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Straits Times
4 minutes ago
- Straits Times
Mental health in the age of AI
Apps may be able to assist in cognitive behavioural therapy, detect depression risk in the user's voice, and more, experts here say. SINGAPORE - It is generally a two-month wait to see a psychiatrist at the Institute of Mental Health (IMH) outpatient clinic. So, to help patients through the dry spell between sessions, the hospital is studying if they can use a locally developed AI-powered app that, among other things, provides guided meditation and is able to predict the user's stress level. Since May 2025, IMH has offered the AmDTx app, or a placebo app, to individuals referred by a GP or a polyclinic doctor to the institute, to participate in the trial. 'Coping skills such as deep breathing and sleep hygiene can help one manage stress, or even symptoms of anxiety and depression. They can learn these from the app and start the interventions first. This will hopefully reduce their distress while waiting to see the specialist,' said Dr Christopher Cheok, a senior consultant at IMH and director of national mindline 1771, Singapore's first helpline and text service for mental health. Dr Cheok said the long wait times in public mental healthcare are because of rising demand and limited manpower. IMH is also exploring the use of other apps to monitor and support the care of mental health conditions, including one approved by the United States Food and Drug Administration (FDA). In general, digital tools include AI-enabled chatbots, mobile apps, wearable devices, and web-based programmes. Apps may be able to assist in cognitive behavioural therapy, detect depression risk in the user's voice, and more, experts here say. Top stories Swipe. Select. Stay informed. Singapore Sewage shaft failure linked to sinkhole; PUB calling safety time-out on similar works islandwide Singapore Tanjong Katong Road sinkhole did not happen overnight: Experts Singapore Workers used nylon rope to rescue driver of car that fell into Tanjong Katong Road sinkhole Asia Singapore-only car washes will get business licences revoked, says Johor govt World Food airdropped into Gaza as Israel opens aid routes Sport Arsenal beat Newcastle in five-goal thriller to bring Singapore Festival of Football to a close Singapore Benchmark barrier: Six of her homeschooled kids had to retake the PSLE Asia S'porean trainee doctor in Melbourne arrested for allegedly filming colleagues in toilets since 2021 Some of these tools can be seen at an exhibition on digital mental health, organised by the Yeo Boon Khim Mind Science Centre and D.S. Lee Foundation Mind Art Experiential Lab (MAELab), which opened at the MAELab space in Alexandra Hospital on July 11. While the centre said it does not endorse any of the tools, they demonstrate the potential of digital and AI-powered technology in mental healthcare. Tech can help An app that is available from a healthcare provider, Rejoyn was the first prescription digital therapeutic for the treatment of major depressive disorder to be approved by the FDA, in 2024. The smartphone app, designed to be used alongside medication, delivers a programme of evidence-based brain-training exercises and therapeutic lessons to help adult patients manage their symptoms. Other tools shown at Maelab include an online assessment tool from local firm Neurowyzr, which screens for early cognitive changes, and a Voice AI tool from another Singapore-based firm, Wonder Technologies, that screens for depression risk. The latter will soon undergo testing over a year with participants recruited from institutions affiliated with the National University of Singapore and National University Healthcare System, said the firm's CEO, Ms Wendy Wu. A similar Voice AI tool to detect early signs of depression in older adults is being developed here under SoundKeepers, a three-year local programme announced in October 2024. Its researchers said that developing a native technology for Singapore facilitates compliance with national healthcare data protection standards. It was at the height of the Covid-19 pandemic in June 2020 that the MOH Office for Healthcare Transformation (MOHT) created as a digital mental health resource website, which now boasts an AI-enabled chatbot Wysa. Ms Janice Weng, deputy director of at MOHT, said digital solutions are useful for mental health self-help, and the office would like to pilot a form of self-directed psychotherapy that is being used at IMH in community and primary care settings. iCBT, internet-based Cognitive Behavioural Therapy, could enhance access to affordable mental health care in the community and help reduce unnecessary visits to the hospitals, she said. MOHT is starting to develop AI models analysing Singlish, multilingual texts, and emotional cues and nuances that Western tools may miss, she added. Another digital health platform that it co-developed with IMH uses data from fitness trackers and smartphones to help care teams tailor support and empower individuals with psychosis and mood disorders to manage their own mental health. It may be useful for predicting depression in youth. Digital phenotyping, which uses smartphone data to understand user behaviour, is emerging as a promising way to detect mental health issues. Researchers have found, for example, that shifts in heart rate variability or sleep patterns can signal anxiety or low mood before individuals are even aware of it. Dr Jill Murphy, the executive director of the APEC Digital Hub for Mental Health who was in Singapore recently, said she is particularly excited about how this technology could lead to more personalised care. 