Feedback needed on moves to help young people better access mental health support

SINGAPORE - In Singapore, about one in three people aged between 10 and 18 years reports having depression, anxiety or other mental health issues.

Yet many do not seek help.

So, a set of guidelines is being developed to support their access to help.

This includes addressing the issue of parental consent as a possible barrier, said the Ministry of Health (MOH), which is seeking the views of the public on the proposed guidelines.

The aim is to improve access to mental health services while also protecting the welfare and privacy of young people, MOH said on Nov 11.

Another goal is to involve parents “in ways that strengthen the process of recovery”.

According to MOH’s public consultation paper, the proposed guidelines tier consent requirements according to the nature of services.

For basic care, the ministry proposes obtaining parental consent for those below 13, for mental health screening and mental health assessment which does not result in a diagnosis.

It said that parental consent should be sought for psychotherapeutic services – psychological therapies such as cognitive behavioural therapy, as well as counselling provided in schools.

The ministry noted that in cases where parental consent cannot be obtained, a care professional may still render such services to young people, if it is in their best interest and the individual in question is at least 13 years old.

Where a young person does not allow consent to be sought from parents, or where he or she wants mental health services but is refused consent by parents, the guidelines recommend that care professionals explore the concerns behind the refusal.

The aim is to improve the experiences of young people seeking mental health help across school and community settings, MOH said.

Citing data from the Singapore Youth Epidemiology and Resilience Study, MOH noted about one in three people aged between 10 and 18 years reported mental health symptoms such as depression and anxiety.

However, 70% of young people with mental health symptoms did not seek professional support for their mental health need, according to the National Youth Mental Health Study conducted by the Institute of Mental Health in 2022.

Childhood and early adolescence represent a critical period where the mental health of an individual begins to take shape, MOH said, noting a third of those with mental health conditions experience the onset of their conditions before turning 14.

“Failure to identify and support young persons with mental health needs increases the risk of long-term consequences, such as poor educational attainment, unemployment, chronic physical conditions and substance misuse.”

The ministry acknowledged that seeking support may not be easy for young people, and that it has received feedback that the need for parental consent is an obstacle to young people with mental health challenges.

MOH pointed out that while a person is legally considered an adult at 21 in Singapore – thus gaining full legal rights, including the ability to make decisions without parental consent – there is currently no minimum age for a young person to consent to mental health services on their own.

This has led to inconsistent practices around parental consent across settings.

While parental consent is important for young people who may lack the maturity to make informed decisions about their own mental health care, there are instances where it may not be possible or appropriate, it added.

These include situations where parents refuse consent, or where delaying services risks causing further harm.

To address this, MOH convened an interagency expert group to develop guidelines to provide service providers with clearer guidance.

In developing the guidelines, MOH engaged young persons, parents, and service providers to understand their experiences and concerns, it said.

“Their feedback has shaped the proposed guidelines, particularly in enhancing young persons’ access to timely mental health support, while recognising the important role of parents.

“Through this public consultation, MOH hopes to receive a wider range of views to further refine the guidelines.”

This follows a World Mental Health Day message on Oct 10, where Health Minister Ong Ye Kung announced that MOH was developing guidelines on parental consent for various service providers.

MOH said it had involved “key stakeholders” – including young people, parents and service providers – to better understand their experiences and concerns when developing the guidelines.

“Their feedback has shaped the proposed guidelines, particularly in enhancing young persons’ access to timely mental health support, while recognising the important role of parents,” the ministry said.

To further refine them, MOH is inviting members of the public to share their views, and assist the ministry in developing and implementing “robust policies that support young persons’ access to mental health care”.

The public consultation will run from 10am on Nov 11 to 6pm on Dec 8.

People can view the public consultation paper – including further details on the proposed guidelines,such as policy objectives and considerations – and submit their feedback at https://go.gov.sg/youth-mental-health-access.

Helplines

Mental well-being

• National Mindline: 1771 (24 hours) / 6669-1771 (via WhatsApp)

• Samaritans of Singapore: 1-767 (24 hours) / 9151-1767 (24 hours CareText via WhatsApp)

• Singapore Association for Mental Health: 1800-283-7019

• Silver Ribbon Singapore: 6386-1928

• Chat, Centre of Excellence for Youth Mental Health: 6493-6500/1

• Women’s Helpline (Aware): 1800-777-5555 (weekdays, 10am to 6pm)

• The Seniors Helpline: 1800-555-5555 (weekdays, 9am to 5pm)

• Tinkle Friend (for primary school-age children): 1800-2744-788

• Mindfull Community HQ (for caregivers, families and persons in recovery): 6460-4400 (weekdays, 9am to 5pm)

Counselling

• Touchline (Counselling): 1800-377-2252

• Touch Care Line (for caregivers): 6804-6555

• Counselling and Care Centre: 6536-6366

• We Care Community Services: 3165-8017

• Shan You Counselling Centre: 6741-9293

• Clarity Singapore: 6757-7990

• Care Corner Counselling Centre: 6353-1180