When
patients feel at their most vulnerable, Head of medical social
services at Singapore General Hospital (SGH) Ms Esther Lim
steps in to help them make sense of what is happening.
Such
patients may have tried to take their own lives or showed signs of
wanting to do so. Ms Lim also helps families cope when they have
lost a loved one.
The
39-year-old's helping hand is extended not just to patients, but
also to hospital staff who face challenges at home or at work, for
instance, if they have been abused by a patient.
In 2003,
she pioneered a programme in SGH to train health-care and social
work professionals in suicide intervention. It is now also offered
in SingHealth's Postgraduate Allied Health Training
Institute.
Since
becoming a social worker in 1995, Ms Lim, who leads a team of 85
medical social workers, has received more than 15 awards. Last
year, she was one of two recipients of the Outstanding Social
Worker Awards given out by the Singapore Association of Social
Workers.
She is
married to a 37-year-old police officer. They have a six-year-old
daughter.
I
specialise in suicide and crisis intervention
because...
When I was
working in the emergency department years ago, I saw how a crisis,
such as a life-threatening illness, a serious road traffic accident
or an attempted suicide, can throw a family off balance.
The sense
of disbelief and loss can be overwhelming, so this is where I step
in to help people make sense of what is happening.
The
immediate goal is to reduce the intensity of the emotional,
physical and behavioural reactions, while the long-term goal is to
help families get back to as normal a life as can be.
A
person's life is precious because...
We live
only once, so we have to live it fully and with dignity, despite
our circumstances.
One
little known fact about suicidal patients is...
They are
not mentally ill. Anyone facing a seemingly desperate situation can
be vulnerable to feeling hopeless and helpless, which may escalate
to suicidal acts if the person does not receive help or cuts
himself off from others.
If I were
to give an analogy for what I do, I would...
Be a bridge
to connect the suicidal person with the resources around him, such
as family service centres, care facilities and legal aid. Often, a
person may think nobody can help him, which is not true.
The
eventual goal is to reconnect the suicidal person with his family
and loved ones through individual, couple or family
sessions.
A typical
day for me would...
Start at
8.30am with administrative duties, followed by morning staff
meetings or journal club sessions. I meet senior staff members
regularly to plan and implement assistance schemes which benefit
patients.
Other
medical social workers also come to me to seek advice on cases they
are working on. I co-manage the difficult cases, such as those
which may involve suicide, or in which patients or family members
consistently display behavioural difficulties.
I also
support hospital staff members who need help and teach them coping
strategies.
I have
come across all types of cases...
But I find
that families with strong social support fare better in crises.
After the initial shock and confusion, members organise themselves
very quickly to protect the affected family member by providing
physiological and emotional comfort.
I love
patients who...
Make it a
point to turn up for their follow-up counselling sessions because
this shows their readiness and motivation for change.
Patients
who are forthcoming, open to working with their families and
willing to reflect on themselves often make better
progress.
They pick
up positive coping strategies to deal with life's challenges, which
range from relationship discord, financial issues to mental health
or addiction challenges.
Patients
who get my goat are...
Those who
blame everyone else for their problems, without realising that they
have a part to play.
For
instance, a suicidal husband may be domineering at home and may
keep blaming his wife and children, without realising that he has
failed to communicate properly with them.
This can
also explain the persistent suicidal behaviour in some patients.
This vicious circle may wear out their loved ones and cut patients
off from the support they used to have.
Things
that put a smile on my face are...
Receiving
handmade cards from the children of one patient whom I saw for
attempted suicide and depression over several years.
Every year,
though the drawings and handwriting would mature, they always
conveyed their appreciation to me for being there for their
mother.
It breaks
my heart when...
An elderly
patient asks me if the doctor can help end his life because he does
not want to burden his children.
I realise,
through interaction with elderly patients, that they are so stoic
and self-reliant that they feel useless when they cannot contribute
financially, take care of their grandchildren or, worse still,
become disabled.
They have
laboured hard all their lives, yet they have not come to accept
that there is a time to receive unconditional care in
return.
I would
not trade places for the world because...
There is
still so much to be done that I cannot find enough time for
everything. This is what I am trained for and playing a part to
restore equilibrium to lives is a constant reminder to live mine
fully.
My best
tip is...
To learn to
take charge of emotions, thus reducing the likelihood of acting on
impulse when emotionally charged.
Some things
which may help include taking slow, deep breaths, sharing your
problems with a trusted mentor and putting vexing matters on the
back-burner, that is, taking your mind off it and revisiting the
issue when you are calmer.