'Although more research is needed in this area, it has the potential to shift the focus from broad categories of mental illness like depression to a more patient-centred approach,' she said. Tailoring interventions and treatment plans to match a person's unique needs, values, culture and experiences could also increase engagement with digital tools, she added. Dr Murphy was a plenary speaker at the July 16-17 Singapore Mental Health Conference, addressing how to use digital technologies to promote equitable access to mental health promotion and care in the Apec region. Treading with caution A big problem with digital mental health tools, however, is the sheer number of options out there, the majority of which have not been proven to be effective. Adjunct Associate Professor Cornelia Chee, head and senior consultant at National University Hospital's psychological medicine department, said plenty of work remains to establish the effectiveness, safety, and ethical use of digital and AI-enabled tools in real-world clinical settings. She cautioned that these tools should complement, and not replace, the therapeutic relationship that remains central to mental healthcare. The Organisation for the Review of Care and Health Apps (Orcha), founded by clinicians from the United Kingdom's National Health Service, reviewed approximately 35,000 uses of digital health technology, and found just 20 per cent to be secure, cyber-safe, and clinically effective. Dr Cheok said a search shows that there are more than 10,000 mental health apps on Apple and Google Play Store. 'In general, I think because apps are not regulated, no one can vouch for the quality of the information contained in the app or the intervention that's within the app, and one thing the public may not be so aware of is how their data is being used,' he said. 'Therefore, whichever apps we choose to evaluate, they must have shown to be useful in other countries and have been subjected to research studies for efficacy and validation.' Dr Cheok said IMH picked the AmDTx app as it was shown to work overseas, and is now studying its effectiveness in the local population. The other test site for the trial, expected to end by the first quarter of 2026, is the Singapore General Hospital. For now, Dr Murphy advises checking app privacy policies, published scientific studies, and endorsements from reputable organisations when evaluating digital mental health tools. She said organisations like Orcha have established standards for reviewing apps. Orcha has also created a Mind App Library, where users can browse apps that meet the standards that it has identified, she said. Associate Professor John Wong, director of the Yeo Boon Khim Mind Science Centre, said that with more apps coming to market, individuals must learn to make informed choices. 'What you really want is not to tell people what to buy, what to use, but what is in the technology, what is it that you need? And then they can be informed users,' he said. IMH chief executive officer Daniel Fung said validated digital tools for the population will likely be accessible through in the future. MOHT's Ms Weng said programmes such as , iCBT, and peer-led platforms could in the future make mental healthcare widely and easily accessible. 'Singapore can pioneer a hybrid model – where AI handles scale and prevention, and limited manpower focuses on where the needs are best met with empathy and complex care,' she said. Tracking tiny shifts in our bodies that hint at mental strain An exhibition on digital mental health tools highlights some biomarker changes that precede mental health issues. It was launched by the Yeo Boon Khim Mind Science Centre at its MAELab space in Alexandra Hospital. 1. Depression and anxiety Biomarkers: Reduced heart rate variability (HRV), poor sleep quality, decreased activity levels. Insight: These changes often show days or weeks before someone reports feeling low or anxious. Wearables can detect the trend early, nudging users to seek help or adjust their lifestyles. 2. Burnout or chronic stress Biomarkers: Elevated resting heart rate, decreased HRV, poor sleep quality. Insight: These signs appear subtly – even before people feel stressed. Smartwatches can send alerts for persistent physiological stress. 