Dad of Autistic NSF says: Counsellor Saved Him

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SINGAPORE - Distraught, he locked himself in the toilet and phoned his mother.

In between sobs, he then told her how he was being bullied by his peers and superiors and that he was unable to cope with his duties in the army.

But more worryingly, he threatened to end his life, prompting his parents to bring his condition to the attention of his superiors and the army.

Bryan (not his real name) has Asperger Syndrome, a form of autism.

He was enlisted as a full-time national serviceman (NSF) in 2012, but after a difficult year, he was exempted from the service in March last year.

Last week, his father wrote in to The New Paper after reading about Private (Pte) Ganesh Pillay Magindren, 23, the NSF who was found dead at the foot of his Sengkang condominium last July. (See report right, below.)

"I wanted to share that what my son went through was similar to Pte Ganesh," he told TNP in a subsequent phone interview.

Bryan's father first noticed unusual behaviour in his son in kindergarten.

"I thought something was wrong with him when he would just sit there and not interact with other children," he said.

Bryan was taken to a psychiatrist, who diagnosed him with Asperger's, said the father.

"He's not able to socialise normally, has trouble articulating and has compulsive behaviours.

"But other than that, he was normal. He's not mad. He even took his A levels and did well," he said.

The father said he had initially encouraged his son to go through national service.

"Bryan was originally very excited to be enlisting. I also thought it would be an opportunity for him to become more independent and learn how to be around people," he said.

FIT FOR ADMINISTRATIVE DUTIES

Bryan was given the Physical Employment Status (PES) E, which meant he was fit for administrative duties and was required to go through only a month-long basic military training (BMT) course.

"Everything was fine during his BMT and he was getting used to being in the army. But things changed when he was posted to his unit as a storeman.

"His superior kept finding fault and labelled him as lazy and stupid. She also regularly punished him with weekend confinement barely two months into his posting," said the father.

His fellow army mates also bullied and made fun of him, said the father.

"They didn't understand his mental condition and why he behaved differently from a normal person," he said.

His only child would return home depressed and grouchy.

"Bryan became afraid to return to camp. He also had terrible mood swings and nightmares where he would wake up screaming," he said.

The final straw came when Bryan told his parents about his suicidal thoughts.

"I couldn't stand seeing him in that state. As parents, we had to do something," he said.

Bryan's parents complained to the Military Medicine Institute and Bryan was referred to a psychiatrist from the Psychological Care Centre and a counsellor.

Meanwhile, his parents engaged a private psychiatrist.

"Things improved for a while. He became more relaxed and the suicidal thoughts went away," he said.

ALLEGED MISTREATMENT

But as the alleged mistreatment by Bryan's superiors and peers continued, his condition regressed.

"My son was on the verge of a complete mental breakdown when he was ostracised and alienated in camp after his condition came to light. Not even the counselling could help him any more," said the father.

And just as Bryan's parents were feeling helpless, a medical review was called and Bryan was given the lowest PES status, PES F, which exempted him from national service, in March last year.

"We're very lucky that he managed to get the right attention and help before something drastic happened.

"That said, there is a system to help these mentally-ill soldiers. It all depends on the people around them and whether there are any gaps in the system," he said.

The father also commended the military counsellor who helped his son.

"My son would not have kept his sanity and may have done something drastic if not for the counsellor. We are thankful for him," said the father.

Bryan is now pursuing a diploma in psychology at a private institute.

Said his father: "His condition has improved since his discharge and now that he is without the pressures of the army.

About PTE Ganesh

Private (PTE) Ganesh Pillay Magindren, 23, was found dead at the foot of his Sengkang condominium in July last year.

The full-time national serviceman (NSF) was seeing a psychiatrist regularly for schizophrenia.

The day before his death, Captain Jessie Goh had given him 14 days of extra duties for not signing a logbook, reporting late for work and unsatisfactory work performance.

She was the manpower officer at 24th Battalion Singapore Artillery and directly in charge of Pte Ganesh when he was posted there in November 2012. He was assigned to clerical work as an administrative support assistant.

In the inquiry into his death, State Coroner Imran Abdul Hamid said he had died from multiple injuries sustained from a deliberate fall from height and that he had known it would lead to his death.

Mr Imran also said Pte Ganesh's army unit had lapses in managing his mental illness.

