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The Unreported Statistic of the COVID-19 Crisis

With the daily spotlight on infection count, hospital situations, and latest governmental measures to open up the economy, the psychological impact of the pandemic has somewhat been neglected. APBN talks to Samaritans of Singapore (SOS) about the mental health situation in Singapore.

by Shaun Tan Yi Jie

As Singapore eases off circuit breaker measures, and we rejoice over our low death toll and plateauing infection count, it is perhaps easy to forget the silent majority that has been indirectly affected by the crisis. ChannelNewsAsia reported that calls from new clients to mental health hotlines have gone up, while existing clients have expressed fresh worries about their health and the economic fallout.1

“SOS observed from its 24-hour Hotline and Email Befriending service that more clients have shared their anxieties about the pandemic – both for themselves and for their loved ones,” revealed Gasper Tan, chief executive of local suicide prevention agency SOS. “We observed an increase of more than 22 percent in the number of calls attended to on the SOS 24-hour Hotline in March 2020 as compared to that of the same period in 2019.”

The outlook is similar worldwide. Calls to US federal crisis hotline Disaster Distress Helpline spiked 891 percent in March year-on-year.2 A survey by the China Psychology Society at the height of the coronavirus outbreak in February found that of 18,000 people tested for anxiety, 42.6 percent registered a positive response.3 University of Hong Kong reported that 11 percent of the population had depression, up from 2 percent during the Occupy protests in 2014.4

Tan singled out the economic downturn as having a major effect on individuals’ mental state. “Some of the common struggles faced by callers at our hotline were about the loss of income due to job and income instability. The gig economy in this pandemic may see a heavy impact as a significant loss of jobs will change the daily way of life for many. Similarly, people who work part-time or hold odd-jobs also feel the pressure of an uncertain economic outlook. Though the effects may differ from person to person, the situation can still be worrying and stressful, regardless of age and gender.”

The uncertainty surrounding the virus and consequently the future is also an aggravating factor, Tan says. “Several callers have cited the fear of contracting and becoming an asymptomatic coronavirus carrier, and passing it unknowingly to loved ones. It is important to note that the uncertainty surrounding the COVID-19 pandemic and its effect on the global economy may bring much anxiety amongst many. The fear, anxiety and the loss of a sense of control over a prolonged period of time can be detrimental to one’s mental health. Being exposed to prolonged stress may be overwhelming to an individual with intense feelings of hopelessness and worthlessness.”

 

The Internet Is a Double-Edged Sword

With people forced to stay at home during the pandemic, it is inevitable that most spend their time in the virtual realm. Netflix, for instance, reported a 16 million rise in paid subscriptions during COVID-19 lockdowns.5 However, Tan cautioned about spending too much time online.

“The directives to stay home as much as possible brings people physically apart, but social media acts as a way to keep connected with friends and family. However, with increased use of social media, there is an increasing concern on issues such as falling for online scams and even cyber-bullying. On top of having to cope with the anxiety and fear associated with the COVID-19 pandemic, additional stressors such as falling for scams may be too overwhelming for an individual.”

Tan also expressed worries that it would be difficult to detect people harbouring suicidal thoughts on social media. “Sometimes, some may choose to express their pain and struggles on their personal social media profiles, but such warning signs may appear ambiguous – making it difficult to spot potential signs of distress. In contrast, knowing what someone is currently going through in life can hint at whether they are facing a crisis. The state and situation of a person at that point in time serves as a highly valuable indicator of their well-being.”

Furthermore, the present climate of uncertainty and economic decline provides the perfect cocktail for suicide. “Suicide is an inherently complex and multifaceted problem. Often, it is a combination of multiple factors and reasons that pushes an individual to wits’ end, where they perceive that nothing but suicide will be able to stop their emotional pain. It is important to note that prolonged stress factors are a risk factor for suicide,” Tan emphasised.

However, Tan lamented that the work at SOS on suicide prevention has historically been hindered by the topic being considered as ‘taboo’ locally. “With a strong stigma attached to the topic of suicide in Singapore, individuals who are struggling to cope are less likely to speak about their struggles or seek help from loved ones and professionals for fear of being judged or associated with negative stereotypes. The desire to avoid being stigmatised as ‘weak’, some may choose to put on a facade that they are coping well even if they harbour thoughts of suicide. Stigma can hinder people from recognising that they may be struggling to cope, and more often than not, discourage early help-seeking behaviours.”

In this regard, it is of paramount importance these days for people to pay more attention to their loved ones, Tan appealed. “By paying close attention to their current physical, emotional, and mental state, one may start to notice warning signs that they might be at risk of suicide. When a loved one notices or suspects someone close to them may be harbouring thoughts of suicide, it is important to let them know that they do not have to face their troubles alone. In such instances, the support of those around them can be life-changing. Alternatively, suggesting to approach professional support resources or accompany them to make an appointment if necessary, can be helpful.”

 

#HopeThroughTheNight

Undoubtedly, mental health organisations will play a crucial role in maintaining the psychological wellbeing of Singaporeans during these turbulent times. SOS will therefore stay fully operational, Tan said. “24-hour SOS Hotline and Email Befriending services will continue its operations to ensure that emotional support is available especially so during this global health crisis. SOS will remain fully operational despite limitations on face-to-face counselling to only high-risk cases. Counselling sessions are also conducted through online platforms during this period.”