3. Menstrual-related mood disorders Biomarkers: Changes in sleep patterns, increased body temperature and resting heart rate. Insight: Devices can track how your body responds across cycles and alert you to abnormal patterns, such as more severe mood changes. Know your biomarkers Heart rate variability HRV – the variation in time between each heartbeat – can indicate overall stress burden and recovery status. Reduced HRV has been observed in anxiety disorders, depression, and more. HRV is highly individual, as it is influenced by factors such as genetics, age and sex, so comparing it across individuals is often unhelpful. Longitudinal tracking of one's own HRV baseline offers more meaningful insights. While a higher HRV is generally considered better, there is no universal cut-off for what constitutes 'low HRV'. A sustained drop of 20 per cent to 30 per cent below an individual's norm over weeks or months may be more indicative of concern than a one-off low reading. Respiratory rate The number of breaths you take every minute reflects how your body is functioning, especially during rest or sleep. Changes in your respiratory rate – especially when you are asleep – can be early signs of not just issues such as infections, but also of stress or anxiety. It can also be due to overtraining or hormonal fluctuations. Body temperature Wearables can measure peripheral skin or wrist temperature (not core temperature). A rise in temperature from your baseline level can signal the early stages of infection or illness while a subtle rise can indicate ovulation due to hormonal changes. Look for repeated or sustained increases from your usual pattern. Also, a small elevation of 0.2 deg C to 0.5 deg C, for example, may not point to illness but, when combined with other symptoms, it might suggest your body is under stress. Sleep metrics Sleep, including its various stages, can be tracked by analysing metrics such as HRV, body temperature and more. They help to detect sleep patterns linked not just to physical issues – such as reduced deep sleep after overtraining – but also mental health issues, such as insomnia in depression or fragmented sleep in anxiety. A lack of sleep is associated with irritability, anxiety, and a higher risk of depression. Deep sleep regulates stress hormones while REM (rapid eye movement) sleep supports emotional processing. Activity metrics These include steps taken, calories burned, distance travelled and activity intensity. Physical activity triggers endorphins, dopamine, serotonin and norepinephrine, which are key regulators of mood, motivation, and stress resilience. Regular activity is linked to reduced stress, improved mood, better sleep, and lower rates of depression and anxiety. Tracking one's activity metrics can reinforce these positive behaviours.
Straits Times
4 minutes ago
- Straits Times
Can AI be my friend and therapist?
Mental health professionals in Singapore say they have been seeing more patients who tap AI chatbots for a listening ear. SINGAPORE - When Ms Chu Chui Laam's eldest son started facing social challenges in school, she was stressed and at her wits' end. She did not want to turn to her friends or family for advice as a relative's children were in the same pre-school as her son. Plus, she did not think the situation was so severe as to require the help of a family therapist. So she decided to turn to ChatGPT for parenting advice. 'Because my son was having troubles in school interacting with his peers, ChatGPT gave me some strategies to navigate such conversations. It gave me advice on how to do a role-play scenario with my son to talk through how to handle the situation,' said Ms Chu, 36, an insurance agent. She is among a growing number of people turning to chatbots for advice in times of difficulty and stress, with some even relying on these generative artificial intelligence (AI) tools for emotional support or therapy. Anecdotally, mental health professionals in Singapore say they have been seeing more patients who tap AI chatbots for a listening ear, especially with the public roll-out of ChatGPT in November 2022. The draw of AI chatbots is understandable – it is available 24/7, free of charge, and will never reject or ignore you. But mental health professionals also warn about the potential perils of using the technology for such purposes: These chatbots are not designed or licensed to provide emotional support or therapy. They provide generic answers. There is no oversight. Top stories Swipe. Select. Stay informed. Singapore Sewage shaft failure linked to sinkhole; PUB calling safety time-out on similar works islandwide Singapore Tanjong Katong Road sinkhole did not happen overnight: Experts Singapore Workers used nylon rope to rescue driver of car that fell into Tanjong Katong Road sinkhole Asia Singapore-only car washes will get business licences revoked, says Johor govt World Food airdropped into Gaza as Israel opens aid routes Sport Arsenal beat Newcastle in five-goal thriller to bring Singapore Festival of Football to a close Singapore Benchmark barrier: Six of her homeschooled kids had to retake the PSLE Asia S'porean trainee doctor in Melbourne arrested for allegedly filming colleagues in toilets since 2021 They can also worsen a person's condition and generate dangerous responses in cases of suicide ideation. AI chatbots cannot help those with more needs Mr Maximillian Chen, clinical psychologist from Annabelle Psychology, said: 'An AI chatbot could be helpful when seeking suggestions for self-help strategies, or for answering one-off questions about their mental health.' While it is useful for generic advice, it cannot help those with more needs. Ms Irena Constantin, principal educational psychologist at Scott Psychological Centre, pointed out that most AI chatbots do not consider individual history and are often out of context. It is also often limited for complex mental health disorders. 