Singapore

Family, bomohs and why mentally-ill aren’t seeking help

Culturally-appropriate tools and informal support networks are lacking here, with the medical scene overshadowed by Western psychiatry
Published: 5:27 PM, October 13, 2013
Updated: 1:00 PM, October 14, 2013
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While treating mental disorders is in itself a challenge, encouraging access to the treatments has proven to be the bigger challenge.

The reality is, a majority of those who suffer from mental disorders here do not seek or receive help – which is surprising for a country like Singapore, where modern mental health programmes, services and platforms are readily available.

There have been increased efforts to provide such services and programmes especially in light of the ageing population, and pressures from work and family. Such efforts, identified in the National Mental Health Blueprint for 2007-2012, include (among other things) public education, outreach in schools, workplaces, integrated programmes such as the Community Mental Health Team and Mental Health-General Practitioner Partnership, and mental health research.

Yet, a 2012 study on where those with mental disorders in Singapore go to for help found that only a minority actually access these services, while more than two-thirds of those with a lifetime mental disorder had not sought any help.

Contributing factors include low education, low income, cultural beliefs, shame, the inadequate number of culturally-competent mental health professionals, language barrier, value conflicts with service providers, non-familiarity with the Western mental health services, preference for informal social support, and negative attitudes toward seeking psychological help.

OF BOMOHS AND CULTURAL FACTORS

Take the case of Singaporean Malays for instance – they are significantly more likely to give a better rating of their mental health status, have a lower overall perceived prevalence of mental illness, and are less likely to be affected by stigma compared Chinese and Indians.

As such, the Malays are significantly less likely to report mental health problems or consult professionals (claiming they offer little help), and believe that medication does more harm than good.

Most also face financial constraints accessing health care services. Instead, as another study in 2000 found, many Malays still turn to spiritual or traditional approaches, particularly the bomohs (spiritual healers), which may be attributed to indigenous Malay belief in supernatural causes.

As such, it is important to understand the cultural background of patients. Unfortunately, culturally-appropriate instruments and informal or alternative support networks are lacking in Singapore, with the medical scene being overshadowed by biological psychiatry.

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