Youth with mental health issues

Overview

This overview provides a synopsis of the current knowledge base. Having considered all the information, we make sense of it by taking a stab at the following: 1) What are the priority issues that deserve attention, 2) What are opportunity areas that community or voluntary organisations can already take action on, and 3) What knowledge gaps deserve further investigation?

Priority Issues

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Actionable Opportunity Areas

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Knowledge Gaps

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Definitions

Definition of Youth

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• According to the National Youth Council, youths are categorised as those between 15 to 35 years old in Singapore. Globally, youth mental health researchers tend to categorise youths as those between 16 to 24 years old.

Definition of Mental Health

It is prudent to note that mental health issues do not solely refer to mental disorders. Good mental health relates to one’s mental and psychological well-being [1] and the absence of mental disorders is only one component towards achieving it [2]. The definition of mental health is evolving and there is no general consensus reached yet [3].

Mental health issues, defined here, will include the issue of attaining good mental well being. Health Promotion Board (HPB) has outlined a continuum of mental health: (i) mental wellbeing, (ii) mental health problems and (iii) mental illness/mental disorder [4]. Mental wellbeing refers to the state of an individual’s mental health. An individual with good mental well-being is able to manage and cope well despite challenging life stressors. Mental health problems would refer to an individual’s inability to maintain good mental wellbeing. They can occur to anyone, even to those with good mental well-being. If remained unresolved, they may worsen and evolve into mental illnesses, a medical condition. More on mental illnesses can be found in Mental Health. However, it is prudent to note that not every mental illness is caused by mental health problems. Mental illnesses necessitate the need for professional medical treatment whilst a mix of preventive and remedial means can be deployed to develop good mental wellbeing and resolve mental health problems.

Thus, the client segments will be divided into two main segments based on their level of treatment: (i) Youths with poor mental well-being and (ii) Youths with mental health illnesses.

(i) Youths with mental health disorders

Youths are identified as a vulnerable population as they are more likely to be linked to mental disorders [5]. The first onset of mental disorders is known to occur usually in childhood or adolescence [6]. Age of onset of mental disorder often lies in the range of late teens through early 20s [7] [8] [9] [10].

(ii) Youths with poor mental well-being

Youths face many stressors during this period of their lives. A common worry of these youths is their uncertainty of the future which may perpetuate feelings of “never enough” [11]. Other common stressors include academic stress [12] [13], cyber-bullying, life transition stresses, financial worries and relationship issues [14]. The presence of multiple stressors may pose difficulties for youths in maintaining good mental well-being.

Youths are found to be more dissatisfied with life in the National Youth Survey 2014 [15]. The survey indicates a decline in ‘Satisfaction with Life’ from 2002 to 2013 and ‘Happiness with Life’ from 2002 to 2012 despite overall greater affluence and educational attainment.

Youths can be further classified by their level of education and stage of life: (a) Secondary level, (b) Tertiary level and (c) Working youths. This classification highlights the differences between each group such as the modes of service delivery, perspectives and others. These differences will be crucial in designing targeted and specific services that best suit each group’s characteristics.

(a) Secondary Level

A common form of mental health support for youths in secondary level comes in the form of school counsellors that are readily present in every school.

However, there are many misconceptions surrounding the topic of school counselling [16]. Majority of the students, especially those who have no counselling experience, believe that counselling prefers, requires or fits students who are infamous for risky behaviours and poor academics. Another perception is that counselling can only be utilised when one is extremely distressed. Such association may impress upon the students that there are eligibility criteria to be able to receive counselling. Furthermore, emotional issues are not something students will seek help for. As such, counselling services in schools may not be fully utilised by the students.

Benefits to counselling need to be elaborated and misconceptions to be clarified in schools to destigmatize and create a more accurate understanding of the counselling process. Safer and more discrete help-seeking methods for self-referrals such as a mailbox or anonymous helpline. Students need to be trained to recognise signs of emotional disturbance and educated on the importance of seeking help when they see the signs in themselves or their peers. Social groups that adolescents are in such as family can be involved as they are influential in adolescents’ help-seeking decisions.

Preventive and developmental programs found unpopular among students due to the stigma of seeing the school counsellor [17]. Among school students, counselling services are often not the preferred sources of help [18] [19].