'In contrast, mental health professionals undergo lengthy and rigorous education and training and it is a licensed and regulated profession in many countries,' said Ms Constantin. Concurring, Mr Chen said there are also serious concerns about the use of generative AI like ChatGPT as surrogate counsellors or psychologists. 'While Gen AI may increase the accessibility of mental health resources for many, Gen AI lacks the emotional intelligence to accurately understand the nuances of a person's emotions. 'It may fail to identify when a person is severely distressed and continue to support the person when they may instead require higher levels of professional mental health support. It may also provide inappropriate responses as we have seen in the past,' said Mr Chen. More dangerously, generative AI could worsen the mental health conditions of those who already have or are vulnerable to psychotic disorders. Psychotic disorders are a group of serious mental illnesses with symptoms such as hallucinations, delusions and disorganised thoughts. Associate Professor Swapna Verma, chairman of the Institute of Mental Health's medical board, has seen at least one case of AI-induced psychosis in a patient at the tertiary psychiatric hospital. Earlier in 2025, the patient was talking to ChatGPT about religion when his psychosis was stable and well-managed, and the chatbot told him that if he converted to a particular faith, his soul would die. Consumed with the fear of a dying soul, he started going to a temple 10 times a day. 'Patients with psychosis experience a break in reality. They live in a world which may not be in line with reality, and ChatGPT can reinforce these experiences for them,' said Prof Swapna. Luckily, the patient eventually recognised that his behaviour was troubling, and that ChatGPT had likely given him the wrong information. For around six months now, Prof Swapna has been making it a point to ask during consultations if patients are using ChatGPT. Most of her patients admit to using it, some to better understand their conditions, and others to seek emotional support. 'I cannot stop my patients from using ChatGPT. So what I do is tell them what kind of questions they can ask, and how to use the information,' said Prof Swapna. For example, patients can ask ChatGPT for things like coping strategies if they are upset, but should avoid trying to get a diagnosis from the AI chatbot. 'I went to ChatGPT because I needed an outlet' Users that The Straits Times spoke to say they are aware and wary of the risks that come with turning to ChatGPT for advice. Ms Chu, for example, is careful about the prompts that she feeds ChatGPT when she is seeking parenting advice and strategies. 'I tell ChatGPT that I want objective, science-backed answers. I want a framework. I want it to give me questions for me to ponder, instead of giving me answers just like that,' said Ms Chu, adding that she would not pour out her emotional troubles to the chatbot. An event organiser who wants to be known only as Kaykay said she turned to ChatGPT in a moment of weakness. The 38-year-old, who has a history of bipolar disorder and anxiety, was feeling anxious after being misunderstood at work in early 2025. 'I tried my usual methods, like breathing exercises, but they weren't working. I knew I needed to get it out, but I didn't want to speak to anybody because it felt like it was a small issue that was eating me up. So I went to ChatGPT because I needed an outlet,' said Kaykay. While talking to ChatGPT did distract her and help her calm down, Kaykay ultimately recognises that the AI tool can be quite limited. 'The responses and advice were quite generic, and were things I already knew how to do,' said Kaykay, who added that using ChatGPT can be helpful as a short stop-gap measure, but long-term support from therapists and friends are equally important. The pitfalls of relying too much on AI Ms Caroline Ho, a counsellor at Heart to Heart Talk Counselling, said a pattern she observed was that those who sought advice from chatbots often had pre-existing difficulties with trusting their own judgment, and described feeling more isolated over time. 