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Mental health

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Parents seeking $3.3m from psychiatrist, IMH in medical negligence suit over son’s suicide​

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IMH said there were no red flags of imminent risk of suicide on Sept 6, 2017, the day before the man took his own life. PHOTO: LIANHE ZAOBAO FILE
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Selina Lum
Senior Law Correspondent

Jan 12, 2023

SINGAPORE - In a lawsuit seeking an estimated $3.3 million in damages, the parents of a 31-year-old man who took his own life have accused two psychiatrists of being negligent in treating their son, which they say led to his suicide.
Mr Steven Joseph Arokiasamy, 67, and Madam Tan Kin Tee, 66, are suing Dr Nelson Lee, a psychiatrist in private practice, as well as the Institute of Mental Health (IMH) for the actions of its senior consultant, Dr Gomathinayagam Kandasami.
Their older son, Mr Salvin Foster Steven, who had a long and complex psychiatric history, fell to his death from his bedroom window on Sept 7, 2017.
They alleged that Dr Lee failed to diagnose their son with schizophrenia, and that both doctors wrongfully prescribed Concerta, a drug used to treat attention deficit hyperactivity disorder (ADHD), to him at inappropriate doses.
They accused the two doctors of failing to prescribe adequate doses of anti-psychotic medication to Mr Salvin.
They also blamed Dr Kandasmi for failing to admit Mr Salvin for observation on Sept 6, 2017 – a day before his suicide – after they took their son, who had been acting erratically in recent weeks, to see the psychiatrist.
Mr Steven and Madam Tan, who are separately represented by Mr V. K. Rai and Mr Anil Balchandani, contended that as a result of Mr Salvin’s death, they both suffered from persistent complex bereavement disorder and could no longer work.

Thus, Madam Tan, who left her job as a school counsellor in 2019, and Mr Steven, who left his job in the civil service in 2020, suffered a reduction in income.
The suit was heard in the High Court on Thursday. The trial has been adjourned to September.
Dr Lee, who practises at The Psychological Wellness Centre, treated Mr Salvin between November 2011 and July 2016. He diagnosed Mr Salvin with bipolar disorder and ADHD, and prescribed Concerta from April 2012.


Mr Steven and Madam Tan said their son developed a dependence on the drug, but Dr Lee continued to prescribe Concerta and did not advise Mr Salvin against taking more than the prescribed dose.
They said Mr Salvin began showing symptoms of psychosis, such as hearing voices or believing that people were plotting against him.
In May 2015, after being charged with the assault of two police officers, Mr Salvin was remanded at IMH and was diagnosed with paranoid schizophrenia.
He was returned to Dr Lee’s care in June 2015. Mr Steven and Madam Tan alleged that, in spite of being provided with the diagnosis, Dr Lee continued to prescribe Concerta to Mr Salvin and did nothing to prevent him from overdosing.
Dr Kandasami took over Mr Salvin’s care in August 2016, after he was sentenced to a one-year mandatory treatment order for the assault.
The couple alleged that Dr Kandasami did nothing to prevent Mr Salvin from overdosing on Concerta and ignored his psychotic symptoms.

Dr Lee, who is represented by Mr Jansen Aw, said his diagnosis of ADHD and bipolar disorder was reasonable in light of the symptoms and medical history.
There was a lack of overt and persistent psychotic symptoms supporting a diagnosis of schizophrenia, he said.
Dr Lee said Mr Salvin showed improvements when he was on Concerta and, for the first time in many years, managed to get a job in a warehouse in July 2015.
IMH, which is represented by Senior Counsel Kuah Boon Theng, said Dr Kandasami’s care and treatment of Mr Salvin was appropriate.
Mr Salvin’s response to medication was closely monitored during his mandatory treatment, and he did not show signs of psychosis, it said.
IMH said there were no red flags of imminent risk of suicide on Sept 6, 2017.
It disagreed with the couple’s assertion that Mr Salvin’s death was caused by psychosis, noting that the coroner had found his fall to be a “deliberate act of suicide”.
“The plaintiffs are understandably devastated, and IMH empathises with them for their loss. However, the deceased’s unfortunate demise was not the result of any negligence on the part of IMH and its doctors or staff,” said Ms Kuah in her opening statement.
 
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Mental health isn’t just about not having a diagnosable mental disorder. It’s about the way you think, feel, and act. It affects how you handle stress, relate to others, and make healthy choices. Unfortunately, I came across depression and had to take antidepressants (you can look for them at Canadian Pharmacy Online). It was not that easy to cope with this but I did it. Support plays the main role so don't hesitate to talk to someone about your feelings.
 
