logo
Views from the couch: Understanding the realities of mental health caregiving

Views from the couch: Understanding the realities of mental health caregiving

Straits Times29-06-2025
Caregivers supporting loved ones with mental health conditions or neurodevelopmental conditions should be equipped with the skills to navigate caregiving. ST ILLUSTRATION: ADOBE STOCK, CHEONG HUAN TING
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
Join ST's WhatsApp Channel and get the latest news and must-reads.
Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

Experts link rise in suicides among Singaporeans in their 30s to job insecurity, family pressures, and mental health stress
Experts link rise in suicides among Singaporeans in their 30s to job insecurity, family pressures, and mental health stress

Independent Singapore

time7 hours ago

  • Independent Singapore

Experts link rise in suicides among Singaporeans in their 30s to job insecurity, family pressures, and mental health stress

SINGAPORE: Job insecurity, family pressures, and mental health struggles are among the reasons behind the rise in suicides among those in their 30s in Singapore, according to experts. New figures released on July 19 showed 75 individuals in their 30s died by suicide in 2024, up from 66 in the previous year. It was also the highest number recorded among all age groups, based on provisional data cited by Channel News Asia (CNA) . Principal clinical psychologist Dr Sharon Lu of the Institute of Mental Health (IMH) told CNA that those in their 30s—the sandwich generation—juggle building their careers, raising children, and caring for ageing parents, while also managing financial pressure. At the same time, they worry about job security, housing loans, and daily family expenses. 'The pressure to meet societal expectations and perceived life achievements can further compound these stresses and create social isolation,' she added. Dr Lu noted that suicide is rarely caused by one issue alone and is the result of biological, psychological, social, and cultural risk factors, along with a lack of resilience factors. See also Woman who threw her son from 9th storey flat jailed 5 years While many assume that depression is the cause of all suicides, Dr Lu said that 'someone who is not depressed can still be suicidal.' Psychiatrist and deputy medical director Dr David Teo of Connections MindHealth said many in their 30s start to question whether they've reached the goals they set in their 20s, and when those go unfulfilled, it can lead to 'a sense of failure or hopelessness.' He also pointed to the role of social media, which often fuels comparison and leaves people feeling left behind. SOS' senior manager and lead counsellor Chan May Peng also noted that those in their 30s are 'at crossroads'—questioning career choices, managing relationship commitments, and adjusting to caregiving roles, with some having little or no support. Dr Teo said having a strong social support system is important, while Dr Lu added that prioritising self-care, practicing self-compassion, and maintaining a clear work-life balance can help too. See also NTUC Study reveals Singaporeans fear becoming Sandwich Generation 'Sometimes, people may feel like they don't have enough time for self-care, but it is not something to be done only when it's convenient,' said Dr Lu. Regular exercise, getting enough sleep, meditation, and improving financial habits can all help. Ms Chan also suggested simple ways to reset mentally, like taking short walks in the park while listening to music, journaling, and shifting focus away from overwhelming thoughts, which can create space for emotional recovery and reduce mental load. Experts advised checking in, listening, and encouraging those showing signs of distress or talking about death. Mental health professionals pointed out that signs of stress may not always be obvious. Changes in sleep and appetite, physical fatigue, irritability, or anxiety could be warning signs. Ms Chua from SOS said asking someone directly if they've been thinking about suicide creates a safe space for someone to open up. Dr Teo added that you can also encourage them to seek professional help immediately and check in with them regularly to remind them they're not alone. Dr Lu said giving away personal items, pulling away from others, or changes in what they like or share on social media could be signs someone is at risk. Many who are suicidal already feel guilty or like a burden. What they need most, said Ms Chan, is someone who will listen without judgment, validate their pain, and encourage them to seek help. If you or someone you know is struggling, support is available through the National Mental Health Helpline (1771), the Samaritans of Singapore Hotline (1767), and the Singapore Association for Mental Health Helpline (1800 283 7019). /TISG Read also: Chinese company's 'unhappy leave' draws mixed reactions from netizens; one says it's just a way of 'protecting their loss margin'

'At my wits' end': A sister's plea sheds light on undiagnosed ADHD in Singaporean kids
'At my wits' end': A sister's plea sheds light on undiagnosed ADHD in Singaporean kids

Independent Singapore

time3 days ago

  • Independent Singapore

'At my wits' end': A sister's plea sheds light on undiagnosed ADHD in Singaporean kids

