Series on schizophrenia Part 3: A doctor’s diagnosis and his mission

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“Doctor, you have educated me. You bothered to explain my mental illness to me, that it is just a biochemical imbalance. You told me not to be afraid, that there is hope.”

Each time he hears a newly-recovered patient say this, or variations of this, he beams and a little hope is raised in his heart.

Dr Ang Yong Guan is a well-known mental health advocate and psychiatrist in Singapore, and was the longest-serving psychiatrist with the Singapore Armed Forces for almost 17 years.

He knows the statistics in Singapore signal a crisis: one in six Singaporeans suffers from some form of mental illnesses, 3 per cent of Singapore’s population has clinical depression and 45,000 people have schizophrenia.

Yet, as each of his patients recovers, the psychiatrist feels that his dream that mental illness be spoken about openly is being realised.

Ang believes that to begin a conversation about mental illness, Singaporeans need to talk about weaknesses in the open.

“Why are we so uncomfortable talking about negative things? In 2011, a girl named Krystal killed herself because she could not get into one of the top three local universities. It is about living up to everyone’s expectations. But what is wrong with going to uniSIM, for example?” he asks.

He believes a major problem lies with the city-state’s heavy emphasis on success, and a reluctance to deal with failures.

“We are very quick in talking about what we are good at. Singaporeans are great problem-solvers, number one here, number one there.”

But often the fruits of our success are measured by material achievements, he said. What happens when we hit a bumpy road?

“We must tell Singaporeans that it is okay to fail and it is okay not to do well. More importantly, we need to learn from our failures and to grow emotionally strong from these failures.”

He further explains: “To do so, we need to develop people who have high self-esteem. The higher your self-esteem, the less likely you will break down. I think people lack that in Singapore.

“Low self esteem and emotional insecurity can be seen in many examples in Singapore – the kiasuism (a fear of losing out to others), the over-the-top demands for tuition and the corporate rat race. We are stressing people out unnecessarily.”

His comments are timely as the current statistics show a startling jump of young Singaporeans afflicted with mental illnesses. The Institute of Mental Health (IMH) has revealed that its hotline received 8,000 calls from schools in 2011 compared to 306 in 2007. IMH estimates the number of mental health patients below the age of 15 to be around 87,000.

Do we have a problem tackling weaknesses since our youth?

It is at this point, Ang suggests: “If I have my choice, I think every student should be given a one-page appraisal every year. The appraisal should consist of their strengths, weaknesses and areas of improvement.

“In this sense, we tell the Singapore child, ‘don’t worry your friends also have weaknesses and strengths. You also have. They also have.’ We have to stop hiding our weaknesses.

“I hope someday it is acceptable to say, ‘I can’t concentrate, I couldn’t sleep last night, I quarreled with my mother last night, my father is too demanding, my brother is too boastful’.

“We must promote this kind of open thinking – so that people know it is okay to admit one has weaknesses — and strengths. So it is acceptable to say, ‘I am weak in some areas, but I am also strong in some areas.’”

I ask him what would happen if we continue to ignore our own failures and shortcomings?

“We will become a nation where everyone wants to be Number One, wants to be the best.

“But ignoring one’s weaknesses and pretending that they don’t exist contribute to emotional tension and insecurity and eventually may lead to national inefficiency.”

He says: “As far as I am concerned, I will continue to educate as much as I can. So that people understand what mental illness is really about. I hope they will go back and educate others about mental illness.

As I leave his clinic, I start doing a mental checklist of my weaknesses and strengths. When I reach home, I feel relieved. It was like looking into a mirror and saying:

“Mirror, mirror on the wall. Please show me my faults.”

Additional reporting by Nicole Chang.