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Wong Kim Hoh Meets​

‘My son didn’t want to end his life – he just wanted to end his pain’​


Jenny Teo lost her only son to suicide nearly five years ago. To help others, she started Stigma2Strength (Singapore) to provide education and awareness on suicide, and co-founded PleaseStay.Movement, an advocacy movement by mothers who lost children
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Wong Kim Hoh
Deputy Life Editor

Oct 22, 2023

SINGAPORE – He was lying on a red sofa, his body cold, his head covered with a plastic bag tied at the neck.
Five months shy of 21, Josh was already dead when his mother Jenny Teo found him in the ground-floor study of their three-storey home on the morning of June 25, 2018.
Josh, 1.9m tall and an only child, had taken his own life. It was not his first attempt. A few months earlier, he had tried to overdose on tranquillisers.
His suicide took place about two weeks after American handbag designer Kate Spade and American celebrity chef Anthony Bourdain killed themselves on June 5 and 8, respectively.
Whether their deaths influenced her son, Ms Teo does not know. “Apparently he told his friends: ‘Even celebrities do it’,” she recalls.
The former radio and television personality, however, has no doubt that her son – like Bourdain and Spade – was besieged by mental and emotional pain so debilitating that it led him to take his own life.
“He left me suicide notes. He kept saying that he was sorry, it was not my fault, and he just needed to end the pain,” she says.

Pain, the 63-year-old was to find out much later, is inextricably linked to suicidal behaviour.
The late American clinical psychologist and suicidologist Edwin Shneidman once said: “There is a great deal of mental pain and suffering without suicide – million to one – but there is almost no suicide without a great deal of mental pain.”
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Former broadcaster Jenny Teo lost her only son to suicide nearly five years ago and it took her a long time to get over her grief. ST PHOTO: KEVIN LIM
Over the course of her three-hour interview with The Sunday Times, the word pain keeps cropping up as Ms Teo talks about Josh’s death and how it led her down the path of grief, blame and shame before she found closure, resolution and purpose.


Today, she is the founder of Stigma2Strength (Singapore), an initiative to raise awareness and break the silence around mental health and youth suicide through education. She also co-founded PleaseStay.Movement with other mothers who have lost children to suicide.
Recent statistics by non-profit suicide prevention centre Samaritans of Singapore (SOS) bear out her assertion that honest talks and conversations about suicide are important. Suicide among youth aged 10 to 29 in Singapore has been steadily climbing: from 94 in 2018 and 2019, to 125 in 2022.
Sitting in the living room of her spacious apartment in the Thomson Road area which has a stunning view of MacRitchie and Lower Peirce reservoirs, Ms Teo radiates the sad but gentle calm of a woman who has not just come to terms with the tragedy of her son’s death but entered what she calls “post-traumatic growth”.
She is eager to talk about Josh.
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Josh with his soft toys in a photo taken when he was four years old. PHOTO: JENNY TEO
“The average person will always avoid talking to you if you are a suicide loss survivor. They don’t know what to say, they’re scared it will bring up sad memories. But they also don’t realise that, at some point, we want to talk about it. We want to mention our child’s name. He’s dead but it’s not as though he didn’t live,” she says.
Her diction is clear, her voice mellifluous – unsurprising, given her nearly three decades of experience as deejay, show host and radio station manager at both Mediacorp and Safra Radio.
The youngest of four children, she spent a large part of her childhood in Johor Bahru where her late father – a Malaysian – had an abattoir and ran a business importing cattle and sheep from Australia.
“Every day, my dad would bring back something to do with a cow, so we had, like, oxtail soup almost every day,” recalls the Raffles Girls’ School and St Andrew’s Junior College alum, who had to commute between Johor Bahru and Singapore to attend classes for several years.

