•             More than 6,700 across Singapore participated in this survey, including primary caregivers for persons with mental health issues (including dementia), and members of the public.

•             Caregivers of persons with mental health issues including dementia: 75% (or 3 in 4) expressed a need for temporary separation from the person they care for. More than 72% also said caring for the person with mental health issues makes them tired and exhausted.

•             Almost 86% (or 8 in 10) of caregivers of persons with mental illness and more than 90% (or 9 in 10) of caregivers of persons with dementia say Singapore needs specialised hiring and training of paid domestic helpers as caregivers for persons with mental health issues. Almost 90% of secondary carers also chose this as the top issue with paid domestic helpers.

•             General Public: More than 63% of the general public rate themselves low in knowledge of mental health issues.

Singapore, 9 Dec 2020 – 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 specialised 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 recognise 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.

Said Mr Daniel Lim, Co-Founder, Enable Asia, “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. 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.

Said Ms Low Yen Ling, Mayor of South West District CDC which champions better support for caregivers, “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.”

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 customised 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

Said Mr Tim Lee, CEO of CAL, “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. I hope too that they will also realise 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 analysing 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 programme since 2015, SMU has had more than 10,000 student enrolment 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.”

Quotes and Testimonials:

Rosie Ching, Senior Lecturer of Statistics at SMU, said:

“In October 2019, I was asked if I could explore the caregiving landscape in Singapore. I had by then already planned a mental health study but with many projects in the offing, it was tough to choose. It was my own family who highlighted such an important need to me, which lit the fuse to kick this into action to train the spotlight on the silent heroes behind the persons they help, understand their state of life and how they and mental health issues are perceived by themselves and the general public.

Alongside mental illnesses, I included dementia, also a mental illness. Over the years, I’ve had many students sharing deeply with me personal stories of their mental challenges with family, friends, of their close relatives with dementia: my ears are always theirs. Even at this moment, I have students who suffer from severe depression who reach out to me. My own beloved great-grandmother died of Alzheimer’s disease when I was a student.

I am deeply grateful to my students both senior and current, for toiling alongside me in this massive Care.For.Me. project, which was doubly painful and difficult in COVID-19 era. It has torn wide open the veil over things not openly discussed nor well understood but which exerts one of the most onerous and immeasurable burdens in caregiving. I feel privileged to have worked on this to serve Caregivers Alliance Limited, Enable Asia and Singapore Association for Mental Health. We hope our statistics will spark greater understanding of our caregivers, or carers as I prefer calling them, and improvement to their well-being.”

Tee Rui Kiat, a 22-year-old undergraduate from SMU’s Lee Kong Chian School of Business, said:

“This Care.For.Me journey could not come at a better time. Why do I say this? My mum recently, due to work issues, has not been the healthiest mentally. This escalated closer to the end of the project and I had to quickly take on the role of a caregiver to my mother. Through this project, I have learnt how to handle such issues and care for her, encouraging her to seek help by professionals – something I would not have done previously due to the stigma that surrounds people with mental health issues. Even though I have not felt the burnout yet, my dad has seen better days and all I can do is to be there for him. As I pen this, tears are forming. Therefore, from the bottom of my heart, thank you Ms. Ching. Thank you for putting us through this project and letting me learn about mental health and how we can actually care for our caregivers, who are often overlooked. I have definitely become a better person through this, one definitely being less stigmatic and will remember the lessons you have taught us through it all.”