Sub-Pages

• Youth suicides: Youth suicides have risen to a 15-year high. 27 young people aged 10 to 19 killed themselves in 2015. This was twice as many as in 2014 and the highest in 15 years.(ST 20 Sep 2016).
• Self-harm
• Cyber-addictions
• Cyberbullying: Cyber Bullying can be an issue within Youth Mental Health page. [To insert this there: The National Council of Social Service (NCSS) in Singapore has launched a free one-stop service, called Help123, for youth cyber wellness issues. Media:http://opengovasia.com/articles/7806-national-council-of-social-service-singapore-launches-one-stop-service-for-youth-cyber-wellness-issues -Useful to have size of expressed need (those receiving services and on waitlist)]

• [To consider starting a page on youth addictions (gaming, social media, tech addiction)?] 

Statistics & Figures

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• According to international research, 1 in 5 of youths globally will encounter a mental health issue.
• According to the Singapore Mental Health Study 2010, 2 in 3 do not seek help. While the ratio might be lesser for youths, given greater awareness of support services and increased normalisation of help-seeking facilitated by national level anti-stigma campaigns like the Beyond The Label campaign, the treatment gap and years lost to disability by the duration of untreated mental illness continues to be significant, especially given that our people are our only resource.
• Annually, individuals aged between 19 and 35 were reported by Institute of Mental Health’s (IMH) to make up 45% of the new patients who are diagnosed with a mental illness and between 2016 to 2018, there were 2,500 of them [20]. These numbers do not include individuals who remain undiagnosed, on a waitlist or seek help from private clinics. IMH’s Community Health Assessment Team (Chat), which serves Singaporeans aged 16 to 30, reported a 190 per cent increase in individuals seeking help [21]. IMH’s Child Guidance Clinic, treating children aged six to 18, has an annual average of 2,400 new cases from 2012 to 2017 [22].
• Treatment gaps among youths may also be present as observed in adults. These gaps may be contributed by stigma among the youth population as negative perceptions and embarrassment towards the issue of mental illness is significantly present [23]. The presence of stigma among youths brings about the question of whether youths have sufficient social support regarding mental health issues.

Areas of Need / Desired Outcomes

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The attainment of a socially inclusive and accepting culture is vital to support youths with mental health issues.

Firstly, the importance of having a good mental-wellbeing needs to be greatly emphasised. What constitutes good mental-wellbeing, how to achieve and maintain it are some of the areas that need to be learnt. This aspect of mental health literacy needs to be enhanced as it serves as a primary safeguard against mental health issues.

Secondly, treatment gaps in youths with mental health issues need to be reduced.

