Views from the couch: Understanding the realities of mental health caregiving
No health without mental health Views from the couch: Understanding the realities of mental health caregiving
SINGAPORE - At 29, he still runs to his mother's bedroom when he has a nightmare. His compulsions – repeatedly flicking light switches on and off, obsessively ensuring items are in their exact spots, and even showering for hours – are routines that provide him with temporary relief from his anxiety.
His mother knows that such behaviour is part of his coping mechanism, the rituals that help him manage his obsessive-compulsive disorder (OCD). While she understands and tolerates them, her husband and daughter have struggled, especially in the early years when his symptoms first appeared.
The mother, one of my colleagues, is familiar with the unspoken weight of being a caregiver. It's not uncommon for her to apologise for missing work to be at the Institute of Mental Health (IMH) with her son or to manage a family crisis. I've seen photos of him in the hospital, strapped to a bed, and it's her strength, her unwavering resolve to support him – and that of other caregivers – that keeps me going in my new role.
Over the past five months, leading the combined operations of Caregivers Alliance Limited (CAL) and Resilience Collective, I've witnessed at first hand how mental illness disrupts not only the lives of those living with it but equally, if not more, those of their caregivers as well.
Many people ask how my first 100 days have been, and I answer honestly: I've been on a listening journey, through conversations with my colleagues, events at CAL and discussions with psychiatrists.
For those living with mental illness and their caregivers, normality is robbed, days become chaotic, careers are halted or eventually given up, savings are depleted and familial ties broken.
Bolstering mental health takes a whole-of-community effort. This means not only supporting individual caregivers, but also building a broader ecosystem of care. The goal is to ensure every individual is connected and supported within their communities, encompassing family, schools, workplaces and social groups.
We need to help caregivers help their families
Mental health recovery extends beyond the clinic or hospital. It takes place in the community. Caregivers supporting loved ones with mental health conditions or neurodevelopmental conditions such as attention deficit hyperactivity disorder (ADHD) should be equipped with the skills to navigate caregiving.
Kelvin, a caregiver to his wife and teenage son, who are both living with ADHD, used to find himself in stressful situations when one of them would trigger the other. Once, while he was driving, his wife screamed at their son, who remained very quiet. They later realised he was so affected that he had swallowed a piece of a plastic bag in the car – as harming himself was his way of coping.
Kelvin now has a better understanding of their condition after going through CAL's 12-week Caregivers-to-Caregivers Training Programme. Not only that, he is now also connected to other parents in similar situations.
Our training programme equips caregivers with knowledge about mental health conditions and teaches practical skills for coping and supporting loved ones. This is complemented by monthly support groups, for both caregivers and care recipients, which provide a safe space for them to share openly and build lasting peer support networks.
Many graduates report increased knowledge, emotional resilience, and the ability to navigate their mental health journeys with confidence.
We need to start caring for young minds
In our close work with IMH's case managers, we find that those struggling with mental health conditions are getting younger – a recent case of depression and vape abuse being a minor at 11 years old.
When youth get burdened with mental health conditions in crucial developmental years, it is even more difficult for them to progress and 'catch up' with their peers.
I met more than 100 first-year students entering the media, arts and design school of a polytechnic and recently discovered from an on-site poll done by CAL that one in four of them was willing to join a support group to help them manage their top five stressors: school, money, family, friends and relationships.
The polytechnic had invited us to meet the students, as part of its month-long mental wellness programme for new students.
The polytechnic students told CAL that most turn to informal support networks such as friends, partners, siblings and parents first when crisis strikes. Bolstering mental health needs to work holistically and is a whole-of-community effort.
Awareness needs to start now, and schools are another key community to start embracing this change. This is why we are going into secondary schools to give talks to raise awareness about mental health for youth.
We continue to partner universities, polytechnics and youth organisations such as the National Youth Council and *Scape, to provide psychoeducation and nurture peer support links early. We conduct mental health talks on topics relevant to students, such as eating disorders and body image. Furthermore, we also aim to 'train the trainer' through peer support training for the school's counsellors and student clubs.
We need to break silos, not just stigma, to collectively help burdened minds find light
Singapore's social service agencies today are still focused on their own areas of specialisation or intervention. Stigma around mental health still exists in Singapore. We need mental health players to band together for greater impact and to normalise mental illness.
One way is to adopt a continuum of care mindset when thinking of our collective clients. How can we journey with youth, families or caregivers through their life stages, pre-empting and preventing mental distress, building resilience for transition periods when they are more vulnerable?
This is why CAL is opening our doors to everyone – those who are well today and those who are in recovery – as we are prepared to connect those in need with other organisations that can help them with the right services.
Tim Oei is the chief executive of Caregivers Alliance Limited, which joined forces with Resilience Collective in January 2025. The new CAL's refreshed brand and mission – 'Mindfull Community' unveiled in CAL's 2024 Annual Report – will be introduced at its mass walk on July 26. Those who are interested to walk in solidarity for mental health and wellness can sign up at https://www.cal.org.sg/a-mindfull-walk
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