Singapore. Such efforts deserve wide support. A mature society ought to treat mental illness as a health issue and not a moral or social affliction.
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