'They found it difficult to stop reaching out to ChatGPT as they felt technology was able to empathise with their feelings, which they could not find in their social network,' said Ms Ho, noting that some users began withdrawing further from their limited social circles. She added that those who relied heavily on AI sometimes missed out on the opportunity to develop emotional regulation and cognitive resilience, which are key goals in therapy. 'Those who do not wish to work on over-reliance on AI will eventually drop out of counselling,' she said. In her practice, Ms Ho also saw another group of clients who initially used AI to streamline work-related tasks. Over time, some developed imposter syndrome and began to doubt the quality of their original output. In certain cases, this later morphed into turning to AI for personal advice as well. 'We need to recognise that humans are never perfect, but it is through our imperfections that we hone our skills, learning from mistakes and developing people management abilities through trial and error,' she said. Similarly, Ms Belinda Neidhart-Lau, founder and principal therapist of The Lighthouse Counselling, noted that while chatbots offer instant feedback or comfort, they can short-circuit a necessary part of emotional growth. 'AI may inadvertently discourage people from engaging with their own discomfort,' she told ST. 'Sitting with difficult emotions, reflecting independently, and working through internal struggles are essential practices that build emotional resilience and self-awareness.' Experts are also concerned about the full impact of AI chatbots on mental health for the younger generation, as their brain is still developing while they have access to the technology. Mr Chen said: 'While it is still unclear how the use of Gen AI affects the development of the youth, given that the excessive use of social media has been shown to have contributed to the increased levels of anxiety and depression amongst Generation Z, there are legitimate worries about how Gen AI may affect Generation Alpha.' Moving ahead with AI For better or worse, generative AI is set to embed itself more and more into modern life. So there is a growing push to ensure that when these tools are used for mental health or emotional support, they are properly evaluated. Professor Julian Savulescu, director of the Centre for Biomedical Ethics at NUS , said that currently, the biggest ethical issue with using AI chatbots for emotional support is that these are potentially life-saving or lethal interventions, and they have not been properly assessed, like a new drug would be. Prof Savulescu pointed out that AI chatbots clearly have benefits with their increased accessibility, but there are also risks like privacy and user dependency. Measures should be put in place to prevent harm. 'It is critical that an AI system is able to identify and refer on cases of self-harm, suicidal ideation, or severe mental health crises. It needs to be integrated within a web of professional care. Privacy of sensitive health data also needs to be guaranteed,' said Prof Savulescu. Users should also be able to understand what the system is doing, the potential risks and benefits and the chances of them occurring. 'AI is dynamic and the interaction evolves – it is not like a drug. It changes over time. We need to make sure these tools are serving us, not us becoming slaves to them, or being manipulated or harmed by them,' said Prof Savulescu.
Independent Singapore
13 hours ago
- Independent Singapore
PHV driver/rider guide for Singaporeans: How being behind the wheel is killing you, and what you can do to stay alive and beat fatigue without hitting the brakes
SINGAPORE: If you're a private-hire vehicle (PHV) driver, delivery rider, or taxi driver in Singapore, you already know: the 9-to-5 life is a distant dream. Your work clock spins on its own terms. One hour you're dropping off someone, and the next hour, you're grabbing food for someone else—all while seated for hours, dodging erratic cars, tolerating demanding passengers, and sitting through the occasional monsoon downpour. It's not just exhausting. It's dangerous. According to a 2022 study by the National University of Singapore's Institute of Policy Studies, platform workers work an average of 59 hours per week, as reported by CNA Lifestyle . That's more than a full-time job and then some. And with roughly 70,000 gig workers in Singapore's ride-hail and delivery sectors (about 3% of the national workforce), that's a lot of folks behind the wheel, pushing through long days with barely a break. These individuals are our unsung heroes, responsible for our food deliveries, midnight rides, and early-morning airport trips. But behind every steering wheel is a platform worker fighting traffic jams, fatigue, dehydration, body aches, and burnout. Sleepless in Singapore Fatigue isn't just about feeling tired. It's a slow fade of your mental reflexes, concentration, and alertness, turning your Grab ride into a potential hazard. 'Drivers experiencing fatigue may show signs such as frequent yawning and blinking, difficulty keeping their eyes open, and decreased concentration and vigilance,' CNA Lifestyle quoted Dr Licia Tan, an associate consultant at Sengkang General Hospital's Department of Occupational Medicine. 