It is reassuring to know that Mr Tan Chuan-Jin, the Minister for Social and Family Development, recognises that suicide is complex and multifaceted, and that a whole-of-government approach is needed to tackle the issue ("Regular visits a key pillar in prevention of elders' suicide"; Jan 11).

While befriending and other preventive measures are important, having a holistic vision of health and using integrated and comprehensive primary healthcare is the gateway to early intervention.

The Tsao Foundation has been providing an integrated holistic model of aged care for more than two decades.

When an elderly person comes into our healthcare programmes, he is provided with a comprehensive scanning of his medical, social and psycho-emotional conditions. This enables the early detection of emotional issues and suicide ideation, even among those who are less inclined to air their feelings.

Counselling is available to any elderly person who comes for a consultation at our primary healthcare clinic.

The counselling service for the elderly and, when necessary, their family members as well, is provided at our premises or at their homes. Group-based coaching in emotional and relationship management is also offered as a preventive, proactive approach to emotional wellness.

Our counsellors work in teams with medical personnel and social workers specialising in aged care.

Because of the dearth of skilled counsellors, we train a group of volunteers as para-counsellors and guide them in offering a lower level of intervention to the clients who are not yet ready for discharge.

To build capacity in professional care, we developed a training programme in gerontological counselling for practising counsellors, and will be offering a course at professional diploma level later this year.

In the whole-of-government approach to suicide among the elderly, we urge policymakers to include counselling as an essential component of primary healthcare.

This is a necessary systemic change to address suicide among the elderlyas, fundamentally, health cannot exclude psycho-emotional wellness.

Also needed is support for the training of professional counsellors and for para-counselling as a volunteer service, as these provide the necessary resources for the rising number of older people in the country.

As Mr Tan noted, every death from suicide is one death too many.

Peh Kim Choo (Ms)

Chief Executive Officer

Tsao Foundation