SMU’s First National Survey on Caregivers in Singapore

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Caregivers of persons with mental health issues expressed a need for temporary separation from the person they care for, the first national survey on caregivers in Singapore has found.

This survey by the Singapore Management University (SMU) with the support of Caregivers Alliance Limited (CAL), Enable Asia and the Singapore Association for Mental Health (SAMH), reveals that 3 in 4 caregivers are tired and exhausted caring for the person with mental health issues. Almost 9 in 10 caregivers of persons with mental health issues, and more than 9 in 10 caregivers of persons with dementia, are calling for specialized hiring and training of paid domestic helpers.

Ms Ngo Lee Yian, Executive Director of SAMH commented: “Caregiver stress has become more pronounced with the changing family and societal structure. More practical and emotional support to caregivers, in particular, primary caregivers would certainly help them to achieve better health status.

Persons with mental illnesses can recover and lead meaningful lives. This has been the experience of SAMH as we continue to support persons with mental health issues in every step of their recovery journey and help them reintegrate into society.  It is therefore important to support our work in enhancing mental health literacy for all, not only to reduce stigma but to recognize the importance of having good mental wellness for all.”

The survey also uncovered the worries of caregivers. 75% of caregivers are concerned about the future of their care recipients, with more than half or 55% feeling that they have to work to financially support the person with mental health issues.

More than half of caregivers believe there is no complete recovery for a person with mental health issues, saying that their relationships within the family have been strained by caregiving for the person with mental health issues.

The survey defines a primary caregiver as the main carer who bears the responsibility of looking after someone who is unable to care for himself or herself fully due to a mental health issue. A secondary caregiver is not the main carer, but assumes a supporting role to the primary caregiver in the caring process, often not living with the person cared for.

“The survey results point to a worrying trend that the pandemic will have a deeper and more far-reaching impact on mental health for both persons with dementia and their caregivers, even as many of us have already experienced an increase in social isolation. We believe there is no better time for communities to work at mending our social fabric, and work at communicating, sharing their experiences and knowledge with each other to ameliorate the effects of isolation for many silent sufferers,” said Mr Daniel Lim, Co-Founder, Enable Asia.

“We thank partners like SMU who work to shed light on areas we need to focus on, and events like the Enabling Festival will continue to be held to collectively train caregivers and link them to sources of support so they know they are not alone in their journey.”

Increase public awareness of mental health issues

Of note, 86% (or 8 in 10) of primary and secondary caregivers believe there is general stigma or discrimination against persons with mental health issues in Singapore, with 89% of the general public who think the same stigma exists.

Highlighting the lack of outreach or education in mental health issues, more than half (63%) of the general public rate themselves low in knowledge, with almost 40% of them feeling awkward or uncomfortable interacting with persons with mental health issues.

This is a higher number than the 60% of primary caregivers who say they have at least above average knowledge of mental health issues.

“In fast-aging Singapore, everyone will be a caregiver at one point or another, especially when families are getting smaller. With longer life expectancy, the level and complexity of care needs is also set to rise. Caregivers need our urgent attention and widespread support, particularly when COVID-19 has exacerbated the stress and demands of caregiving,” said Ms Low Yen Ling, Mayor of South West District CDC which champions better support for caregivers,

She adds, “This survey underscores how vital it is to connect and support caregivers with practical help and resources and offer avenues for rest and self-care. The findings lend strength to South West CDC’s Caregiving @ South West initiative which seeks to create robust communities of care that offer caregivers an ecosystem of support – from funding and training to caregiver-friendly guidelines for the workplace and a caregiver hotline.”

After sharing her customized survey with CAL, Enable Asia and SAMH, Senior Lecturer of Statistics at SMU, Ms. Rosie Ching, and her 175 undergraduates collated 6,706 responses across Singapore. The project, code-named “Care.For.Me” by Ms. Ching, sought to paint a picture of Singaporeans’ attitudes and awareness towards caregivers of those with mental illnesses including Alzheimer’s disease and related dementias. The survey results are available at http://www.screeningstatistics.com/carers

“During the project presentation, one student shared that she has been caring for her mum who suffers from schizophrenia. Caregivers are a vulnerable group that requires equipping and support to cope with the stresses and challenges in caring for someone with a mental health condition. In the course of acquiring the research and statistical skills, I hope the students from Ms Ching’s class will also gain empathy for caregivers,” said Mr Tim Lee, CEO of CAL.

“I hope too that they will also realize that non-caregivers are caregivers-to-be and that they will help to spread awareness of the needs of caregivers and how caregivers can receive help and support.”

In the process of collating and analyzing survey results, Care.For.Me served as an experiential framework for SMU students to assimilate statistical concepts, applying them to real-world problems beyond the classroom walls.

The project was infused with elements of the University’s unique SMU-X pedagogy, which brought an added dimension of real industry practice to classroom learning. With the introduction of SMU-X as a University-wide program since 2015, SMU has had more than 10,000 student enrolments in some 90 SMU-X courses over the years, in collaboration with over 500 industry partners.

Prof Venky Shankararaman, Vice Provost (Undergraduate Matters), said, “Through the immersive experience of this project, our students gained wide exposure to real-world issues, from mental health stigmas to the hard realities of caring for persons with disabilities. Care.For.Me is an example of the University’s efforts, working alongside industry partners, to nurture graduates with a social conscience.”

“Concurrently, we hope that the findings from Care.For.Me, in triggering thoughts and discussion, can serve to help Singaporean better understand the issues faced by people with mental illness, as well as their caregivers.”