Singapore: In a heartfelt Reddit post on r/askSingapore, a concerned sister described her younger brother's growing struggle with schoolwork as he approaches Primary 6 — a make-or-break year for many students in Singapore's education system. 'All of my family is tired,' she wrote. 'He seems to have no motivation to do things better for himself… I'm open to any suggestions.' A silent struggle One of the top-rated comments asked a simple but powerful question: 'Have your parents got him assessed for ADHD?' For many Singaporeans, this would be a difficult suggestion to swallow. And for this family, it was no exception. The original poster explained that her parents were 'VERY VERY resistant' to exploring possible behavioral conditions unless a doctor or teacher explicitly recommended it. 'Because of their mindset,' she added. This experience isn't uncommon. In Singapore, stigma around mental health and neurodevelopmental conditions remains deeply entrenched. While awareness has grown in recent years, the belief that academic underperformance is purely a result of laziness, defiance, or parenting failure still lingers — especially among older generations. But ADHD — attention deficit/hyperactivity disorder — is neither a character flaw nor a result of poor discipline. It's a recognised, diagnosable neurological condition that affects millions of children globally and often continues into adulthood. And critically, it can be managed — and sometimes even turned into a major asset. See also Ajoomma is Singapore's pick for the Oscars 2023! What ADHD really looks like According to the Mayo Clinic, ADHD presents in two key clusters of symptoms: inattention , and/or hyperactivity/impulsivity . Inattentive traits may include frequently making careless mistakes, difficulty staying focused, avoidance of tasks that require sustained mental effort, forgetfulness and losing things. Meanwhile, hyperactive and impulsive children may fidget or squirm constantly, interrupt others, talk excessively, struggle with waiting turns or sitting still. However, not all children with ADHD fit a hyperactive stereotype . Some are dreamier, quieter — struggling internally with attention regulation, but dismissed as merely lazy or disinterested. And while every child zones out or fidgets occasionally, what differentiates ADHD is the persistence and intensity of these symptoms, especially when they disrupt life at home, school, or socially. A lens Many parents worry that a diagnosis might 'label' their child. But experts argue it can instead be a lens through which to understand them — one that opens doors, not closes them. Many experts say it's about knowing how they learn, how they think, and how we can meet them where they are. This user shared how their son — the same age — had benefited tremendously after early diagnosis and support from a proactive school. Why early intervention matters Left unaddressed, ADHD can spiral into low self-esteem, school refusal, strained family relationships, and even depression. But early diagnosis and intervention can make a world of difference. Treatment often includes psychoeducation (understanding ADHD and its impact), behavioral therapy, parent training, and in some cases, medication , such as stimulants, which help regulate focus and impulse control. While ADHD can't be 'cured,' children thrive with the right support — the same brain that jumps from idea to idea may also be the one that sees connections others miss. In fact, many experts now describe ADHD as a 'superpower in the right environment.' But it begins with awareness — and a willingness to listen not just to teachers or doctors, but also to the child. Getting help in Singapore For families in Singapore, there are both public and private pathways to ADHD assessment. Polyclinic referral : Parents can request a referral to a public hospital (such as KK Women's and Children's Hospital, National University Hospital or the Institute of Mental Health) by describing their child's symptoms to a general physician. This is usually subsidised. HealthHub direct booking : Through the HealthHub app, parents can also request appointments. Private clinics : These typically offer shorter waiting times but come at a higher cost. Neuropsychological assessments can range from $450 to over $4000, depending on the depth and provider. Reframing the narrative The sister's post ends on a tired but hopeful note: 'I'm open to any suggestions.' And in that openness lies the beginning of something better — not just for her brother, but for countless children in Singapore who are battling battles few can see. They are not broken. They are wired differently — and in the right light, that wiring can shine.

I was angry about growing up in my special-needs brother's shadow, but now I'm grateful for it
I was angry about growing up in my special-needs brother's shadow, but now I'm grateful for it

CNA

time18-07-2025

  • CNA

I was angry about growing up in my special-needs brother's shadow, but now I'm grateful for it