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Resource Directory

Organisations	Details	Contact Details
[Campus PSY (Peer Support for Youths)]	Conduct educational programs for youth ambassadors to equip them with knowledge on mental health, and soft skills to support youths in distress.	Email: campuspsymovement@gmail.com
[Child Guidance Clinic]	Young patients (18 years old and below) who are facing emotional or behavioural problems. Services include: Neurobehavioural Clinic (NBC) - Autism Services Neurobehavioural Clinic (NBC) - ADHD Services The Mood & Anxiety Clinic (MAC) Forensic Rehabilitation, Intervention, Evaluation & Network Development Services (FRIENDS)	IMH Clinic Buangkok Green Medical Park 10 Buangkok View, Block 3, Basement 1 Singapore 539747 HPB Clinic Health Promotion Board Building 3 Second Hospital Avenue, #03-01 Singapore 168937 Telephone: 6389 2200 Opening Hours: Mon - Thurs: 8am – 5.30pm Fri: 8am – 5pm
[Community Health Assessment Team (CHAT) ]	Provides mental health checks for young persons between 16 and 30 years old, who are currently living in Singapore.	CHAT Hub Scape, 2 Orchard Link, #05-05, Singapore 237978 Telephone: 6493 6500 / 6501 Email: CHAT@mentalhealth.sg Opening Hours: Tue - Sat: 12pm - 9pm (excluding Public Holidays) Appointment form available on webpage
[CHAT Special Projects]	Projects on youth mental health	Forms available on page: Partnering on a new project Collaterals such as pens or Mini Guide
[Help123]	National Cyber Wellness Hotline, one-stop service for youth cyber wellness issues. Provided by Fei Yue Community Services, Touch Cyberwellness, NCSS, Community Chest and Singtel	Hotline: 1800 6123 123 Email: hello@help123.sg Opening Hours: Mon – Fri (excluding public holidays): 10am to 6pm Chat service: https://www.help123.sg/ClientChat Opening Hours: Mon – Fri (excluding public holidays): 2pm - 10pm
[Limitless]	Services: Outreach program Counselling and casework Scholarship Employment	[Helpline and Counselling] (form accessible on the webpage)
[Mindset]	Registered charity Services: Awareness and Outreach Back to the Workforce - Job placements and Interview Training Workshop, to equip its clients of the mental health organisations with basic interview skills and knowledge. Social Enterprise - Working with VWOs to retail handicraft products made by mental health clients and running Shelf Projects during holidays. MLH Café at MINDSET Learning Hub as a touchpoint for the public to learn more about mental illness. Fund Raising
[REACH Community Services]	[REACH Counselling Service]	Telephone: 6801 0730 Email: counselling@reach.org.sg
[Singapore Association for Mental Health (SAMH) Creative SAY!]	Preventive and wellness centre that serves the youth and young adult population (12 to 35 years old) through creative multi-modal learning and interventions.	Blk 317, Woodlands Street 31, #01-196, Singapore 730317 Telephone: 6362 4845 Email: creativesay@samhealth.org.sg
[SAMH MINDSET Learning Hub]	Support people recovering from mental health issues reintegrate into the workforce by empowering them with relevant job skills through both Workforce Skills Qualifications (“WSQ”) and non-WSQ training, as well as a source for job placement opportunities.	Blk 257 Jurong East Street 24#01-405 Singapore 600257 Telephone: 6665 9220 Email: mindsetLH@samhealth.org.sg Opening Hours: Mon - Fri (except public holidays): 9am – 5pm. Sat: 9am – 12pm Referral form on webpage
[SAMH Youth Reach]	Psychosocial support and recovery programmes for youths (aged 12 to 21) with emotional, psychological and psychiatric issues in the community.	SAMH YouthReach (referral only) Social Service Hub @ Tiong Bahru 298 Tiong Bahru Road #10-06 Central Plaza Singapore 168730 Telephone: 6593 6424 Email: youthreach@samhealth.org.sg Opening Hours: Mon - Fri (except public holidays): 9am – 6pm
[TOUCH Counselling Services]		5 Stadium Walk, Leisure Park Kallang , #04-05/06, Singapore 397693 Telephone: 6709 8400 Fax: 6709 8401 Email: counselling@touch.org.sg Online registration: https://www.touch.org.sg/about-touch/our-services/touch-family-life-homepage/counselling-services/tfl-counselling-form
[TOUCH Cyber Wellness (TCW)]	TCW is a service of TOUCH Youth, a division of TOUCH Community Services that focuses on cultivating responsible use of digital technologies and healthy cyber culture in youths. Three main pillars: Centre, Counselling and Education.	5 Stadium Walk, #04-02, Leisure Park Kallang, Singapore 397693 Telephone: 6730 9520 Fax: 6271 5449 Email: cyberwellness@touch.org.sg
[TOUCH Youth Intervention (TYI)]	Services: 1. Assessment of cyber wellness issues 2. Face to face counselling 3. Group mentoring, Peer & Community Support 4. Family Therapy sessions 5. Innovative counselling programmes such as DigitalMINDSET (Nine-month intervention programme for youths to tackle both mental health issues as well as excessive gaming and device usage at the same time - Youth’s difficulty coping with or controlling their emotions and mental conditions.) Programs: Enhanced Step Up, LIT Program and many more	5 Stadium Walk, Leisure Park Kallang, #04-02, Singapore 397693 Telephone: 6730 9520 Fax: 6271 5449 TOUCHline: 1800 377 2252 Opening Hours: Mon - Fri: 9am - 6pm
[WINGS Counselling Centre]	Provides counselling services for individuals, couples, families, and children with youth-related issues. Services: Counselling - Resolving personal or psychological problems. Supervision - Clinical internships & supervision for budding counsellors. Specialist - Assessment, treatment, and management of clinical conditions that impair the emotional, cognitive, physical, behavioural, and social functioning.	179 Bartley Road Singapore 539784 Telephone: 63835745 Fax: 6383 5393 Email: admin@wingscounselling.org.sg Opening Hours: Mon - Fri: 8:30am – 5:30pm Sat: 9:00am – 1:00pm (Closed on Sundays and Public Holidays) Appointments/General Enquiry/Content Request Forms: https://www.wingscounselling.org.sg/contact

Other forms of resources

Our Student Dialogues (2020)

Publication by ground-up initiative and Singapore's largest online student and Reddit community SGExams which discusses the impact of Singapore's education system on mental health among students, among other matters. The book is novel for its analysis of website and reddit inputs from the student community.