An army directive said camps are supposed to keep a medical register of servicemen with psychiatric illnesses. But Khatib Camp did not, the coroner said.

Unit commanders who are in charge of servicemen with psychiatric problems would need to be informed by a letter from the Personnel Management Centre. But Pte Ganesh's unit did not receive any such letter about his condition until a day before his death.

Following the inquiry, the Ministry of Defence said in a statement that it will study the State Coroner's findings carefully to improve and tighten its procedures to ensure better compliance by Singapore Armed Forces units in dealing with soldiers with mental problems.

This article was published on April 21 in The New Paper.

Samaritans of Singapore (SOS): 1800-2214444

Singapore Association for Mental Health: 1800-2837019

Sage Counselling Centre: 1800-5555555

Care Corner Mandarin Counselling: 1800-3535800

NS have counselling hotlines for you to call if need arises.
The counsellors are experienced professionals.

You can call them at the following counselling hotlines:

If you think you have been treated unfairly, you can bring up the case to your Commander. We will listen to your case. Do remember to bring along all facts and supporting documents.

We will do our best to address your concerns. Servicemen are to seek redress through proper channels. Together, we can address your issue more expeditiously.

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COUNSELLING

The SAF seeks to promote the well-being of every serviceman by providing
counselling support for those whom might be facing difficulties coping with their
personal or work/training related problems. Servicemen who are experiencing
difficulties can seek help through the avenues described below.

Commander interviews of all recruits are conducted within 48 hours of enlistment into full-time NS. Regular interviews are subsequently conducted on a monthly basis during the PTP/BMT phase. Special interviews are also granted upon request. Servicemen can highlight their difficulties during these interviews for assistance.

Orientation Officers identify, assist and counsel BMT recruits with adjustment
and/or other personal problems.

NS SAF Counselling Hotline is a 24-hour confidential telephone
counselling service provided by the SAF Counselling Centre. Manned by
trained counselling personnel, the SAF Counselling Hotline offers a crisis
and telephone counselling service to all servicemen. Callers may
choose to remain anonymous. Face to face counselling is also available
at the SAF Counselling Centre upon request/referral.

SAF Paracounselling Scheme complements other existing counselling
services and provides another avenue of help at the unit level for those who
need help to deal more effectively with their problems. Paracounsellors are
specially selected, trained by and work closely under the professional guidance
and support of counsellors from the SAF Counselling Centre. Paracounsellors
can be identified through their identification badges as well as through publicity
posters displayed in their units.

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Being psychologically prepared is all about knowing what to expect and being prepared for it.

To be better prepared, you can participate in Total Defence activities and Open Houses organised by the SAF/SPF/SCDF.

Perhaps you should also talk to your family members and friends who have lived the NS experience. The more you discuss with others, the more comfortable and mentally prepared you’ll become.

Because NS life is different from civilian life before enlistment, there are many adjustments you need to make.

A good way to cope is to get support from your buddy and fellow recruits. They are going through the same tough training as you, so talking to one another will help relieve some tension.

In most evenings during your leisure time, you’ll also have some time to call your family or loved ones to talk. They can give you emotional support during NS.

You can have a one-on-one interview sessions with your officer to highlight any problems you may have. If you have a personal or family problem that need to be addressed, do let the officer know—he may be able to give you some advice or time off to settle your problems.

Life in NS revolves around structure, routine and discipline. This helps us stay united as a uniformed organisation as well as imparts the rigours necessary to protect our nation and citizens.

This does not mean there is just work and no play. In fact, after a few weeks in NS and you’ll find new friends and new reasons to smile!

As a soldier, one of the biggest adjustments you’ll have to make quickly is in regimentation and discipline.

Being in a uniformed organisation, you’ll have to obey orders from your superiors. Thus some of you may feel a sudden lack of freedom to do what you want and you may find yourself having difficulties accepting authority initially.

Regimentation and discipline build strong character and toughness, so that you’ll be tough enough to handle difficult combat, crime-fighting or rescue situations without giving up or breaking down.

When you first enlist into NS, you may have concerns of being in a new territory, with new faces and new things to do. But don’t let this get to you. Just remember the saying that “when the going gets tough, the tough gets going”.

