Meet Bob*– an energetic teenager who, on the surface, appeared to have everything under control. But deep inside, Bob was struggling. He was often overwhelmed by emotions and had been experiencing persistent low moods since he was six. He did not sleep well and had lost interest in his hobbies.
In school, he was being bullied by his peers and was sometimes reprimanded for behaviours beyond his control, like his inability to concentrate on tasks. He had also entertained thoughts of hurting himself and others.
Barriers to help-seeking
Despite all these, Bob was hesitant to seek help. He was afraid of burdening the adults in his life and he also felt that sharing his thoughts and emotions with others would be too much for anyone to bear. Growing up in a difficult family environment, he feared interacting with his parents and found it hard to form and maintain trusting relationships with others. Bob is not alone in feeling this way.
In the National Youth Mental Health Study conducted by the Institute of Mental Health in 2022, which surveyed youth aged 15 to 35, one in three did not seek help despite having severe or extremely severe symptoms.
The three most common reasons were the perception that specialists would not be able to help them, being worried about what other people may think if they sought treatment and being worried about privacy, confidentiality or being left with a permanent record. While this study did not include children under 15, another study which the Singapore Children’s Society had conducted did.
We carried out an analysis of randomised mental health-related chats received in 2020 and 2021 through our Tinkle Friend helpline and chatline, which serves children aged seven to 12. Findings showed that children often hesitated to share their problems due to a lack of trust in adults, fear of being judged and strained relationships.
Moreover, those who did seek help frequently encountered dismissive or invalidating responses, worsening their distress. Some children struggled to access appropriate support, and in some cases, parents themselves obstructed access to mental health resources.
All these local patterns reflect global trends. They also highlight that help-seeking is not just about awareness but also about feeling safe enough to reach out.
Getting Appropriate Help
Singapore has established various avenues for children and youth to seek help from. For example, they can approach their school counsellors, youth integrated teams, CHAT or general practitioners.
Fortunately for Bob, he has had some positive experiences with staff members at our youth centre, and that led him to eventually approach them for help. He was recommended to book a mental health check-in session with a trained professional.
Children’s Society started offering mental health check-ins last year to support children and youth like Bob overcome the barriers that often stand in the way of help-seeking. Children and youth who wish to speak with someone on their mental wellbeing can book an appointment online. They have the flexibility to decide their mode of engagement— in person, through calls or text. This choice has been appreciated by those who value anonymity or find face-to-face conversations difficult.Just like physical health screening where the primary intent is detection and early intervention, one does not need to reach a certain level of severity in their mental health to tap on this service.
Mental health check-in is not meant to be a counselling nor diagnostic service, rather it aims to provide clarity on the issues children and youth face and bridges the gap between them and a wider support network. Knowing that they are interfacing with a professional provides greater assurance of non-judgemental help and greater certainty that they can experience trust and confidentiality.By empowering children and youth to seek help independently, they are also more likely to commit to the entire process.
If it is deemed that the child is doing okay, such check-in sessions can end with just providing them with self-help strategies and resources. However, there are situations where more support is needed.
Bob’s turning point
Bob’s check-in surfaced mental health challenges that required intervention. He was referred for a clinical assessment with the REACH (Response, Early Intervention and Assessment in Community Mental Health) team and was diagnosed with persistent depressive disorder (dysthymia) and symptoms of trauma related to his experiences of family upheaval.
At the same time, we supported Bob with sense-making of his behaviours, thoughts and emotions. With continuous psychological intervention, he grew in his awareness and healthy management of his emotions. Gradually, he learnt to challenge his negative thoughts as part of developing cognitive coping skills and picked up different ways to express himself with others.
We further engaged Bob’s father to convey the importance of having a strong support system for his child. His father also learnt to regulate his own emotions better and found more appropriate ways of expressing his care for Bob. As both father and son grew in their new-found skills, they were better able to form a closer parent-child relationship.
Normalising Help-seeking
For children and youth to feel safe enough to talk about their problems and to nip them early, we need to build a societal culture where mental health conversations are nothing out of the ordinary. Check-ins and services should be regarded as perfectly normal in one’s mental wellness journey.After all, early detection and intervention motivate many of us to participate in physical health screenings. In the same vein, children and youth do not need to wait for their struggles to be bad enough before accessing services.
Mental health check-in is just one of the solutions to lower the barriers of supporting children in need. There is potential to explore embedding it within the educational system as part of routine screening for children and youth. For it to be effective, we must also ensure that parents and educators support our young persons in the appropriate services thereafter.
Today, Bob continues to use the coping skills he has learnt, both for himself and to support his friends. His relationship with his father has grown stronger and he has found a sense of peace and understanding within himself.
Bob’s story is one of hope, resilience and the power of early intervention — reminding us all of the importance of mental health support for every child.
*Name changed to protect client’s identity.
Side bar: Building support systems around our children and youth
Children and youth’s mental health challenges do not exist in isolation and recovery is often a collaborative process involving the family, school and community.
Studies have identified social support as a protective factor for children and youth’s mental health. Children who had safe and nurturing relationships with trusted adults in their lives were found to have better physical and mental health outcomes. How can adults support our young people?
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