'Passengers might also notice the driver becoming fidgety, veering off the lane, or driving erratically,' she added. How long does it take before you hit the sleepy slope? Just one to two hours of non-stop driving, according to Dr. Tan. That's because driving—especially in Singapore's bustling streets—is mentally demanding. 'Driving is a cognitively demanding task that relies on sustained attention, quick reflexes, and decision-making – all of which would decline when a driver is tired,' she explained. And on scorching hot days, it gets worse. 'Intense weather conditions, such as a high environmental temperature, show a positive association with fatigue symptoms and have been linked to poorer decision-making and road traffic accidents,' said Dr. Tan. Translation: Singapore's weather isn't just bad for your hair—it's bad for your brain. Even more worrying: Staying awake for 18 hours is the cognitive equivalent of a 0.05% blood alcohol level. Push that to 24 hours, and it's 0.10%—above the legal limit of 0.08% in Singapore. You may be sober, but your brain thinks you're drunk. It's not just traffic that's draining you Fatigue comes in two nasty flavours, said Dr. Tan: active and passive. Active fatigue happens when you're constantly dodging other bad vehicle drivers, navigating heavy traffic, or trying not to hydroplane during a thunderstorm. You're mentally switched on, but that intensity burns you out fast. Passive fatigue, on the other hand, creeps in during long, boring driving journeys. Think: driving along the expressway on autopilot. It's so monotonous, your brain starts to doze off before your eyes do. And let's not forget the psychological stress, such as dealing with rude customers or being under pressure to meet incentive targets. Add in mobile phone distractions and the occasional sip of alcohol (which you shouldn't be doing at all while driving/riding), and you've got a cocktail of concentration killers. The health toll behind the wheel You'd think mental stress would be the worst of it—but nope, your body takes a massive hit, too. Driving is, at its core, a sedentary job. Hours spent sitting still, missing meals, or wolfing down fast food, and barely moving your limbs is a one-way street to chronic diseases like hypertension, diabetes, high cholesterol, and obesity. Also on the danger list are lower back pain, musculoskeletal disorders, and the condition known as whole-body vibration (WVB). If you've ever felt your bones rattle after a long day on rough roads, that's WVB in action—and it's linked to nerve damage, spinal degeneration, and vascular issues. So, what can a road warrior like you do about it? Doctor's orders: 4 easy habits to stay road-ready 1. Fuel your body right (not just your car) Stick to regular meals and stock up on healthy snacks. Think: fruits or unsalted nuts—basically anything that won't leave a grease trail on your steering wheel. 2. Hydrate like your life depends on it (because it does) Two litres of water a day is the bare minimum. Keep a reusable bottle in your car and top it up regularly. Dehydration can make you drowsy, dizzy, and cranky—not a great combo for safe driving. 3. Take micro-breaks Even a 5–10-minute pause every hour can work wonders. Stretch your legs after dropping off a passenger. Do quick lunges or shoulder rolls. Park and pace around the car. The more you move, the more your body will thank you. 4. Say no to marathon driving Driving more than 12 hours a day isn't heroic—it's hazardous. Long hours heighten fatigue-related errors and hurt your heart in the long run. If no time to stop, here's a hack If you really can't pull over for a proper break, then micro-stretch at the wheel. Dr. Tan recommends neck rolls, shoulder shrugs, and upper body stretches—simple seated exercises you can do while waiting at a red light or in a queue. And don't underestimate your seat. Adjust it for the most ergonomic posture—for comfort, and to prevent strain that creeps in after long shifts. Even the best engines need regular maintenance, and so do you You're not just a driver. You're the engine of the gig economy. But even the best engines need regular maintenance. Similarly, your body, mind, and health deserve pit stops, hydration, and decent fuel. Don't let fatigue take over the wheel. Take control of your health—one break, one stretch, one good habit at a time. Drive safe. Stay sharp. And don't forget to take care of the person behind the steering wheel first before anything else. In other news, a Grab rider's wife opened up about her growing concerns for her husband's safety on the road. She said, 'It's just the risk in riding that concerns me, especially during rain. Even when we're careful, others may be careless.' You can read their full story over here: 'Are you embarrassed or even humiliated to say your husband is a Grab rider?' — Singaporean 'abang Grab' asks his wife, and gets an honest, shocking answer