Attending university was not an option when her father died from lung cancer while she was in junior college. There was a brief stint as a relief teacher before she landed a job as an announcer in 1980 with Singapore Broadcasting Station, which is now MediaCorp.
Ms Teo, whose contemporaries include the likes of Florence Lian, Leslie Pillay and Dahlia Z, went on to wear many hats – deejay, producer, programme manager – becoming a radio and TV personality in the process.
Thirsting for adventure, she quit the station to go to Hong Kong, hoping to land a broadcasting job. But before she could find one, she was headhunted to start a radio station, Power 98, for the Ministry of Defence in 1994.
It was a big job. She was given 10 months to build the station, buy transmitters and other equipment, as well as hire and train deejays. “You know Rod Monteiro? He was one of the people I took a chance on,” she recalls, referring to the veteran radio personality.
“I thought my job was done after I set up the station. They said: ‘No, no. Now you’ve got to set up the Chinese station Dongli 88.3 FM (now 88.3Jia FM)’.”
Three years later, in 1997, she left Safra Radio to start a family with her husband, a corporate professional.
Josh, she says, was a miracle child.
Both she and her then husband – they later divorced – were medically challenged. They tried intrauterine insemination for a couple of months but gave up because the procedure was stressful.
“In my third month, I said: ‘No, I’m not going to work on it; I’m just going to leave it to God.’ And I got pregnant.”
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Josh with his mother Jenny (extreme left) and maternal grandmother on his twentieth birthday on Nov 13, 2017. PHOTO: JENNY TEO
Josh, she says, was an active and precocious child who wrote his own story books by 10, and made his own movies with his movie camera by his early teens.
“He was my Mr Bean. He was always making me laugh,” says Ms Teo, who spent 11 years enjoying motherhood before going back to work at Safra Radio in 2008.
All was well, at least on the surface. Then, Josh started struggling in school. A few months before his PSLE, he cried for a couple of hours after his father berated him while Ms Teo was at work.
“He became a different child after that, hiding in his wardrobe, behind the sofa. He was always cowering,” she says.
She took him to the Child Guidance Clinic at the Institute of Mental Health, where he was diagnosed with anxiety disorder. She decided to quit her job to look after him.
Things got a little better for Josh in secondary school, especially after he found a tutor who not only helped him obtain a distinction for Maths in his N levels but also became a mentor. But his feelings of inadequacy came back to haunt him when he missed qualifying for polytechnic by just one point.
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Josh, mother Jenny says, was an active and precocious child who wrote his own story books by 10, and made his own movies with his movie camera by his early teens. PHOTO: JENNY TEO
It did not help that all was not well with his parents. Large cracks had surfaced in their marriage, and Josh was witness to a toxic family situation with frequent quarrels between them.
Ms Teo and her husband divorced in 2014, and she spiralled into depression the year after.
“I literally lost all the pleasures of life, my emotions. I couldn’t feel joy or pain; I couldn’t feel anything. You feel like you’re merely existing, not living. You feel that you’re a burden, and even if you died, nobody would care or miss you, you’re just a number,” says Ms Teo.
It got so bad that she even wrote her son a suicide note which, fortunately, she did not give him. She finally saw a psychiatrist, who put her on medication.
Her condition, which lasted for two years, meant she could not be an emotional pillar for Josh when he, too, fell into depression after a girl he was dating broke up with him. They patched up a year later, but she broke up with him again.
The heartbreak, compounded by stress from his parents’ broken marriage, as well as his struggles doing national service, pushed him down a ravine of pain he could not climb out of.
Ms Teo still remembers how she called 999 on that fateful day and was told by the paramedics over the phone to perform CPR on Josh’s lifeless body.
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Former broadcaster Jenny Teo started Stigma2Strength (Singapore) which sets out to provide education and awareness about suicide and mental health. ST PHOTO: KEVIN LIM

She experienced excruciating grief as well as guilt and self-blame over the next few months; the slightest thing would trigger memories of her lost son and bouts of weeping.
“You feel that you cannot go on and have nothing to look forward to. You don’t know if you will survive or live another six months or six years. The day you lose your child, you start to count: ‘Oh, it’s been a week since I lost him; oh, it’s been a month; oh, it’s been six months.’
“That’s why they say the risk of suicide is very high for those who’ve lost someone to suicide.”
Five months after Josh’s death, she turned a corner when a production company approached her to make a video on suicide loss.
She agreed to do Silent Cry – A Mother Shares Story On Her Only Son’s Suicide, because she wanted those who are suicidal to choose life and hope, not death. The response, especially from suicidal youth who wrote to her and told her that they’d changed their minds after seeing her grief, gave her a sense of closure.
“It liberated me, in a sense. I didn’t need to keep it a secret any more. It freed me from my self-stigma,” she says.
Several months later, she gave a talk to a live audience at Caregivers Alliance Limited, a non-profit that helps the caregivers of those with mental health issues.
“It was the second and last closure for me. I remember the talk was on a Saturday. On Sunday, I woke up and felt as though a voice was telling me that I never lost my son. ‘You’re sharing his story; he’s always with you’.”
Something, however, also told her she needed to know more.
“I still had a lot of questions,” she says.

Over the next four years, she devoured books, scientific papers and articles related to suicide. Definitions now roll off her tongue – “suicide is a consciously intended act of self-inflicted cessation of consciousness” – and she can talk at length about the works not just of Shneidman, but also experts in the fields of psychiatry and trauma like Dan Siegel and Gabor Mate.
Suicide, she says, is a complex web involving a myriad of factors, among them biological, sociological and psychological.
One key understanding from all her research is that “the majority of those whom we’ve lost to suicide never wanted to end their life – they only wanted to end their pain”.
In August 2020, she launched Stigma2Strength (Singapore), a ground-up public education initiative. Besides contributing articles, she gives interviews and talks to schools, tertiary institutions and the mental health community. She also offers advice and emotional support to parents who are suicide loss survivors or have suicidal children.
“I want to reduce the social stigma by sharing from my lived experience but in the context of evidence-based contemporary suicidology,” she says.
Social stigma – a neighbour who knew her from her broadcasting days once said: ‘Oh, you’re a celebrity again, but a different kind’ – makes what she does difficult, she says.
“People always think: ‘Oh, it’s not going to happen to me, why should I be interested in this topic?’ That’s not true – it’s a myth.”