Following are some tips on what you can do to prepare yourself psychologically:

You can also speak to your friends or family members who have been through NS. Ask them to share their stories. The sharing will help you reduce some of your fears, uncertainties and doubts.

During NS you’ll be living with different people.

Because these people come from different backgrounds, they may not think like you do or react to situations like you would. Instead of trying to select your type of people, you should cherish the diversity. This is a chance for you to learn more about your fellow mates and their cultures.

You’ll find that you have many opportunities to absorb the different cultures—during training, eating, chatting or just seeing and listening. Take these opportunities and learn from people around you, you’ll have a much better appreciation of Singapore’s cultural diversity.

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Story by Benita Teo

Serving in the military is certainly no mean feat. And when the security of the nation is in one’s hands, mental strength is as important as, if not more so than, physical fitness.

When the going gets tough, it is often helpful to talk it out with a trusted family or friend. But, even with the best of intentions, not everyone is able to fully comprehend the intricacies of military life.

To help the servicemen and women of the Singapore Armed Forces (SAF) cope with the challenges of their military roles, the counsellors of the SAF Counselling Centre (SCC) are always ready to lend a listening ear. In fact, the team at SCC provides professional counselling services not only to all members of the Ministry of Defence (MINDEF) and SAF, but also to their families.

Learning to live the military life

Unlike civilian counselling centres, the SCC comes under military mandate, and its primary purpose is to provide mental health care to ensure that servicemen are able to carry out their duties efficiently.

Of the types of cases the SCC sees, Mrs Marlene Koh, Head of Education and Prevention Services, noted that the majority were Full-time National Servicemen (NSFs) with adaptation issues. "Not everybody is used to dealing with authority. They all came in as students who only had to take care of their own studies."

She added: "The second, smaller group would be Regulars with career or family issues. A third group comprises families and soldiers affected by critical incidents that happened around them, for instance training incidents or a death in the family."

Servicemen in distress may seek help directly with the SCC through two channels: face-to-face sessions or the 24-hour SAF Counselling Hotline. On top of these, a Family Support Helpline is also available for the family members of soldiers deployed overseas who are in need of assistance.

Eyes and ears on the ground

To help junior and senior commanders to identify and assist men under their charge who are at risk of emotional distress, the SCC conducts regular workshops. In addition to basic counselling skills, stress management and suicide prevention are also taught at the workshops.

Ms Cheryl Chia, an SCC counsellor with 14 years of experience, explained that equipping commanders with these skills is essential because "they are the eyes and ears on the ground".

Another set of eyes that the SCC relies on to spot at-risk servicemen are the paracounsellors - Regulars who volunteer to help look after the mental welfare of servicemen at the unit level. To be appointed as paracounsellors, they have to go through a five-day course organised by the SCC that teaches basic counselling, suicide prevention and crisis management skills.

Military Expert (ME) 3-3 Sulinder Singh, a Logistics Warrant Officer, has been a paracounsellor in his unit, 201 Squadron (SQN), since 2010. And being a familiar face in the unit means that servicemen know what to expect when they confide in him - trustworthiness.

"I'm quite approachable, and they know that if they talk to me, it will be confidential."

Allaying fears

Besides assuaging doubts over client confidentiality, the counsellors and paracounsellors also dispelled the stigma of seeking help.

"(For) those who are in a position of command, it may be a 'face' issue," said SCC counsellor Lawrence Yap. "But so far, I've not encountered any clients (Regulars) who claimed that attending counselling affected their careers."

ME3-3 Singh echoed his sentiments: "Is there a stigma attached to people in the unit who see paracounsellors? No, not at all. They are not mentally ill, we just need to help them find the right way to organise their thoughts."

The counsellor is in

Help for a distressed soldier often begins with a visit to the Medical Officer (MO) with complaints of symptoms of stress. Said Ms Chia: "Usually they will say that they are unable to sleep or eat. When the MOs probe deeper and realise that the problem goes beyond a medical issue, they will refer them to us."

At the SCC, the soldier will be assigned a counsellor. Through the sessions, counsellor and soldier will work together to identify the problems and set goals towards overcoming them. The counsellor will also impart skills such as stress or anger management techniques.

When facing mental turmoil, a soldier may despair and lose his sense of self. One approach a counsellor may take is to remind him of his capabilities.

