SINGAPORE - More can be done to monitor and support national servicemen with mental health issues, according to two experts who used to work with the Singapore Armed Forces (SAF).
These include fighting the stigma attached to such illnesses, raising awareness about mental health and having more in-camp psychiatrists.
Earlier this week, State Coroner Imran Abdul Hamid delivered his findings on the death of Private Ganesh Pillay Magindren, who was found at the foot of his Sengkang condominium last July.
The 23-year-old had been diagnosed with schizophrenia, which distorts a person's thoughts and emotions, causing him to lose touch with reality.
The coroner pointed out several lapses, such as how the medical officer at the unit where Pte Ganesh was posted had not been informed of his condition.
Captain Jessie Goh, the officer in charge of Pte Ganesh, also did not do any research into schizophrenia.
In response to Straits Times queries, Mindef pointed to a previous report on how it screens all servicemen before enlistment and assigns them a Physical Employment Status (PES) grade. Those with medical conditions, including mental health ones, may be assigned a lower grade.
The grades range from A - fit for all combat vocations - to F, which exempts the person from national service. Pte Ganesh, who enlisted in October 2012, was given the E9L9 grade, the second lowest, because of his illness.
He became an administrative assistant in the army.
Mindef highlighted how it has a comprehensive system to track its soldiers' well-being.
Interviews are conducted by commanders every few months to find out how full-time national servicemen (NSFs) are adjusting. Some commanders are also taught counselling skills. Soldiers with issues may be then referred to medical officers, counsellors, psychologists or psychiatrists in the SAF. There is also a 24-hour SAF counselling hotline.
Dr Christopher Cheok, who was formerly head of psychiatry at SAF between 2003 and 2009, pointed out a "weak" link in the chain. There is a lack of awareness about mental health issues among junior commanders such as NSF officers and specialists, said the senior consultant, who now leads the psychological medicine department at Khoo Teck Puat Hospital.
"They may not understand or be equipped to deal with mental illnesses," he said, calling for more training workshops to be held.
He urged the SAF to take a more "rehabilitative, rather than punitive" approach to discipline, saying "there should be special considerations when punishing soldiers with serious mental illnesses".
There is also the perception that soldiers who downgrade their PES status because of mental health issues are malingering. Such stigma must be addressed, Dr Cheok said.
He also believes that SAF needs to invest more resources into its mental health services.
"This is not just about having more doctors, but also case managers who call to check on patients regularly."
Dr Ang Yong Guan, who was SAF's head of psychiatry from 1986 to 2003 and sees a handful of soldiers in his private practice, believes that SAF should consider expanding its pool of psychiatrists, but noted that it probably faces constraints.
He added that whether a person with mental illness should be exempted from serving should depend on how mild or severe their condition is, the likelihood of relapse if they are subjected to stress, their attitude towards NS, and their parents' attitudes.
Mindef declined to comment and referred to a statement issued in response to the coroner's findings. It said it would study the findings carefully to improve and tighten its procedures to ensure better compliance by SAF units in dealing with soldiers with mental problems.
No foul play, but coroner highlights some issues
State Coroner Imran Abdul Hamid ruled out any foul play when he delivered his findings on the death of Private Ganesh Pillay Magindren on Tuesday.
The 23-year-old was found at the foot of his Sengkang condominium last July.
But the coroner did highlight several issues on how Pte Ganesh was treated in the army.
Mr Imran said that Captain Jessie Goh, who was his direct superior when he was posted to the 24th Battalion Singapore Artillery at Khatib Camp in November 2012, was "out of her depth" in dealing with the soldier's schizophrenia.
Mr Imran also said that the 14 charges of extra duties given to Pte Ganesh by Cpt Goh the day before he died was a "daunting prospect even for soldiers without any mental issues".
The coroner noted that Dr Mogilan Mohan, medical officer at Khatib Camp Medical Centre, was not informed of Pte Ganesh's condition by his former unit, Kranji Camp. This is a "classic case of non-compliance" with an army medical directive.
This article was published on April 12 in The Straits Times.
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