Two years ago, after she gave a talk on suicide prevention to a church congregation, the owner of a printing company asked her if she wanted to write a book on suicide, losing Josh and finding purpose from his death.
Since the idea had been percolating in her head for some time, she decided to self-publish Grieving And Living: A Mother’s Hope, A Mother’s Journey, which was released earlier in 2023. She donated the proceeds from book sales – matched dollar for dollar by the Tote Board – to Caregivers Alliance Limited.
“It is a gift from a caregiver to caregivers with loved ones struggling with suicidal thoughts and mental health challenges,” she says.
“(Josh) remains alive in my life now as he is the focal point of my work in suicide awareness and prevention. I’m now a mother to ‘my silent partner’,” she writes in her book.
Her work is cut out for her. Although she revisits old wounds each time she tells Josh’s story, she believes it has to be done: “One life lost is one too many. One life saved is all worth it.”
She adds: “I named my inititiave Stigma2Strength (Singapore) because strength means you heal. It’s possible to heal from suicide loss, divorce, all the negative events in your life. I just want to give hope.”
To buy Grieving And Living: A Mother’s Hope, A Mother’s Journey, go to https://www.wordimagesg.com/product-page/grieving-and-living-a-mother-s-hope-a-mother-s-journey





 
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About 71,600 in S'pore have psychotic disorders, says study​

Ms Michelle Lai volunteers regularly, giving talks on mental health.


Ms Michelle Lai volunteers regularly, giving talks on mental health.
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Timothy Goh

MAY 21, 2021

SINGAPORE - Like many others her age, Ms Michelle Lai enjoys baking, hiking, drawing and doing barre, a workout that incorporates elements of ballet, yoga and pilates.
She hangs out with friends and volunteers regularly, giving talks on mental health.
The 30-year-old is living proof of what a diagnosis, medications and therapy can do for someone with a mental health condition.
Ms Lai has a schizoaffective disorder, and up till just three years ago, used to experience things that were not there.
"When I'm unwell I hear voices, see things people can't see, smell smells that people can't smell, and feel people punching or pinching me. Sometimes, my mouth will have a bitter taste too," she told The Straits Times.
And she is not alone in her experience. Results from the 2016 Singapore Mental Health Study, released by the Institute of Mental Health (IMH) on Friday (May 21), found that one in 43 of those aged 18 and up here has had a psychotic disorder in their lifetime.

This translates to about 71,600 people.
The study was conducted on 6,126 participants, representing the population, between 2016 and 2018 in collaboration with the Ministry of Health (MOH) and Nanyang Technological University. It was funded by MOH and Temasek Foundation
It is the first nationwide study to examine the prevalence of psychotic disorders in the Singapore resident population aged 18 years and above, the factors associated with such disorders and the treatment gap for the disorders.
Psychotic disorders may involve one or more of the following:

- Delusions, which are the fixed belief in something that is not true.
- Hallucinations, which are sensations that are not real, such as seeing things that are not there.
- Disorganised thoughts, making a person's speech difficult to follow with no logical connection.
- Abnormal motor behaviour, which includes inappropriate or bizarre postures, or a complete lack of response to instructions.

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Ms Michelle Lai started manifesting symptoms of a psychotic disorder around the age of 18.

The most common psychotic disorder in Singapore was schizophrenia, with about one in 116 - or 26,800 people - having been diagnosed with it at some point in their lives.
This condition comes with a wide array of symptoms, including hallucinations, delusions, disorganised behaviour, social withdrawal and attention impairment.
The study found that the average age of onset of psychotic disorders here was 23.1 years, and that those with such conditions were 4.3 times more likely to be unemployed - although the researchers could not say for sure that this was directly caused by their condition.
At least 80.4 per cent of those with such conditions had sought help for their symptoms.
Professor Chong Siow Ann, senior consultant at the Research Division and Department of Psychosis at IMH and principal investigator of the study, said that while psychotic disorders are not as common as other mental health conditions, the extent of impairment and disabilities - including death - caused by psychotic disorders can be considerably greater.
"The publication of this study is a timely reminder as we commemorate World Schizophrenia Day on May 24 that early detection and intervention can make a big difference in relieving the distress and suffering of the tens of thousands of people afflicted, and (who) will be afflicted, with these disorders," he added.
For those living with a psychotic disorder, the experience can be very distressing.
Marilyn (not her real name) was 20 years old when she began experiencing symptoms of schizoaffective disorder.
Those with this condition have symptoms of schizophrenia as well as a mood disorder, such as depression or bipolar disorder.
Now 30, the housewife told ST that her rush of thoughts used to keep her up for days.
She said: "My mind tried to link things that were not connected - it'd affect my thinking, so I couldn't speak properly, I couldn't have a proper conversation with my family.
"When I watched TV, I'd think that it was talking about me and my family, and that could mean that something bad may happen to my family members. So I got very scared and worried, and my thoughts would run wild."
Ms Lai, who is currently unemployed, and started manifesting symptoms of a psychotic disorder around the age of 18, had similar experiences in the past.
She said: "I thought that people were looking at me from the HDB block opposite, and when I went out I thought that people were pointing at me.
"I wanted to dash across the road - the voices (in my head) were saying that the cars would not hit me, and I was running away from something."
The lack of understanding of mental health conditions made it even harder to cope, said Ms Lai.
"When I was having symptoms of depression, I didn't know what was going on. People thought I had an attitude problem… some teachers even said I was wasting space in the school," she said, adding that she did not even know she had a mental health condition at that time.

