Number and Profile of Persons who Attempted Suicide

11 Assoc Prof Daniel Goh Pei Siong asked the Minister for Social and Family Development (a) what is the number of people who have committed suicide or attempted suicide each year in the past five years; (b) how many were aged 60 and above; (c) how many of these seniors were living by themselves and how many were living with their families; and (d) what resources and programmes are currently in place to help to address the likely causes of such suicides and to prevent the suicide rates from increasing.

The Minister for Social and Family Development (Mr Tan Chuan-Jin):Mdm Speaker, between 2011 and 2015, there was an average of about 415 deaths from suicides each year, of which an average of 116 involved persons aged 60 and above. In terms of trends, for the elderly specifically, there are no particular trends that we picked up. It varies from year to year but there is no particular spike in numbers. We do not also have the specific breakdown of the living arrangements of these persons who committed suicide.

As the causes of suicides are complex and multi-faceted, we do need to take a holistic perspective when we examine and try to review each individual suicide and to see how we should approach it. Certainly, we take a whole-of-government approach.

Why it seems a lot more visible today, I guess a lot of it has got to do with media, especially social media. When news breaks, stories sometimes are shared in various forums. It is circulated and a lot more awareness is there. But when we look at the numbers themselves, the trends are not picking up in a big way. It does not mean that it is not important because every life lost via suicide is one death too many and we should endeavour to try to prevent it.

It is also, perhaps, a bit simplistic to label the reasons as to why it happens because there are social issues, there are relationship issues, family issues, mental health issues and sometimes a combination of various factors that causes individuals to take their own lives.

We want to work together with community partners, particularly to raise awareness on suicide prevention, encourage distressed persons to seek help, and provide professional support and crisis intervention to at-risk groups.

Essentially, there are four ways in which we want to approach this.

The first one is through public education. Under the Seniors Health Curriculum, which is rolled out by Health Promotion Board (HPB), this is part of our National Seniors' Health Programme, where seniors are taught social-emotional and self-care skills, and how to seek help if necessary. HPB also conducts workshops in workplaces to educate Singaporeans, in particular mature workers, on mental resilience and well-being.

Secondly, it is through proactive outreach and support. To prevent social isolation and to help us detect risks among seniors early, Senior Activity Centres (SACs) conduct social activities and carry out home visits to reach out to elderly living in rental flats. The Agency for Integrated Care (AIC) also works with community-based organisations, including the SACs, to support seniors who may be at risk of depression and dementia via the Community Resource, Engagement and Support Teams (CREST) programme. It is part of the Community Befriending Programme that volunteer befrienders visit seniors regularly to prevent social isolation and support their needs. This is something that all of us as individuals can do. We really should think about mobilising our residents and volunteers to play a part in this effort because it is really about picking up information, picking tell-tale signs and providing social support where we can. Of course, Family Service Centres (FSCs) support families and individuals, including seniors, through casework and counselling to resolve their relationship, financial, emotional difficulties and so on.

Thirdly, in the crisis response effort. Those in distress or who are facing crises do call the Samaritans of Singapore, which operates a 24-hour hotline. IMH also operates a 24-hour Mental Health Helpline manned by counsellors who can assess and after that triage cases, and activate home visit teams if necessary.

Lastly, while all these initiatives are important, the most critical role really is played by the individuals themselves. Families − let us not forget the role that families play − and, of course, the community − the people who live around us.

At the individual level, individuals should take personal responsibility. They need to raise self-awareness − be self-aware and recognise tell-tale signs so that they can seek help early when feeling overwhelmed and emotionally distressed.

Family members must help to pick up signs of distress and render emotional support, or help the troubled family member to seek professional assistance early. Co-workers, colleagues at work, friends and neighbours can also play a very important role in offering assistance and support to those facing life's challenges.

Without these steps, even the best support programmes that we put in place will be rendered ineffective. So, we must all step forward and play an active part in looking out for our fellow Singaporeans, our loved ones and together with the rest of the other programmes we put in place, I think we have a good shot at reaching out to those who need help.

Mr Dennis Tan Lip Fong (Non-Constituency Member): I thank the Minister for his comprehensive explanation. On the issue of social isolation, I understand from press reports that there has been a huge number of increase, over the last, say, 15 years, in the number of elderly people living alone compared to 15 years ago. I am particularly addressing people who live alone and whose spouses have moved on, passed on. I understand from my grassroots activities that some of these elderly do not want to be involved in some of these current activities at the SACs and other activity centres. I am just wondering whether the Ministry will consider taking a new approach to some form of befriender programme or something to interact with these elderly whose partners have passed on and to provide social company and to try to re-integrate them into society.

Mr Tan Chuan-Jin:I would like to thank the Member for his question and follow-up comments. I think it is a very real concern for a number of reasons. One, the number of people who are ageing are increasing so the volume itself is increasing. The other factor that we are all familiar with is family structures are also changing. Families are smaller. So, sometimes, you may have children but they may be working abroad or, sometimes, in some cases, you do have strained relationships. So, you will gradually begin to see, of course, one, more elderly and, of course, there are elderly who are living alone for a range of reasons and you will also correspondingly see some of these numbers increase.

Now, does isolation in itself represent a problem? No, not necessarily. But certainly, isolation, I do not think it is necessarily a good thing either because people do need to be socially engaged. They may be living alone but it does not mean that they are necessarily socially engaged. They may be in contact with their family, their regular social activities. So, those are less of a concern. But they can become a concern at some point where they become less mobile, when they become less able to meet up with other people. Which is why it is very important for us to realise that the grassroots activities are very important. Ultimately, at some stage your neighbours and the community in which you live in become very critical.