"Counselling is about instilling a sense of hope," said Mr Yap, who specialises in substance and drug addiction counselling. "Everyone has it in them to overcome a difficult situation. We just need to help them see that they are not as helpless as they think they are, and that the situation is not as hopeless as they think it is."

SCC counsellors also work with psychiatrists and psychologists from the Psychological Care Centre (PCC) at the SAF Medical Corps' Military Medicine Institute to provide all-round care to the soldier. PCC psychiatrists prescribe medication for conditions like depression while psychologists run tests to ascertain if a behavioural problem is linked to a learning or intellectual disability.

Helping others help themselves

With the ever-evolving social landscape, counsellors must stay up-to-date on new behavioural problems or addictions, such as social media addiction.

Mrs Koh also pointed out that there are now more cases of servicemen suffering anxieties about not performing well or meeting expectations, and that many expected others to solve their problems.

Mr Yap agreed: "To change, clients have to take personal responsibility for their actions."

Nonetheless, the counsellors take comfort in the knowledge that they are changing lives for the better.

Mrs Koh remembered a recruit who had attempted suicide after his girlfriend of four years ended their relationship and started seeing a friend of his behind his back. Mrs Koh helped him acknowledge his feelings of hurt and disappointment, and taught him constructive ways of managing his anger.

The recruit started to improve his relationship with his family and make new friends in his unit. Nine months later, he was finally able to move on from the break-up.

Ms Chia also recounted a recent case: "I had a client who wanted to kill himself. But after working with his unit and the psychiatrist, just before his ORD (Operationally Ready Date) he said, 'You gave me hope. Even though life ahead will be challenging, at least I know now that there are people who care, and that there is more to life than thinking about hurting myself.'"

She added: "He even baked us cupcakes as a 'thank you'. It's the little things like these (that let me know I’ve made a difference)."

If you are in need of help, or know someone who needs help, please call the following 24-hour hotline:
SAF Counselling Hotline
1800 278 0022

Families of service personnel deployed overseas who are in need of help can call the following 24-hour hotline:
Family Support Helpline
1800 278 0023

If you are interested in volunteering to be a paracounsellor, call the following number for more information:
6373 1066

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Handling a mentally ill soldier is not easy. They require proper attention and a suitable working environment for them to thrive, said psychiatrists contacted by The New Paper. For this to happen, the Singapore Armed Forces (SAF) has to take ownership of its soldiers, Dr Ang Yong Guan said.

Dr Ang, who is in private practice, was the head of the Psychological Care Centre (PCC) at the Military Medicine Institute during his 23 years with the SAF from 1986 to 2003.

He said that of his 4,500 patients, there are fewer than 10 cases of full-time national servicemen (NSF).

"I forward each NSF's case to the SAF. I believe the organisation should be responsible for its own soldiers," he said.

But he thinks that the majority of these cases do not get picked up.

"(When I was at PCC) I always made it a point to monitor those soldiers who had severe mental illnesses. I would even call their private psychiatrists to find out more.

"Only if the organisation's leaders are committed to monitoring and helping these patients can they be given the right attention and help," Dr Ang said.

Consultant psychiatrist Ken Ung of Adam Road Medical Centre said that when a soldier is found to be mentally ill, steps should be taken to ensure he is placed in a suitable working environment.

Dr Ung, who sees about 30 to 50 cases of NSFs a month, said that superiors and colleagues should also understand that problematic soldiers may not always be trying to play the system.

BE UNDERSTANDING

"There are cases where the superiors are very understanding and sympathetic towards their condition and always willing to listen to them, and (the patients) thrive," he said.

But those who had difficult bosses could lead to a downward spiral of the soldier's condition, he said.

"I've had such patients who became more and more depressed, constantly had nightmares. Parents would complain about their behaviour and some even had suicidal thoughts," he said.

Superiors should give their subordinates the benefit of the doubt, said Dr Ung, adding that they should be proactive and take the time to find out if their soldiers are all right.

"The SAF is a microcosm of society. It's inevitable that you will get soldiers who are mentally ill. So you should learn how to handle and manage them."

The Ministry of Defence (Mindef) said in a statement on Tuesday that it will study the State Coroner's findings carefully to improve and tighten its procedures to ensure better compliance by Singapore Armed Forces units in dealing with soldiers with mental problems.

This article was published on April 12, 2014 in The New Paper.