PHP 31 May 2021 (Virtual) Learning Journey

by Max Yeo (22A13A) and Mirella Ang (22A01C)

“Prevention may just be a matter of having the right person with the right knowledge at the right time.”

In 2012, suicide rates in Singapore spiked. This was thought to be a result of the economic fallout from 2008 – the delay was speculated to be due to individuals’ initial hopefulness turning into fatigue as their circumstances didn’t improve. A similar trend is expected by counselling services following the pandemic, which means proper suicide prevention is becoming all the more important.

Just as well, then, that the PHP (virtual) Learning Journey on the 31st of May centred on raising awareness about local counselling services and trauma-informed care, to teach the Peer Helpers how to become the right people for those in need.

Talk by Emily Tandar from the Samaritans of Singapore

“Suicide prevention is everyone’s business”.

Such was the theme of the talk delivered by Ms Emily Tandar of the Samaritans of Singapore (SOS). However, many remain in the dark about the prevalence of suicide, what causes it, and how we can respond to suicidal indviduals.

General Background Information about Suicide

Which words do we think of when picturing suicide? For the peer helpers, at least, words like “loneliness”, “depression”, and “hopelessness” immediately come to mind. However, there are a myriad of factors which cause suicidal thoughts and affect one’s vulnerability to them.

For example, men have significantly higher suicide rates than women – their 266 to the women’s 134 suicides in 2019 – which is thought to be due to an unwillingness to seek help as a result of patriarchal norms, as well as the tendency to choose more drastic and effective means of suicide.

This is just one of the several facts about suicide that Ms Emily Tandar shared. As she made clear, there are several misconceptions about suicide persisting in Singapore, reinforcing biases and preventing suicidal individuals from reaching out. For one, there is a common perception of suicide as a “selfish” act, which dissuades suicidal individuals from talking about their thoughts. She also prefers to use the term “complete suicide” instead of “commit suicide”, the latter being indicative of illegality and perpetuating stigma.

Understanding the Suicidal Mind

In reality, there are a variety of complex factors which cause suicidal thoughts in people. Some common stressors include relationship problems, wherein suicidal individuals lose someone whom they loved and cared for, and financial difficulties, which cause some to feel like they are a burden to their families and loved ones.

Oftentimes, these factors are combined, and plunge people into a state of hopelessness if the problems go unresolved. Ultimately, suicidal ideation is borne not out of a desire to end one’s life, but rather, to end the pain of various struggles in life when no other recourse exists.

Other possible triggers of suicide.

However, even if someone is already considering suicide, two things can worsen their condition: firstly, an unwillingness to reach out, and secondly, reaching out and being met with judgement and dismissal.

“Prevention may just be a matter of having the right person with the right knowledge at the right time.”

Suicide Warning Signs

So what kind of warning signs can peer helpers look out for? Certain verbal signs exist, such as verbal expressions of feeling like a burden to others, having no reason to live, feeling trapped, or hopeless. Some actions can also be indicative of suicidal desires, like giving treasured items away, writing suicide notes, or looking for methods of completing suicide. Sudden mood changes can be warning signs as well, as is abuse of drugs or alcohol and withdrawing from society. It’s important to note that mood changes may not necessarily be negative in nature: sudden lightheartedness and joy are common emotions felt once individuals have set their minds on suicide as a solution.

Ultimately, however, we can’t rely on just one warning sign to determine if someone is suicidal – usually only a combination of them can be reliably indicative of suicidal thoughts.

Once suicidal thoughts are recognised, though, it’s important to realise that it’s not too late. People can and do recover from suicidal thoughts and even suicide attempts, especially with the aid of community resources. These can range from immediate support and care to long-term therapy.

Community Resources and the SOS

Some types of community resources and support.

How do the Samaritans of Singapore (SOS) come into the picture? Established in 1969, the SOS seeks to provide non-religious emotional support services to Singaporeans via a range of mediums. To date, they provide 11 (!) different services, free of charge, to treat mental health issues and prevent suicides. This holistic approach aims to reach out to as many at-risk individuals as possible and provide sufficiently personalised care.

SOS’ range of emotional support services.

Most commonly used is their 24-hour hotline, which is manned by trained volunteers. No callers are turned down or hung up on, even if they are perceived to not be in any immediate danger of harming themselves. This is because even mundane conversations could be the callers’ only source of interaction, and may be the support they need to keep going. Ms Tandar recalled incidents of students who would call the hotline every morning on their way to school just to talk about their plans for the day – even though it seemed unexciting, the volunteers still lent them a listening ear.

Other services include CAREmail, an email address which individuals can contact to share their worries, and one preferred by youths less comfortable talking directly to someone else. Successful suicide attempts can also result in trauma and suffering for suicide survivors – people who have been impacted as a result of someone they know completing suicide. Local Outreach to Suicide Survivors, or LOSS, aims to reach out to families immediately following a suicide, directing them to relevant resources and help, and teach them coping strategies in the long-term.

