A recent survey by the Institute of Mental Health (IMH), revealed that “one in seven people in Singapore has experienced a mood, anxiety or alcohol use disorder in their lifetime”. 

The study further highlights the existing problem of a “treatment gap”, in which the majority of people suffering from such mental health issues did not seek professional treatment. According to the study, this could be due to two reasons.  First, the failure to recognise the symptoms and second, the stigma around mental health issues.                                                     

The results suggest that although having a mental health condition is not uncommon in Singapore, it unfortunately remains a misunderstood and taboo subject.

Stigma Around Mental Health Issues​

It’s All Your Fault

Stigma can take many forms. How many of us have heard dismissive statements in response to being open with our feelings? These include statements such as “you’re always so negative”, “Don’t be such an attention-seeker” or “you wouldn’t be in this situation if you [had or hadn’t done something]”? 

Such statements unwittingly place the blame for a mental health issue on the person experiencing it. They do not acknowledge the various biological, social and economic factors that influence mental health.

In fact, the 2017 Attitude Survey conducted by the National Council of Social Services (NCSS) showed that “six in ten believe that mental health conditions are caused by a lack of self-discipline and willpower”.

Indeed, stigma around mental health issues often stems from a lack of awareness on how they come about.

The Truth About Mental Health

Mental health issues are rarely due to the “lack of self-discipline” or because those individuals are “weak” as commonly believed (Institute of Mental Health, 2015). At the same time, the fear of being judged and being discriminated against can obstruct one’s road to recovery (Yang, 2007).

Often stigma results in someone refusing or delaying treatment. Things that could have been resolved easily and quickly with early interventions often become buried deep in inner vaults guarded by shame and guilt.

What We Can Do About It​

Choose Your Words Wisely

As with most things, it begins with small steps. These can include being mindful of  things we say casually.

The constant description of others as “crazy”, “gila”, “siao” or “psychotic” tend to imbue these words with negative stereotyping and often result in social distancing. A study published in 2017 revealed that among Singaporean youth, 44.5% of the respondents associated pejorative words and phrases with mental illness (Pang et. al, 2017).

Another example is making statements such as “I was so embarrassed, I wanted to kill myself” which could be triggering for those battling with depression if overheard unintentionally.

Avoid Defining People by Their Experiences

Language plays an important part in both stigmatising and destigmatising mental illness. Next time, instead of saying “she’s depressed”, try “she felt down” or “she had a depressive episode”. 

This separates the illness from the individual, reminding them that they are bigger than their emotions or mental state.

Be More Accepting

Acceptance also plays a huge role in removing prejudices. One way to show acceptance is to emotionally validate our peers or loved ones when they come to us with problems. 

Invalidation occurs when we tell other people to “not think about it anymore” or to “not be sad”.

By normalising sadness and anxiety, people will feel more understood and accepted. For example, instead of saying “don’t think about it”, try saying “it’s normal to feel anxious about having to present!” 

This would encourage them to talk about their feelings, which would lead to improved mental well-being as they are better able to cope.

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Institute of Mental Health. (2015, Oct 6). IMH’s National Mental Health Literacy Study Shows Dementia, Alcohol Abuse and Depression are the Most Recognisable Among Common Mental Disorders. [Press Release]. Retrieved from https://www.imh.com.sg

National Council of Social Services. (2018, October 30). NCSS Study Reveals That Workplace Adjustments In Companies Will Address Barriers to Hiring Mental Health Conditions [Press Release]. Retrieved from https://www.ncss.gov.sg/Press-Room/National-Council-of-Social-Service/Press-Releases/Detail-Page?id=NCSS-Launches-First-Nation-Wide-Campaign-to-Fight

Teater, B. (2013). Cognitive Behavioural Therapy. In The Blackwell Companion to Social Work, 4th Edition. Wiley-Blackwell

Yang, L.H. (2007). Application of mental illness stigma theory to Chinese societies: synthesis and new directions. Singapore Medical Journal, 48(11), pp. 977-985. http://www.smj.org.sg/article/application-mental-illness-stigma-theory-chinese-societies-synthesis-and-new-direction 

Pang, S. Liu J., Mahesh M., et. al (2017).  Stigma among Singaporean youth: a cross-sectional study on adolescent attitudes towards serious mental illness and social tolerance in a multiethnic population. BMJ Open, 7(10). DOI: 10.1136/bmjopen-2017-016432

Tags: poor listening habits; active listening; listening ear; peer support; improve communication

When we feel depressed, stressed or anxious about a personal issue, we often first confide in a friend for an outside perspective. Mostly it feels great to talk your heart out, and unburden yourself.

