Deep Dive - What will it take to revitalise Singapore's nightlife?
Singapore reported 314 suicides in 2024, with the sharpest increase among adults aged 30 to 39. Nearly two-thirds were men. What pressures do these groups face? And what are the warning signs? Otelli Edwards and Steven Chia speak with Dr Jared Ng, a psychiatrist and the former chief of emergency and crisis care at the Institute of Mental Health, and Eugene Chong, counselling psychologist at Seeding Minds. WHERE TO SEEK HELP If you or someone you know is struggling and needs support, please consider reaching out to one of the helplines below. Youthline: +65 6436 6612 (call), 8533 9460 (text) and over email at hello [at] youthline.sg. Youthline provides free mental health support to youth via phone, email or a live chat service. It runs from 9am to midnight daily. Calls outside of operating hours are redirected to Samaritans of Singapore or the Singapore Civil Defence Force for emergency medical services. Samaritans of Singapore: 1767 (call), 9151 1767 (WhatsApp text) and over email at pat [at] sos.org.sg. Samaritans of Singapore provides round-the-clock confidential emotional support for individuals in crisis, thinking about or affected by suicide. The call and text-based services are operational 24 hours a day, every day of the week. National Mindline: 1771 (call), 6669 1771 (WhatsApp) and through online webchat on the http://mindline.sg/fsmh website. This is a round-the-clock confidential national-level helpline. Beyond immediate counselling, those who require more support can be directed to the appropriate care and resources.
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CNA
a day ago
- CNA
People pleasers beware: 'Fawning' may be hurting your relationships
Meg Josephson, a psychotherapist in San Francisco, once had a client who said she left every social event convinced, without any proof, that everyone hated her. It was a pattern Josephson recognised both in herself and in her other clients. It's the prickle of alarm when a friend's text ends with a period instead of a 'friendly' exclamation point. It's the 'tailspin of insecurity,' as Josephson put it, that occurs after a neighbour doesn't say hello. It's hearing that your boss wants to chat with you and immediately assuming you're going to be fired. So Josephson posted a video on social media to say, 'You're okay – they're not secretly mad at you.' Thousands of people commented that they had similar fears. ('I realised how much I torture myself' was a typical response.) This nagging feeling that you're in trouble is common, Josephson said, and there's a name for the strategy that some people use to keep it at bay: Fawning. When we sense danger, our nervous systems can respond in three ways: Fight, flight or freeze. But some psychologists, like Josephson, believe that fawning is a fourth stress response. The term was coined by Pete Walker, a psychologist in Berkeley, California, who has written about complex post-traumatic stress disorder. He defines fawning as a protective response developed in childhood as a reaction to trauma – an extreme form of people pleasing. Research on fawning is still emerging, said Nora Brier, an assistant professor of clinical psychiatry at the University of Pennsylvania Perelman School of Medicine. It has been cited as a reaction to interpersonal violence, a form of disassociation and a submissive response to avoid conflict. However, Dr Brier cautioned that there wasn't enough evidence yet to consider fawning a nervous system response such as fight, flight or freeze, but she added, 'I would love to see fawning be considered for more research.' People who fawn scramble to be helpful and agreeable to a person who is a threat, said Josephson, who has been a practising therapist for five years and has 337,000 followers on Instagram. She grew up in a chaotic household in which she was constantly mollifying and accommodating her volatile father. Fawning is sometimes necessary to keep us safe, she said, whether it's for our physical security or for a paycheck. But for those stuck in the fawn response, the impulse to be vigilant to threats and emotionally monitor others is in overdrive, and it spills over into situations in which we're actually safe 'but our body thinks we're not,' she said. With her new book, Are You Mad At Me? How To Stop Focusing On What Others Think And Start Living For You,' Josephson hopes to help people who think that 'I can't feel okay unless the other person is okay,' she said. I asked Josephson to explain three key takeaways from her book that can help people stop the urge to fawn. DON'T AUTOMATICALLY ASSUME YOU DID SOMETHING WRONG You can challenge your perception that someone is mad at you, Josephson said, by asking these questions: Is this story I'm telling myself absolutely true? Is this person's behaviour unusual or just consistent with how he communicates? Could there be other reasons for the person's perceived distance, such as work stress or a recent breakup? For example, when a friend doesn't text Josephson back, she sometimes thinks: 'Oh my gosh, is it something I said?' Then she reminds herself of the many times that she has received a text that later said, 'Sorry, I was in a meeting,' or 'Sorry, I responded to you in my mind.' It's not that people won't ever be mad at you. But it's helpful to pause and remind yourself that your anxious mind has lied to you in the past, she said. CHECK FAWNING BEHAVIOUR BY STARTING SMALL For people who habitually fawn, it can feel intimidating to set boundaries and say no, Josephson said. So begin with low-stakes situations. Notice when you're using people-pleasing phrases that you don't actually mean, such as 'no problem' if something does present a problem, and 'is this okay with you?' if it's not okay with you. If, for example, someone is apologising for hurting you, your instinct may be to rush to relieve the person of guilt by saying something along the lines of, 'No, it's totally fine,' Josephson said. Instead, she said, you can say, 'Thank you, I'm glad we're talking about this.' And if a person tells you that she is not mad at you, take her word for it, Josephson said. 'Get comfortable with the discomfort of taking what people say at face value without second-guessing what else they could secretly be feeling.' 'If someone is being passive-aggressive in their communication and not directly bringing something to you, there's nothing for you to fix,' Josephson writes. 'You shouldn't have to work to master ESP.' MAKE HONEST COMMUNICATION YOUR GOAL When we're fawning, Josephson said, 'the fearful part of ourselves chooses dishonest harmony over deep, authentic connection.' But honest and clear communication is the most important part of any relationship, and it erases the need to read between the lines, Josephson said. Practice being more direct with someone you feel safe around. Tell the person you are doing this and ask for help, she said. If you are cancelling plans, for example, be honest instead of making up an excuse so that the person won't be upset with you. 'This practise might be uncomfortable in the short term but saves us so much energy in the long-term,' she said. 'And it strengthens the relationships we really value.' The next time you have the urge to fawn, Josephson said, give yourself an authenticity check: Do I really mean what I'm about to say? Am I saying something I don't mean to try to appease the other person? 'It's not in your control to make someone else happy,' Josephson said. What is in your control, she added, 'is how you spend your time, your energy and your focus.'