Family members are there, and that is always the first line. That is critical and we hope that families continue to visit. Which is why we also want to re-define the sort of family structure and look beyond just the nuclear family, the extended family becomes important − cousins, nephews, uncles, aunts. We need to nurture that extended family relationship as well. Relationships within a family do not just automatically happen. We also need to put in effort to make sure that at least that part in terms of providing emotional support to their elderly and to family members remain. But the community becomes important.

Indeed, the Member is right. As Members know, some of the activities that we have, we have the same old people taking part in the activities. We want new old people to take part. And the Member is right that some do not participate, for a range of reasons. Sometimes, they may have just moved in, there is no social connection with the local community as yet. The befriending effort is on-going. That is a very important part of our programme in terms of outreach; slowly getting to know who are those people who are isolated, and then how do we begin to get to know them and slowly begin to connect them with the community at large and begin to get them out of their homes and to participate in activities. Once that ice is broken, we can begin to see some of them beginning to play an active role.

There are some who do not want to come out, again, for a range of reasons. Sometimes, when you become older, you have physical infirmities and then you feel self-conscious and, sometimes, it is just a question of perhaps regular visitation and that is something that we are looking at through the Befrienders' Programme, which is why I would urge Members to grow these grassroots activities, whether from the neighbours, the grassroots organisations, volunteers and, in fact, working with corporates. That is something I am exploring as well, because companies are looking at CSR efforts. Sometimes, we may be looking for some big-bang activities. But, actually, low-key, simple, weekly, fortnightly befriending visitation goes a very long way and that becomes a bridge to the other activities that we have.

So, indeed, the Member is right. It is something we need to pay attention to because we all know the ageing profile is changing, the numbers will expand, and it behooves us to put in the effort today, so that by the time we reach that stage in 10, 15 years' time when the numbers are quite phenomenal, we can have an environment where we may live long, but I think we can age well, both as individuals and as a community as well.

Dr Intan Azura Mokhtar (Ang Mo Kio):Madam, I certainly agree with the Minister that in reaching out to our elderly, all of us have a part to play. Even here, in this House, all of us, as Members of Parliament, elected or otherwise, we can do something about it. We can visit them regularly at home with our volunteers and not just wait for grassroots events or the Government to do something about it.

Would MSF consider working with MOH to look at how our PG Ambassadors can also be that first line of befrienders to visit our elderly, because they are already out there and are already trained?

Mr Tan Chuan-Jin:Indeed, the partnership between MSF and MOH is critical. It is very hard to just draw a line that this is a social issue, this is a health issue. I would say the third factor is a community issue. So, the grassroots organisations and structure are a very valuable set-up. The PG office is particularly important because they are actively visiting the Pioneer Generation. We are also picking up information from them because they sometimes notice that elderly folks are just so happy to have someone to talk to. These are not the elderly folks living on their own. They are living with family members. This suggests to us that, sometimes, they may be living with their older parents but they are not being engaged or are being disregarded in some ways. What we are trying to do, now that the information is being picked up, whether at the Pioneer General Ambassador level or the grassroots level, is decide how we then pool the information together so that we can then direct efforts at befriending in a lot more targeted and effective manner.

That is something we are focusing on to see how to operationalise this. Some of us are doing this on the ground as Members of Parliament. I have spoken to a number of you on some of the possible outreach efforts that can be done and I do sincerely believe that this is possible. It is really a question of us organising ourselves at the ground level to do this. No shortage of outreach efforts, but I think we need to work together to collaborate. But that effort is on-going.

Mr Kok Heng Leun (Nominated Member): I thank the Minister. In my experience working with the elderly, I realise that language plays a very important part in communication. I wonder if all of MSF's outreach programmes would also include other languages. Besides English, which most of the organisations are comfortable with, we are really looking at Mandarin, Malay, Tamil or even various dialects. Would such programmes be available? And how do we make sure that these are going out to the elderly?

Mr Tan Chuan-Jin:I thank the Member for the insight. Indeed, the Member will notice we have a lot more dialect programmes and advertisements. We work closely with the getai community to get some of the messages out. Dialects become important, as well as Malay, Tamil and so on. In terms of the outreach for befriending, it is not just in English. We are looking out for volunteers from different backgrounds. I would urge the different communities to step forward to play a part because we do need to leverage on your language skills.

We do have people who want to reach out. But sometimes there is an impediment because of language. When that happens and we find that some elderly person is not able to communicate beyond a particular language, we will then source for someone who is able to speak the language to come in.

It definitely helps once again to call out for those who are from different backgrounds to play a part, because that is important. In terms of collaterals, such as videos, we are stepping up the effort, working with different producers, directors, to generate some of the materials. I am sure you have seen a lot of the Hokkien and various advertisements which have gone down very well with the elderly. I know some people are a bit ‒ for want of a better word ‒ kind of scornful about "Why do you have this kind of videos? It is a bit slapstick". But it is different strokes for different folks. We may not always relate to some of these types of programmes and collaterals, but it reaches out to different segments of our society. The key thing, as far as we are concerned, is that it does not matter what the platform is. Get the message out and then enable individuals to then look after themselves as well, and also to encourage those around them to do that. It really takes a collective effort.

So, the Member is absolutely right. Language plays a very important role, particularly presently when a lot of the elderly, perhaps because of their education level where their language competencies are not quite the same. As we go forward in the next 10, 15 years, this issue should be less acute. A lot more people should be able to speak the main languages. But it is something that we still need to look out for.