There are times, however, we come out of the conversation feeling unheard, confused or even more frustrated! Has this ever happened to you? You know your friend cares about you, so how did you end up feeling this way? 

Below, we discuss some poor listening habits that people often have, and some tips on how to improve communication.  

1) Hogging Airtime With a “Similar” Problem They Had​

You: “I’m so irritated at work. My boss said…” 

Friend: [Interrupts] “Oh! I don’t like my work either… (Continues on about their own work issues)”

Why It’s Unhelpful

Of course you’d like to be there for your friend too, but on this occasion, you were trying to share your difficult experience and vent your frustration about the issue affecting you. Unfortunately, you found yourself stopping midway because your friend started telling you about their situation instead.

How Else Could They Have Responded?

While people may go through similar situations, every individual’s experience is unique. Take some time to listen to what your friend has to say, without interrupting or changing the topic on your own.  At the end, a simple statement paraphrasing the main points could also show them that you’ve been listening.

“It seems like you feel that your boss is micromanaging you, and that stops you from clearing your work effectively.”

2) Providing Unsolicited Advice

You: “I’m very stressed. My partner and I have been arguing daily.”

Friend: “Just break up.”

Why It’s Unhelpful

You’ve probably thought a lot about the issue and considered various options. You could also be experiencing conflicting feelings, not all of which you may have verbalised. It might be a complicated decision. However, when your friend tells you what to do, it diminishes your thoughts and feelings and suggests that there is one simple solution. It also undermines your ability to decide for yourself.

How Else Could They Have Responded?

Instead of thinking about what you would do or immediately coming up with a solution, imagine being in your friend’s shoes, in their circumstances. What could they be feeling? You could observe their facial expressions and body language, or simply ask them.

And don’t worry if you get it wrong – you can then ask what they are feeling instead.

“If I were in your shoes, I would probably be feeling worried. Is that what you are feeling?”

3) Predicting the Future

You: “I just went for an interview, but I doubt I’ll get the job. There were many other candidates who seemed more qualified.”

Friend: “Don’t worry. You will definitely get the job.”

Why It’s Unhelpful

Well, unless your friend has insider knowledge, how would they know that you would definitely get the job? False reassurance is not reassuring at all.

Also, telling someone not to worry is counterintuitive. I wonder what you would think of if I asked you not to think of a pink elephant?

How Else Could They Have Responded?

Landing an interview is in itself an achievement that you could congratulate your friend for. People often think that congratulations are meant for events like graduations and weddings, but small successes can be celebrated too!

You could also acknowledge that being nervous while waiting for interview results is normal. When people realise that they are not the only ones feeling a certain way, it can take a load off their shoulders.

“Oh you got an interview! Congratulations! If I had to wait for interview results, I’d be nervous too!”

4) Being Distracted

You: “Are you even listening??”

Friend: [5 second pause, then looks up from phone]“Huh what?”

Why It’s Unhelpful

We’ve all been there, haven’t we? Having to repeat yourself makes you feel that you were not important enough, or that you were somehow less interesting than whatever your friend was scrolling through on their phone.

How Else Could They Have Responded?

Many people hear what others say, but few listen. Truly listening to someone isn’t a passive process where you sit back and do nothing; it is effortful and requires much focus. Try putting aside distractions like phone notifications and even your own thoughts about what to have for your next meal, and focus on what the other person has to say.

We have probably all been guilty of some or all of the poor listening habits above at some point or another. The next time a friend approaches you, try to use these tips to really listen.

While changes like these don’t happen overnight, with enough practice, we’ll be on our way to building better rapport and more meaningful relationships!

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