CNA
2 days ago
- CNA
Heat stress: Land transport infrastructure sector employers urged to adopt heat measures
Authorities are urging the land transport infrastructure sector to step up heat-stress management, as temperatures rise with climate change. Their latest guidelines build on earlier measures for outdoor work, and cover workers involved in road works and related activities. Professor Marcus Ong, Senior Consultant at the Department of Emergency Medicine at the Singapore General Hospital, examines if these measures are enough. He also puts forward his own proposed recommendations.
CNA
2 days ago
- CNA
Demand for home hospice services rising faster than manpower, say providers
SINGAPORE: When 86-year-old Paul Wong was diagnosed with terminal stomach cancer in January, he chose to spend the rest of his days in the comfort of his home. A year ago, his wife passed away from colorectal cancer at home with the support of Assisi Hospice's hospice home care service. 'I saw the care she received and I hope would be able to receive that too,' he told CNA. 'I've stayed here for over 40 years. I find the place quiet, and the neighbours are friendly. I hope to be comfortable and manage my pain.' His daughter and grandchildren also live nearby and visit him for meals and activities. Mr Wong is among a growing number in Singapore opting for palliative support at home. They have also gotten a boost from the government, which is looking to increase the availability of such end-of-life care. To help more people spend their final days the way they wish to, the Ministry of Health (MOH) has put in place a National Strategy for Palliative Care. Since its launch in 2023, home palliative care capacity has grown by 25 per cent, from 2,400 to 3,000 places. It is set to increase to 3,600 places by the end of this year. An equipment rental scheme that was put in place, which provides patients with subsidised essentials like hospital beds, has benefited more than 1,000 Singaporeans so far. Care providers said it is not just about infrastructure, but also having competent palliative care staff – and there is a shortage. HIRING STRUGGLES In fact, demand for such care is rising faster than manpower, with providers saying they need more trained staff to keep up. HCA Hospice Care, the nation's largest home hospice provider, said hiring is an ongoing issue. "One of the things I struggle with is to find the right people with the right heart to do this work,' said its medical director Dr Chong Poh Heng. 'It's not a terribly glamorous (job) to work in the home, in different settings, some of which are, in my opinion, not quite habitable,' Dr Chong added. 'But the patient is comfortable there, so within those limitations (we must) find the means to deliver the same quality of care to those patients and their families." The hospice looks after about 1,400 home patients and will soon increase capacity to take in more. Among its ways to manage manpower issues is enlisting the help of the patients' caregivers. "We teach (caregivers) some of the knowledge aspects, including hands on (care), hygiene care, serving of medication, sometimes giving injections too,' said Dr Chong. Family members also learn to prepare special food and manage appliances like oxygen concentrators or suction machines, he added. TRAINING TAKES YEARS One challenge in hiring is finding personnel with adequate skills and qualifications, as roles in the sector can take years to learn. Assisi Hospice said its staff nurses are trained for up to three years before they are fully competent and can deliver care effectively. It is the largest inpatient facility in Singapore, and is leveraging home care to meet growing demand. Its home caseload has grown nearly five-fold over the last decade to about 700 today. The figure is projected to reach 850 by late 2026. Aside from medical know-how, staff also need training to understand how to manage the mental and psychosocial needs of the patients and their families. 'Palliative care patients (are) very ill, with many comorbidities, different organs may not be functioning. They have been through a lot,' said the hospice's CEO Choo Shiu Ling. 'Their journey in the healthcare system would have been very long. They have a high complexity of needs. Their caregivers could be emotionally and financially exhausted,' she added. 'It is the nurses and the special skills of a palliative care team that can possibly address all these very complex (issues).' She said the hospice's priority is to train its healthcare staff well and continue to grow its home care team. 'Because we discover (that) when nurses are confident and competent, it aids retaining so they stay with us, and we actually have a very low or almost no attrition for our home care team,' noted Ms Choo. Assisi Hospice currently has 48 staff tending to end-of-life patients at home, and plans to grow the team to 60 by the end of next year. There are around nine providers in Singapore that specialise in home palliative care. The sector needs at least 20 to 30 per cent more home hospice staff as the population ages, warned the Singapore Hospice Council. Board member Mervyn Koh suggested adequate remuneration and recognition could attract more to the industry. With funding another key concern as home hospice is fully subsidised, he said he also expects such care to be chargeable in future. 'Chargeable doesn't mean expensive. If it is MediSave deductible, that may be the way to go in future to keep healthcare costs sustainable,' said Dr Koh, who is also a senior consultant of palliative medicine at Tan Tock Seng Hospital. 'This will enable families to still (fulfil) the wishes of patients passing on at home without having to fork out cash by themselves.' He pointed out that most home hospice care providers are charity organisations, and it may be challenging to keep up free home care due to rising costs. "Policy makers can consider potentially opening up, say, MediShield Life to support home hospice care,' Dr Chong said. 'Currently, it can be used in the hospital, in inpatient hospice facilities, but it's not quite possible to use MediShield or insurance to pay for home care."