Living a normal life is possible, with help​

Dr Charmaine Tang, chief of the Department of Psychosis at IMH, said early intervention is key to helping those with psychotic disorders cope with their conditions.
"While schizophrenia and psychotic disorders are serious and chronic conditions, medications and psychosocial therapy can help people manage these conditions, recover and lead normal, fulfilling lives," she said.
She added that when a person is more stable, individual and family therapy, social skills training, vocational rehabilitation and supported employment, as well as the support of family and friends, play a big role too.
Ms Lai now takes a monthly injection to manage her symptoms, and has been largely symptom-free for the last three to four years apart from periodic bouts of depression, which she is able to manage on her own.
Up till recently she worked in the special needs sector and as a peer support specialist, drawing on her own experiences to support those with mental health conditions.
Marilyn experienced a total of three psychotic breaks from 2010 till now, and was admitted to IMH for a short period of time on each occasion.
But with the help of medical support, she has managed to lead a relatively normal life, working as an accountant for seven years, getting married in 2017, and recently becoming a mother to a one-year-old child.

'We're not crazy people'​

Ms Lai said it has been heartening to see a general increase in mental health awareness in Singapore in recent years.
However, both she and Marilyn noted that there are still misconceptions surrounding psychotic disorders.
Ms Lai said that people tend to think someone with schizoaffective disorder has multiple personalities - which is incorrect - or is dangerous.
"From my experience, people with this condition are more likely to be harmed than harm people," she said, adding that she hopes to see greater efforts in mental health education and more opportunities for people with mental health issues to integrate into society.
Such harm may take the form of discrimination when applying for jobs or to schools, leading them to miss out on opportunities in life.
This in turn perpetuates stigma about those with mental health conditions, said Ms Lai.
Marilyn said: "A lot of times, people think that those with this condition cannot be cured, and it's the end for them. They also think it means they have to stay in hospital on a long-term basis."
But she added that her experience shows this is not the case.
She said: "We can lead a normal life as well with proper medication and intervention.
"Stigma against those with mental health conditions still exists in Singapore. I hope that people here can learn more about these conditions and reduce this stigma, because we are able to lead normal lives - we're not crazy people."
She looks like @JohnTan 's mistress.
 

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Jail for man whose stress led him to kill wife so she and unborn child can ‘go to heaven’​

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A CID vehicle outside a block in Ang Mo Kio Street 23 on Jan 12, 2022. A woman was found dead in a second-floor unit in the morning. PHOTO: SHIN MIN DAILY NEWS READER
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Selina Lum
Senior Law Correspondent

Oct 26, 2023

SINGAPORE – The managing director of a security training centre was so convinced that his company was in financial trouble that he decided to kill his wife so that others might not go after her and their unborn child because of his business failure.
David Brian Chow Kwok-Hun had lost sleep and was overwhelmed with stress after he was given a set of unusually low financial figures by an employee.
In the early hours of Jan 11, 2022, he developed suicidal thoughts and hoped that by killing Ms Isabel Elizabeth Francis and their unborn daughter, they would “go to heaven” instead of suffering shame.
He turned his sleeping wife face up on their bed and thrust a knife into her abdomen, telling her: “Sorry, I have no way out.” He then continued to stab her in the head, neck and body.
He then stabbed himself in the neck and stomach, and asked the devil to “take him” and for his wife and unborn daughter to go to heaven.
The figures he was given later turned out to be wrong. His company, KnowledgeTree Training Centre, was in fact doing much better.
On Thursday, Chow, who is now 35 years old, was sentenced to seven years in prison after he pleaded guilty to a charge of culpable homicide for killing his wife, who was 15 weeks pregnant, at the couple’s flat in Ang Mo Kio.