In addition, SOS is also invoking its #HopeThroughTheNight initiative for this COVID-19 period. “This hope repository was created in 2019 for World Suicide Prevention Day to bring hope to the despairing in their darkest moments,” said Tan. “However, the intent behind spreading hope, support and kindness is even more crucial to anyone who needs that bit of encouragement during this period. While we observe that many may feel the effects of isolation and fear during these unprecedented times, SOS believes that everyone can play a small part to spread hope and encouragement.”

The Instagram page for the initiative6 urged people to create encouraging messages for each other – “it could be in the form of a photo, an illustration, a song, a quote, or a FB/IG Live session” – and post it on their social media with the hashtag. “#HopeThroughTheNight shall act as platform where we express our concern for others in our community and to check in to see how they are coping,” said Tan. “If an individual is not coping well, it can be useful to express our concern and talk about their worries. It is important that this is done in a caring and non-judgmental manner. Concerned third parties may also refer and let individuals know of the hotlines and resources that are available in Singapore.”

Tan has also not forgotten about his own hardworking staff. “[While] the current situation limits physical interaction between staff and volunteers, SOS has organised a digital gathering as a platform for staff and volunteers to support one another.” Finally, on behalf of SOS, Tan would like to proffer the following advice for individuals having difficulties coping with their emotions, or feeling stressed, confused and scared about the current situation.

  1. Manage exposure to media reporting – Repetitively tuning in to news stories about the severity of the pandemic may heighten one’s sense of anxiety. If you are already aware of the basic information, it may be good to mute or turn off notifications of all news mobile applications during this period. You can still check in to reliable and official sources to keep yourself informed but limit your media consumption to once a day or to a specific time of the day. If you will feel better avoiding media completely, ask someone you trust to pass on any major updates you will need to know about.
  2. Engage in hobbies or activities to keep yourself occupied at home – When we engage in a particular activity or hobby, it helps us to focus on something, and this in turn helps to distract you from issues that may be overwhelming. Spending time on your favourite activities and picking up new skills can be a simple way to destress and keep yourself occupied.
  3. Stay connected – Though most of us may be kept physically apart from colleagues and friends, it does not mean that we have to be isolated. Maintaining a strong social connection, either through social media, texts or calls, is as important as prioritising a healthy diet and sleep pattern. This period is also an opportunity to catch up and engage in meaningful conversations with family members. When we are able to communicate and connect with loved ones, it not only helps to feed off some anxiety and boredom but it can also allow an individual to feel supported and surrounded by positivity. It also allows you to check in to find out how your loved ones are coping.
  4. Reach out for support – Some may be experiencing an overwhelming sense of loneliness, anxiety and fear about the situation and be uncertain about the future. It helps to be able to have an open conversation about your thoughts and feelings with someone you trust. When we share about what’s bothering us, it helps to put things into perspectives and manage the anxiety before it gets overwhelming. Individuals may also wish to seek emotional support from available community resources. Several mental health agencies offer hotline or online counselling services that the community can readily access without leaving their homes during this period.

These are dark days for us all. Let’s do our utmost to stay mentally healthy ourselves, and care for our loved ones. Individuals requiring professional assistance may visit the SOS website at www.sos.org.sg, email a befriender at [email protected] or call the 24-hour emergency hotline at 1800-221-4444. [APBN]

Footnotes:

  1. Rachel P. and Hwee Min A. (April 15, 2020), COVID-19: Worries about pandemic see more calls to mental health helplines, Retrieved from: https://www.channelnewsasia.com/news/singapore/covid-19-fear-toll-mental-health-hotline-anxiety-singapore-12631710
  2. Amanda J. (April 10, 2020) A crisis mental-health hotline has seen an 891% spike in calls, Retrieved from: https://edition.cnn.com/2020/04/10/us/disaster-hotline-call-increase-wellness-trnd/index.shtml
  3. Chinese public dial in for support as COVID-19 takes mental toll (February 13, 2020), Retrieved from: https://www.channelnewsasia.com/news/asia/coronavirus-china-mental-health-hotlines-anxiety-ptsd-covid19-12430656
  4. ‘Unprecedented’ mental health issues seen in Hong Kong amid COVID-19 fears (March 3, 2020) Retrieved from: https://www.channelnewsasia.com/news/asia/covid19-mental-health-issues-hong-kong-coronavirus-12494362
  5. Netflix sees record sign-ups during COVID-19 lockdowns (April 22, 2020) Retrieved from: https://www.channelnewsasia.com/news/world/netflix-sees-record-sign-ups-during-covid-19-lockdowns-12665200
  6. https://www.instagram.com/hopethroughthenight/?hl=en

About the Interviewee

Gasper Tan is currently the Chief Executive of local suicide prevention agency Samaritans of Singapore (SOS). Prior to SOS, Tan had been in the corporate sector for more than 25 years, taking up various leadership positions and managing a portfolio of dynamic businesses and start-ups in the Asia Pacific region. He also served on the Board for multiple companies and his passion to give back to society gave him the opportunity to lead NGO projects and, eventually, to SOS.