I first came across the term "glass child" in 2023, when it went viral on TikTok. It describes siblings of children with disabilities who are often seen through or overlooked because the attention is focused on their brother or sister. And it hit me. That was me. My younger brother Emmanuel was born prematurely and diagnosed with global developmental delay, apraxia of speech (a motor speech disorder), attention deficit hyperactivity disorder (ADHD) and dyspraxia, also known as developmental co-ordination disorder. Much of my early life revolved around his many developmental struggles: therapies, appointments, meltdowns and milestones. I learnt to adapt quickly, often helping him with his meals, supervising his homework, playing with him and stepping in whenever he became overwhelmed or overstimulated. I was never explicitly asked to do these things. It was simply understood. I had to be the reliable one. I remember one incident clearly. I was around seven years old, doing my homework at home, while Emmanuel, aged four, was playing nearby. He accidentally swallowed a few pieces of my grandmother's bead necklace and ended up vomiting, spewing forth the necklace beads in front of her. She scolded me harshly for not watching him closely enough. I don't remember her exact words, but the feeling stayed with me – a deep sense of shame and guilt. From that day on, I began to believe that any mistake he made or any mishap he suffered was my fault, and I carried that responsibility silently for the next several years. AN UNEXPECTED OUTBURST As I grew older, I only bottled up more and more of my fears and frustrations. There were days when I wanted to speak up about how I felt, but I kept quiet. I saw how hard my parents were working and I didn't want to add to their already heavy load. Mum and Dad had left their careers to co-found Bridging the Gap, an early intervention centre for children like Emmanuel. With both of them working long hours, most of the day-to-day caregiving for him fell to my grandmother and me. By the time I was 10, I started getting angry a lot, often without knowing why. I began to feel resentful that my needs always seemed to come second to Emmanuel's – like I didn't matter. I felt like I was under constant pressure to be perfect all the time, just to avoid being yet another burden. Looking back, it was a lot for a young child to bear. One day, after a minor disagreement, I yelled at my mum – something I had never done before. Mum was taken aback. To her, I was always the quiet, well-behaved child. Thankfully, I think she saw through the outburst to the real cause. She began setting aside more intentional time just for me. We started going for weekly mother-daughter dates for a nice meal or dessert at my favourite spots – Fu Lin Tofu Yuen in Siglap or Swensen's at Parkway Parade – just the two of us. We laughed, talked and enjoyed each other's company without having to think about my brother. As I got older, we even started taking overseas girls-only trips. Most recently, we went to Hong Kong earlier this year. I started to feel seen and heard. A REAL SIBLING BOND During my teenage years, I started volunteering at Bridging the Gap. I met other siblings who lacked the same support I used to lack, who struggled to express themselves the way I did. I've realised that while I had my own emotional wounds, I was still incredibly privileged. With both parents working in special needs and early childhood education, I had access to resources, language and support systems that most people in the same boat may never have. What also helped me to heal was growing closer to my brother – not just as a caretaker or guardian, but as a true sibling. We started baking together when I was around 11 or 12. We love cupcakes and over the years, we have experimented with all kinds of flavours: blueberry, strawberry, lemon and, our favourite, chocolate chip. In the kitchen, Emmanuel is always so eager to try new things, whether it is cracking eggs, mixing the batter or carefully arranging cupcake liners. Even when he doesn't get it quite right, he approaches every task with excitement and a fearless curiosity. He's never afraid to make a mess or try again, and he has taught me so much about embracing the process instead of just focusing on the outcome. We started playing badminton together around the same time, at the common court in our estate. Initially, he struggled with coordination and frequently missed the shuttlecock. I could see he was frustrated, but he never gave up. Over the years, he has improved so much that he now wins rounds against me. Watching him grow, both in the kitchen and on the court, has taught me so much about being resilient and finding joy in the little things. Bonding with him in these ways has helped me see him not just as someone I need to care for, but as someone I admire deeply. These days, my brother has even started teaching me things instead. Earlier this year, he taught me to play chess and we now play together during my free time. It has become our quiet way of connecting, a moment in the day when the two of us get to bond as siblings without distractions. He takes chess pretty seriously. When we play, he is focused, strategic and often a few steps ahead of me. Honestly, he wins more than I do. But what I love most is his kindness. When I make a mistake, he doesn't gloat or get impatient. Instead, he gently lets me try again. In those moments, I feel like I can see my brother at his core – thoughtful, patient and generous in his own way. SEEING GLASS CHILDREN AS THEY ARE Today, I'm 19 and preparing to begin a degree in speech and language therapy at the Singapore Institute of Technology. I still volunteer at Bridging the Gap, where I shadow speech therapists and assist children with speech or developmental delays. It's not just my way of giving back – it's also my way of healing my own past wounds. When people talk about families of children with special needs, the spotlight often shines on the parents or the child with the diagnosis. But I hope that more people will recognise that siblings of children with special needs need support, too. Not every glass child has the space or the words to name what they're feeling, or the tools to help them unpack it, even if it is just the listening ear of a loved one. We are often the ones quietly observing, helping, adjusting – doing our best not to add to the weight our families already carry. But silence doesn't mean we're unaffected. Many of us grow up feeling unseen, as if our needs matter less simply because we appear "fine". Our burdens may be invisible but they can still be heavy: guilt, confusion, loneliness, and a deep longing to be acknowledged. We may not struggle with the same things our special-needs siblings do, but glass children are like any children. We need to feel seen and heard, to be reminded that our perspective and experiences matter. If you are a glass child like me, I want you to know: your feelings are valid. It is okay to feel conflicted – to love your sibling deeply, yet also feel hurt or unseen. It does not make you a bad sibling or a bad person; it makes you human. Isabelle Lee is an aspiring speech-language therapist studying at the Singapore Institute of Technology. She volunteers at Bridging the Gap, advocating for sibling support and raising awareness of the experiences of glass children.

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into a world of global content with local flavor? Download Daily8 app today from your preferred app store and start exploring.
app-storeplay-store