Residential facility for youth at risk of self-harm helps plug gap: Advocacy groups

The planned facility aims to provide an additional period of stabilisation for patients. PHOTO ILLUSTRATION: ST FILE

SINGAPORE - When Ms Kiet heard that an intermediate residential facility would be set up for youth who are hospitalised for risk of suicide or severe self-harm, she felt hopeful.

The 50-year-old, who declined to give her full name, lost her 23-year-old son to suicide in June last year. He had been discharged from the Institute of Mental Health (IMH) after attempting to take his own life, but was unable then to find a place that would take him in and support him on his recovery journey.

"I am hopeful that such a facility will be built soon as the need for it is urgent," said Ms Kiet, a member of the PleaseStay movement, which aims to raise awareness about youth suicides.

From January 2021 to February 2022, the Samaritans Of Singapore (SOS) attended to more than 800 clients who attempted suicide or had suicide ideation, and were at high risk of self-harm.

More than 80 per cent of them were youth.

During the debate on his ministry's budget on March 9, Senior Minister of State for Health Janil Puthucheary said some youth who are hospitalised for risk of suicide or severe self-harm may require post-discharge residential care to allow for space and time to integrate back to the community in a more gradual way.

He announced that the Ministry of Health (MOH) would be developing an intermediate residential facility to address this.

MOH later told The Straits Times that, currently, when such youth are discharged, they are linked up with care professionals in the community, such as psychologists, counsellors and social workers in social service agencies.

These care professionals will continue to provide post-discharge support for the youth, some of whom may return to IMH for follow-up appointments.

"Although youth with significantly reduced suicide risk may be discharged from acute inpatient care, some may benefit from a safe and stable environment away from psycho-social triggers," said MOH.

It added that the planned facility aims to provide an additional period of stabilisation to ease their transition back to the community.

Mr Gasper Tan, chief executive of SOS, noted that most social service agencies do not operate 24 hours a day, but suicidal thoughts can come at any time.

In fact, SOS helplines get their highest call and text messaging volumes around midnight when people feel lonely, he added.

"When people are in crisis, it's not something you can predict - we can listen to them, help counsel them, follow up with them, but there may be times when they are not engaging with us when they're at risk."

The residential facility will provide a 24-hour safe space for such people, said Mr Tan. "I'm very glad the Government is addressing this gap," he added.

"Youth are a vulnerable group, as they are exposed to social media and a lot of external and peer pressure. The world is now more competitive too. All this creates a lot of pressure on the next generation," said Mr Tan.

"I hope this facility can be a go-to safe space for those at risk, where people who feel unsafe can seek help, with integrated professional care and programmes."

Ms Valerie Lim, one of the founders of the PleaseStay movement, said: "I'm very, very glad they're looking into this much-needed facility."

She noted that a dedicated facility would be good for youth as it would allow them to recover in an environment separate from older, long-stay patients with mental health conditions, who may have different care needs.

More importantly, she hopes that the new facility will focus on helping such youth reintegrate into society.

"When you have a condition like depression, it's not so easy to just have intensive treatment, and then go home. Because your home environment may not be the best place for you at the moment, and may not have the supportive elements to help you reintegrate," she said.

Mr Tan said the facility should not just be for those who were previously hospitalised for self-harm, but also for youth who are not hospitalised to seek help.

By facilitating this kind of step-up care and making it more accessible to those who need it, the facility will help reduce the stigma surrounding help-seeking behaviour, he added.

Ms Lim said, ideally, youth at the facility would be given some independence and freedom, rather than being strictly regimented, while still being watched over and cared for.

For instance, a therapist could come in the morning and engage the young person, who would then be given time to pursue his own activities such as art therapy, while having the option of seeking help at any time during the day.

The facility should also provide access to counselling, be affordable and cater for short stays of no more than 28 days or so, said Ms Lim, citing a similar model of care in Australia. Check-ins should also be voluntary, she added.

Emphasising that there is a need to look at wider, systemic issues that may put youth under pressure, she added: "If a young person falls out of the system because of his condition, there must be a pathway back into the system."

Join ST's WhatsApp Channel and get the latest news and must-reads.