'You might end up becoming a patient': Mental healthcare professionals share their stigma stories

When Dr Lee Cheng first started out, he wanted to major in psychiatry but was met with great scepticism from his family. 

Lee, who was trained as a medical doctor, recalled his family questioning him then: "There are so many fields of medicine, why do you want to choose psychiatry?" 

Despite the naysayers, Lee persisted because of his interest in the field. 

Some 30 years on, Dr Lee today is the clinical director for the office of population health at the Institute of Mental Health (IMH). 

Working in this field, and in a public hospital have given him the chance to create policy change.

"I think the satisfaction comes from knowing that I can help to change the mental health care in the future," he said. 

However, the stigma against healthcare practitioners is ever present. 

For example, some of his patients, he shared with AsiaOne, refuse to acknowledge him in public.

"They don't want to recognise us, because that means others will know they're seeing a psychiatrist. But this doesn't happen with gynaecologists or surgeons," he said, adding that the mental health field is a small one here with only 300 psychiatrists in Singapore.

While the stigma towards mental healthcare has decreased in recent years as people have started to recognise its importance, it still remains a relatively unpopular field compared to other forms of healthcare, said Lee.

And just like individuals who experience stigma and discrimination due to their mental health conditions, mental health care providers share with AsiaOne that they too encounter similar treatment from both acquaintances and the public.

And this is solely due to negative associations with their workplace and the nature of their work.

Safety concerns

Voon Yen Sing, deputy director of clinical services at the Singapore Association for Mental Health (SAMH), shared that she too, faced resistance from her family when she told them that she wanted to become a counsellor.

She remembered her mother saying to her: "Instead of providing help, you might end up becoming a patient." 

Other relatives could not comprehend why she wanted to work with persons suffering from mental illnesses. 

Voon's friends were also worried about her safety. "You want to work at SAMH? Will you be safe?" they asked. 

Although it's been almost 20 years since Voon entered the mental health field, she still gets these remarks when people struggling with mental health issues appear on the news. 

"My friends will look at the newspaper, point to them and say, 'Eh, your client ah?'" 

Another misconception people have is that counsellors don't need qualifications, Voon said.

"It's common sense, you just need to have a good heart to do the job," she's been told. 

Voon has a bachelor's degree in social work and psychology, as well as a master's degree in counselling psychology. 

Weird looks from taxi drivers 

As a clinical nurse who works at the remand ward in IMH, Kuganesh Suppiah says he's gotten odd looks from others on public transport. 

"Sometimes when I take a taxi and I tell the driver I'm going to IMH, he'll look at me [in a certain way]," he told AsiaOne. 

He likens it to those who avoid standing near nurses on public transport, especially during the pandemic, for fear of getting infected. 

When he tells the driver that he's working there, he gets comments about the "mad people" at IMH. 

To 'fend' off these comments, Kuganesh usually jokingly replies: "No lah, there are more on the outside." 

Dealing with 'challenging' patients

Working in the mental health field also means having to deal with difficult patients. 

"Because I work in the forensic ward, the patients who come in are very anxious, so they can sometimes be verbally and physically challenging," said Kuganesh.

The forensic ward at IMH is where patients who have been remanded by the courts stay while they are being evaluated by psychiatrists. 

As these patients are kept in remand for two weeks at a time, there are limits on visitations and phone calls, which can add to their anxiety. 

Kuganesh told AsiaOne about an incident whereby a patient became aggressive towards his colleagues while demanding to be discharged. 

He also tried to use his size to intimidate some of the junior nurses in the ward. 

Luckily, he eventually settled down after Kuganesh stepped in — thanks to the rapport they had.

"When patients see some senior [nurses] they recognise, they feel comfortable, and then we try to negotiate with them and see how we can stabilise the situation," said Kuganesh. 

Added Dr Lee: "For example, when we don't allow them to use the phone...they'll get upset and ask how come they're not allowed to do this and that, and sometimes they will curse my whole family." 

And it's not just patients who can be tough to handle. Sometimes, they also have to deal with agitated family members and caregivers who accuse them of improper care. 

In her experience as a counsellor, Voon said she used to have clients who expect her to be at their beck and call.

"They expect that they should be able to call or text us whenever they want, and they should be able to reach us," she said. 

"But in these cases we explain to them that it's not possible, because we need to have our rest too." 

'I don't blame them' 

Despite these difficulties they encounter, all three mental health professionals said they don't hold any grudges against those they serve. 

"I don't blame them," says Dr Lee. "But if they [cross a line] then we just need to be firm with them." 

Kuganesh says he has also come across patients who apologise to him after they've calmed down. "After they're stable they'll be more approachable, so I don't take it personally. It's my job after all." 

When the going gets tough, Kuganesh is reminded of how his superiors have reminded him over the years not to give up if he has the passion for mental health work. 

"I also remind myself that my patients need help, and that's the reason why they're here. 

"If my passion is still there, I'll keep doing it for as long as my body is able to." 

Voon, on the other hand, remains hopeful that the stigma towards those in her field will decrease with time. 

"I think it's inevitable to have misconceptions because they don't interact with us. But when there's an opportunity for interaction, we hope that you will be open-minded and listen to what we have to say." 

ALSO READ: Better ventilation, more interaction: SAMH launches refurbished group homes in Bukit Batok

claudiatan@asiaone.com