Thursday, January 29, 2009

Job losses leading to mental health concerns in Singapore

From Asia One Business:

The past year has been challenging for Singaporeans, with many witnessing job losses, pay cuts and stocks losses first-hand. The reality, reflecting a rise of anxiety and depression cases could not be more true.

'There is definitely an increase in patients suffering from anxiety, panic attack and depression over the past 12 months,' said Yeo Seem Huat of Yeo Seem Huat Psychiatric Clinic. Many private psychiatric clinics in Singapore have noticed an increase of 10 to 15 per cent in depression cases, and the economic crisis is cited as the root cause.

Public hospitals such as Singapore General Hospital (SGH), National University Hospital (NUH) and the Institute of Mental Health (IMH) have also reported an increase in cases since 2007.

SGH reported that 400 more people sought treatment for a variety of mental health problems in 2008 as compared to 2007. This figure represents a 3.2 per cent increase in patients treated. NUH also reported an increase in patient consultations, but a larger one of about 15 per cent.

Out of the various mental ailments treated for, the most common ones are anxiety and depression.

Anxiety is commonly associated with bodily tension and is usually accompanied by physical effects such as heart palpitations, nausea, chest pain, shortness of breath, stomach aches, or headaches.

Depression on the other hand, is characterised by overwhelming feelings of sadness and hopelessness, but it can manifest itself in many ways such as becoming socially withdrawn, being unable to function in daily activities and in most extreme cases, suicide.

Chua Hong Choon, vice-chairman of the IMH medical board estimated in a report last November that around 5 per cent of Singaporean adults are affected by depression. The report was presented in the Singapore-based Medical Tribune newspaper and was based on a survey conducted in 2004.

Although this figure is lower than that in the United States, Dr Chua said that they were comparable to many developed European Countries.

Till now, mostly white-collared workers have been feeling the brunt of the economic meltdown, and majority of patients seeking treatment belong to the middle and high income group, said Ang Yong Guan of Ang Yong Guan Psychiatry.

Polyclinics, which provide subsidised healthcare for the masses, have seen only slightly fluctuating numbers over the past 12 months, with numbers remaining stable over the entire year, National Healthcare Group corporate communications assistant manager Christine Wee said.

As explained by Barclays Capital economist Leong Wai Ho, 'this crisis is hitting people disproportionately and is currently affecting professionals more than lower income workers.'

Patients seeking treatment for anxiety and depression usually fall into one of six categories, Dr Ang said.

The first category consists of patients who have been retrenched recently and are therefore experiencing some form of anxiety or depression.

The second comprises of patients who are still holding onto jobs but fear getting retrenched. The third is middle management who are tasked with retrenching employees and are unable to decide who to axe, resulting in stress and anxiety.

The next comprises of patients who as a result of company retrenchments have to work doubly hard in order to meet company's expectations.

Housewives make up the fifth category, seeking treatment due to their anxiety over spouses' loss of jobs or paycuts.

In the final category, patients experience anxiety due to the falling prices of property, stocks and bonds with fear of being unable to hold onto investments made during the boom period.

While it may still be too early to attribute all the increase in cases to the harsh economic climate, Adrian Wang, a consultant psychiatrist at Gleneagles Medical Centre feels that the recession is bound to affect everyone in some way or other.

Head of Psychiatry at SGH, Ng Beng Yeong said that the inability to control the financial crisis also results in distress for patients.

With a future so unpredictable, worry and anxiety seem almost inevitable. However, solutions do exists and a depression attack can be prevented, Dr Ang said.

An anxiety or depression attack is best identified by a sudden change in behaviour. As such, colleagues and family are more likely than others to notice changes and play an essential part in the intervention process.

Companies for one, can engage the help of company doctors to monitor the mental well-being of employees periodically.

In December last year, Dr Ang gave a talk to employees of a pharmaceutical company on how to stay happy in an uncertain world.

Although drastic action need not be taken, Dr Ang suggests companies to have wellness managers to check the wellbeing of employees. 'These wellness managers can help in both prevention and intervention of stress-related ailments by organising relaxation programmes as well as being available to offer a listening ear', he added.

On the national level, help is already being offered to ensure the mental wellbeing of Singaporeans.

The government recently announced that it is injecting another $35 million over the next three years to support efforts aimed at raising the mental emotional resilience and well-being of Singaporeans. This commitment, on top of the $88 million announced in 2007, will give further impetus to synergise efforts to improve mental well-being in the community.

However, with the recession soon to affect more of the population, depression is a serious worry for some doctors who are afraid that no amount of intervention will be sufficient.

This is because some individuals are unable to engage in positive thinking, Dr Ang said. This results in them getting trapped in a mindset of negativity which is really dangerous.

'Some patients feel that they can only be cured if they find a new job, and no amount of psychotherapy, counselling or medication will help,' he added.

But there is hope, even for this group of people.

18,000 jobs will be created over the next two years, the government announced in Thursday's Budget. This will hopefully curb the rise of job-related depression and improve mental well being in Singapore.