He was originally charged with murder, but the charge was reduced after he was found to be suffering from a mental disorder that diminished his responsibility for the acts.
A report from the Institute of Mental Health stated that due to his adjustment disorder, Chow had “catastrophic thinking that he would be bankrupt with no way out and had suicidal thoughts but felt that his death would bring shame to his wife”.
Chow and Ms Francis, whom he married on Dec 28, 2019, moved into the flat in May 2021, and were expecting their first child.

Deputy Public Prosecutor Jiang Ke-Yue told the court that in December 2021, Chow went through the half-year financial report for his company and asked the accounting staff to check the numbers, which were unusually low.
On Jan 5, 2022, a staff member said the numbers in the report were accurate.
Chow began to believe that the business would fail, even though it had earned about $1 million in profits between July 2020 and June 2021, and was not losing money between July 2021 and November 2021 despite the Covid-19 pandemic.
Between Jan 7 and Jan 9, 2022, he clocked one to two hours of sleep per night on average due to worry and stress over the company’s finances.
His family, colleagues and his wife noticed his behaviour over those few days.
On Jan 7, he took Piriton, a sleeping aid medication, but it did not help his insomnia. The manager of the company saw him the next day and said he looked stressed.

The manager also told Chow that the company was still making profits.
Chow also met his mother and brother at their home and told them about his worries that the company would make a loss from January 2022 onwards.
They reassured him that the company made profits in the previous months, and that it was in a financially sound position to weather through the next two years.
That evening, Ms Francis told Chow that she had booked a session with a Catholic counsellor to help him deal with his work stress.
However, he continued to lose sleep, and would see random images such as marching soldiers when he tried to close his eyes.
On Jan 10, he went to the office at about 6am as he could not sleep and was observed by his staff to be extremely listless.
His mother took him out for lunch and took him home to rest after he repeated the same concerns to her.
His parents and sister, who were concerned about his deteriorating mental state, visited him and Ms Francis for dinner, and assured him that they would support him.
His father made an appointment for him to see a psychiatrist the following day, and arranged to pick him up for work in the morning.
At about 1am on Jan 11, Chow started pacing up and down the corridor of his unit, ruminating over his business concerns, and looked at the LinkedIn profiles of his business competitors.
He started to worry that his employees would leave his company or lose confidence in him.
Chow then thought about taking his own life. But he feared that his wife might suffer the shame of having a husband who committed suicide, and that others might go after his wife and child as a result of his business failure.
At about 5am, he took the sharpest knife from the kitchen, and headed for the master bedroom to his sleeping wife.
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The second-storey unit in Block 228B Ang Mo Kio Street 23 where Ms Isabel Elizabeth Francis was found lying motionless on Jan 11, 2022. PHOTO: SHIN MIN DAILY NEWS
At one point during the attack, Ms Francis crawled towards the door, but Chow thrust the knife into her head.
After she stopped moving, he went to the kitchen to get another knife, pierced himself in the neck and stabbed himself in the stomach. He then knelt on the floor and asked for the devil to “take him”.
Some time after 7am, he checked his phone and realised that his father was on his way to pick him up.
“When the accused realised that him stabbing himself was not killing him fast enough, he went to the fridge and consumed a random assortment of tablets. However, he still did not feel that he was dying,” said the prosecutor.
At about 7.35am, he decided to call the police to report that he had killed his wife as he did not want to implicate his father. He also called his father and told him not to come over.
He then crawled to the main door to unlock it, and lay down on the floor to wait for the police.
In mitigation, Chow’s lawyer, Mr Shashi Nathan, said his client and Ms Francis were an extremely loving couple who were looking forward to welcoming a child into their lives.
The lawyer said Chow had lost his wife and and daughter for reasons he could not explain. “This is his life sentence,” said Mr Nathan, as Chow shook uncontrollably in the dock.
Arguing for five to seven years’ jail, Mr Nathan added that there is strong family support from Chow’s siblings and parents to help him reintegrate into society.
The prosecution sought nine to 12 years’ jail. DPP Jiang agreed that it was a tragic case, but said the the tragic circumstances must be balanced by society’s abhorrence of the violence inflicted on Chow’s innocent wife.
Chow’s parents and siblings, as well as Ms Francis’ brother, were allowed to speak to him briefly after he was sentenced.
Chow’s father told reporters that the family accepted the sentence and added that it was tragic, before other family members ushered him away. Ms Francis’ brother declined comment.
 