How to help a suicidal person

Despite the abundance of support systems, however, friends and family are often the first responders. How, then, can we respond? SOS recommends:

1. Talking to the individual privately and discreetly.

2. Letting them know you care about them, even if you feel shocked or inexperienced.

3. Acknowledging and validating their feelings.

4. Responding without judgements, assumptions, or interrupting.

5. Referring them to community services like SOS.

To keep our peers safe and suicide-free, make sure you’re looking out for them, and ready to render assistance if needed. Suicide prevention is everyone’s business, after all.

A picture of the Peer Helpers with Ms Emily Tandar. 🙂

Acceset Training

“It’s not about what’s wrong with you, but what happened to you.” This is one quote that stood out from Mr Matt Oon’s workshop, as understanding it is a cornerstone of trauma-informed care. In order for the peer helpers to work through trauma with their helpees, they first must understand what trauma is, and their individual helpee’s situation.

This is what Acceset Singapore aims to do: to teach more Singaporeans on how to train and practise digital empathy skills for online counselling. The need for such services is indisputable, especially in the current pandemic situation – and so is the need for the peer helpers to be guided in their online helping journey.

Trauma

Trauma is a person’s emotional response to a distressing situation and has often been described as “being in a constant state of imbalance”. It can manifest as fear, high sensitivity to external conditions, and a lack of control over emotions or executive functioning. Few, if any, can go through life without a single instance of trauma – and the prevalence of trauma has been rising through the years.

Graph taken from Mr Oon’s sharing on trauma.

Trauma can occur in a myriad of ways – be it an inevitable drastic life transformation or environmental factors – but the one thing all trauma cases have in common are fundamentally external events that lie outside of anyone’s control. And it is this instability that grows and spreads across all aspects of life, keeping the helpee in a vulnerable, negative state of trauma.

Trauma-Informed Care

Trauma-informed care is based on a four-pillared framework that enhances the trust and safety of helpees in a collaborative manner where they regain control. This kind of care helps to empower survivors and help them live the way they want to live their lives. It focuses on personal strengths, provides helpees with ways to have fun and self-reflect, all while helping them learn to be respectful and inclusive with others. One method draws on Positive Childhood Experiences (PCE). Building on good relations with a survivor’s loved ones, PCE provides stability in everyday life, allowing the helpee to have the freedom to look to the future and develop as a person.

“Help them without judgement, but with EMPATHY” said Mr Oon.

Digital Empathy Skills

Mr Oon began the second half of his workshop with the four skills crucial for communicating empathy online.

The Four Pillars of Digital Empathy Skills

1. Mattering

Making the helpee feel important and creating a strong sense of self is the first and most crucial step in creating significance. Giving them genuine encouragement and acknowledgment makes them feel listened to and validated which makes them feel like they matter.

Some techniques include showing that you’re listening and treating the survivor as an equal by sharing related experiences, and asking genuine questions to show your interest and attention. Make it a two-way conversation where both helper and helpee are listening and bouncing off each other.

2. Psychological decentering

Shifting from feeling the negative emotions to noticing where it comes from helps to stop the uncontrollable spiral of worthlessness. Instead of just thinking “I am angry”, think instead “I am thinking angry thoughts”. While simple, this method helps the helpee regain some control over their emotions.

3. Helpful thinking Although related to psychological decentering, helpful thinking focuses more on sidestepping negative thoughts which can then lead to acceptance. Understanding and realising that the self is more than just unhelpful thoughts is key to healing and growing from the trauma.

4. Problem-solving

Lastly, the helper should encourage the helpee to think for themselves and get back on their own two feet. After identifying a stressor that can trigger the helpee, the helper can brainstorm possible solutions with the helpee to cope with specific situations.

Workshop

Images taken from Mr Oon’s workshop depicting peer helpers on screen.

Shortly after concluding his webinar, Mr Oon conducted a workshop on practising digital empathy skills, whereby he offered his feedback on each individual peer helper’s applications. He presented us with a scenario to tackle: a student who, riddled with self-doubt, found it difficult to see themselves succeeding and achieving what they wanted in school. We then individually penned down our counsel to the peer (with whom many of us could unfortunately relate to) and did our best to help them as best as we could.

It was a helpful session for peer helpers to get professional guidance in online counselling and one that definitely left a deep impression. Being able to apply everything taught from the morning’s webinars served as a gratifying finish to the first Learning Journey of the year.

A picture of the Peer Helpers with Mr Matthew Oon 🙂

Conclusion After several hours of back-to-back Zooming, the peer helpers gained valuable new insights from the speakers who took the time to teach them about mental health and help develop their peer helping skills. As Ulrico Nolan Orlando (22S06S), a peer helper, put it, “I felt enlightened after listening to the talks and better equipped as a peer helper with skills that will be useful in many situations.” We would like to express our heartfelt gratitude to Ms Tandar and Mr Oon for taking the time to coach us on how to better reach out and support our peers. See you at the next learning journey!