SINGAPORE - The State Coroner has recommended that the Singapore Civil Defence Force (SCDF) undertake a review of its structure and protocols to better deal with mental health issues among its servicemen.
The recommendation came following a coroner's inquiry into the death of SCDF full-time national servicemen Muhammad Ahad Lone, 18, who was found to have committed suicide in April last year.
He had exhibited signs of depression and had, prior to his suicide, expressed to doctors his intention to self-harm during his time of service with the SCDF.
Ahad was found to have fallen from a height to the ground floor of Block 1A Pine Grove in April last year.
At the time of his death, Ahad was residing alone in a rented room in a unit at apartment block 1A in Pine Grove and had been doing his national service in the SCDF since Feb 6, 2018.
The coroner's report revealed that between his time of enlistment and his death, Ahad was seen on six occasions at the National University Hospital (NUH), on 11 occasions at the Civil Defence Academy (CDA) Medical Centre, and once at the Institute of Mental Health (IMH).
Ahad, however, had his medical certificate privileges restricted on March 27, as his unit said that he had been taking multiple medical certificates (MCs) at NUH Emergency Department (ED) whenever he booked out of camp.
He was informed that visits to the ED ought to be reserved for emergencies only, and to report sick in camp or to the camp's primary care doctor instead.
At that point, Ahad had visited NUH six times, between Feb 18 and March 21 that year, and been advised to attend a follow-up appointment with the NUH Psychological Medicine Department after his second visit on Feb 25.
Prior to that, he had visited the CDA for various reasons, including symptoms of vomiting, headaches, problems sleeping and heartburn.
The CDA also referred Ahad to see doctors at IMH, after he revealed to a CDA doctor that he had suicidal thoughts and thoughts of slitting his wrists.
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He was seen at the IMH on April 24, where a senior psychiatrist diagnosed him with adjustment disorder with a depressed mood - echoing the CDA doctor's first diagnosis of Ahad on his enlistment day.
The coroner's inquiry found that as Ahad was identified to be a suicide risk, he was provided timely and appropriate treatment, with his commanding officers having taken steps to ensure his well-being within the constraints they faced.
"Ahad could have also benefited from a supervisory arrangement with a trained counsellor," said state coroner Kamala Ponnampalam, adding that the IMH resident had recommended Ahad be referred to the SCDF counsellor and the camp's psychological care centre.
"There is no dedicated Psychological Care Centre (PCC) within SCDF. There is only a Behavioural Sciences Unit located at the SCDF HQ and an orientation officer within each camp who functions as a counsellor. The orientation officer has no formal training in counselling," he said.
Mr Ponnampalam also recommended that the SCDF undertake a review of its structure and protocols and implement evidence-based measures, including, but not limited to, the appointment of trained mental health professionals to each SCDF camp.
"Mental health literacy is generally not intuitive. It is a learnt skill. Often, good intentions alone is not sufficient to support those in crisis. They require support and intervention from trained professionals."