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Forum: Caregiving is different for those with fewer means​

NOV 10, 2023

It is heartening to know that more emphasis is given to understanding mental health issues (Parents take on caregiver role after son develops mental health issues, Nov 9). But it was also frustrating for me to read the article.
The caregivers mentioned seem to be fairly well-to-do, and can afford private healthcare for their child.
I am a single mother caring for three children below 16 who all have mental health issues at the moment. Two have been diagnosed with attention deficit/hyperactivity disorder (ADHD) with mood disorders, and the other is now having depression.
Sadly, I do not have the means to afford private healthcare for them and we have been referred to the Child Guidance Clinic at the Institute of Mental Health for the past year.
I find the support from public healthcare limited and there is not much collaboration between the psychiatrist or psychologist and schools and parents.
The waiting time is long and the session is short. I feel that I still need more answers and help after a session, and often leave frustrated.
If the long wait time is because IMH is short-staffed, more can be done to bring in more public healthcare staff.

I have also attended the caregivers-to-caregivers programme for persons caring for those with mental health issues mentioned in the article but again, at the end of the day, I need physical assistance, not just empathy from support groups.
I have written to the authorities for better support in the public healthcare system, especially for mental health issues. There are many more like me who need more help in this area. Right now, it is just draining to anyone looking for help.

Lok Pei Ping
 

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Anxiety is the invisible disorder among kids: ‘I was suffering every day in school’​

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Singaporean youth miss 24 days of school a year on average because of depression and anxiety symptoms. PHOTO: ST FILE
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Stephanie Yeo
Senior Correspondent

NOV 14, 2023

SINGAPORE – When Hannah was in lower primary school, she began feeling anxious all the time. She was overwhelmed by the marked change to her usual routine as well as the new environment and classmates.
While her peers eventually adjusted and adapted, every day was a struggle for her.
“I did not understand what I was experiencing. I did not have many friends and I was depressed at a young age,” says Hannah, now 22, who did not want to reveal her full name.
Secondary school was even more stressful because of the presentations she had to do. She resorted to self-harming to obtain medical leave and avoid showing up for them.
Near the end of Secondary 2, she mustered up the courage to tell her mother, who took her to see a psychologist in private practice. She was diagnosed with social anxiety.
“I felt relieved because my parents could understand how I was really feeling,” she says. “Before that, I felt like they didn’t think that it was serious if I experienced anxiety. It was taken lightly when, in fact, I was suffering every day in school and it affected my mental health.”
While she informed her school about her condition, she felt like “nothing much was done” as some teachers were not understanding when she missed presentations because of anxiety.

Hannah’s story is more common than one might think.
Singaporean youth miss 24 days of school a year on average because of depression and anxiety symptoms, a recently released survey of parents conducted by Duke-NUS Medical School and the Institute of Mental Health (IMH) found.
Their school performance dropped by an estimated 63 per cent compared with how they were expected to do if they had no symptoms of anxiety and depression.

Researchers polled 991 parents about their children, who totalled 1,515 and were aged four to 21, between April and June 2022. The survey found that 13 per cent of young people had symptoms of anxiety while 12 per cent had symptoms of depression, based on their parents’ responses.
In total, 16.2 per cent of youth had symptoms consistent with at least one condition. However, only 15 per cent of this group had a medical diagnosis and two-thirds had an unplanned visit to an emergency department.
The parents in the study reported that they spent an average of $10,250 on medical care because of their children’s mental health condition.

At a national level, the direct healthcare cost for these conditions among youth is estimated to be $1.2 billion, the researchers say.
“The real effects of untreated mental health conditions among youth will extend well into adulthood, when they are less able to obtain rewarding and high-paying jobs due to poor school performance and other challenges resulting from their illness,” says Professor Eric Finkelstein, a health economist from Duke-NUS’ Health Services & Systems Research and a senior author of the study.
A similar survey by the same researchers among Singaporean adults during the same period revealed that depression and anxiety could be costing Singapore as much as 2.9 per cent of its gross domestic product or nearly $16 billion.
About one in five adults have such symptoms.

What is anxiety disorder?​

Everyone has moments of anxiety, such as before a high-stakes examination, for instance.
But children with anxiety disorders have frequent worries that may seem out of proportion to the actual situation and they may avoid situations or activities because they fear it, says Assistant Professor Sharon Sung from the Health Services and Systems Research Programme at Duke-NUS.
Some of the common physical symptoms include headaches, stomachaches, giddiness, a racing heart, muscle tension and/or shortness of breath.
Anxiety often occurs together with depression and there may be overlapping symptoms such as social withdrawal, over-thinking, high levels of self-criticism, fatigue and sleep disturbances.
“It can sometimes be hard for parents or caregivers to tell what is driving these behaviours,” says Prof Sung, who is also a supervising clinical psychologist in the Department of Psychological Medicine at KK Women’s and Children’s Hospital.
She says that most research on this topic has documented higher rates of anxiety disorders among girls versus boys. A 2021 population study of youth in Singapore found the highest rates of anxiety among teens aged 14 to 16, she adds.
However, Associate Professor Daniel Fung, a senior consultant and chief executive of IMH, says the Duke-NUS and IMH study was based on parental responses.
Parents were not likely to report internalising symptoms such as sadness, which are more common in females.
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Males, on the other hand, tend to have externalising emotions such as anger and behavioural changes. The study also did not set out to answer questions about age group differences, he adds.
Well-intentioned parents may inadvertently reinforce their children’s anxiety when they tell them there is nothing to be afraid of.
“This makes children less likely to share their fears. If every time children say they are scared and the parent invalidates those feelings, they will often translate into physical symptoms like pain in the stomach, head or elsewhere,” Prof Fung says.
“Parents respond to physical ailments more seriously, so children with anxiety start doing that. Anxiety as a symptom may then be missed.”
Anxiety disorders are more pronounced and do not go away no matter how parents try to help, Prof Fung says, adding that the pandemic could have had an impact on the results of the study.
“One misconception about fears and worries is that if we avoid these fears, we will no longer have them. This is a fallacy as fears will grow through avoidance. Facing fears needs acknowledgement that they exist.”

A little help makes a huge difference​

Managing anxiety disorders in children and youth is not always about getting the right medication or therapy.
In Hannah’s case, support from a teacher and classmates was crucial.
In 2018, she enrolled in Ngee Ann Polytechnic’s information technology (IT) course, but could not adjust to the new environment and took a 10-month leave of absence.
The following year, she wanted to explore her creative interests and enrolled in the polytechnic’s immersive media diploma programme. Her anxiety and depression flared up in her second semester and she deferred her studies for four months until the next academic year.
“The poly environment involves more social interactions and I was trying really hard to cover up my anxiety. It took up a lot of energy and left me feeling very tired. In the end, I could not handle it,” she says.
In 2020, Hannah resumed her studies in IT.
Ms Charis Tang, a senior manager at Ngee Ann Polytechnic’s School of InfoComm & Technology, swung into action when she found out about Hannah’s condition.
Hannah was allowed to do group projects as individual ones and some presentations on a one-to-one basis instead of in front of the class.

During times when her condition worsened, Ms Tang made arrangements for her to attend physical classes via an online link.
Hannah’s classmates also readily took on responsibilities to help her once they learnt she had mental health challenges, Ms Tang adds.
Hannah, who was also diagnosed with autism spectrum disorder, a neurodevelopmental disorder, in late 2021, says: “Whenever I was feeling very down, Ms Charis encouraged me not to give up.”
She adds that her parents supported her wholeheartedly. She has an older sister who is 26.
Ms Tang, who also taught Hannah some modules, helped her look for a suitable internship in her final year with the help of SG Enable, the focal agency for disability and inclusion in Singapore.
“What truly surprised us was her resilience and determination. Despite the challenges she faced, Hannah refused to give up and put in exceptional effort in her work,” says Ms Tang, who has been with Ngee Ann Polytechnic for eight years.
Buoyed by their belief in her, Hannah persevered and graduated in the top 15 per cent of her cohort in May. She is now studying computer science in a local university.
“Every time I felt like giving up, I thought of Ms Charis’ kindness and the tutors and classmates who helped me along the way. I did not want to waste their efforts,” says Hannah.

What to do if your child has an anxiety disorder​

Parents may find it hard to understand their child’s seemingly irrational fears.
“They may assume that anxiety is not a big deal or that the child will grow out of it,” says Prof Sung.
But if your child’s anxiety becomes severe and interferes with his or her life, it is time to seek treatment, she adds.
Parents may also try to help their children avoid stressors, but this could backfire and worsen their anxiety.
“When our children are anxious, it is natural to want to help them feel better. But if we allow them to avoid all stressful situations, we miss out on opportunities to teach them how to cope with anxiety.
“A better approach is to work with your child to gradually approach stressful situations, so he or she can learn how to manage them effectively,” Prof Sung suggests.

Prof Fung says cognitive behaviour therapy (CBT) is the most important tool in managing anxiety and medication is seldom the first line of treatment.
In CBT, children learn about the origins of fears and worries, and how to recognise their body’s reactions. Older children will learn the difference between a feeling and a thought and how thoughts drive feelings, he adds.
“For example, if we think that something bad might happen, we will feel scared. Conversely, if we imagine a coping thought that good outcomes happen, the feelings will be more hopeful. This is practised in a series of behavioural experiments that we get the child with his or her parents to participate in.”
Prof Sung adds: “It is important for parents to understand that the goal of treatment is not to eliminate all anxiety, but to help equip young people with tools to manage life stressors effectively.”
Hannah says parents play an important role in helping their children manage their mental health conditions. They should avoid labels and instead make time to listen and communicate with their children without judgment.
Hannah, who has battled anxiety since primary school, tells other children and teenagers: “We should not give up hope because whenever we face challenges, we can learn ways to overcome these challenges and this will make us stronger and more resilient.”
 

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Girl, 15, killed her grandfather, 84, in Bukit Batok flat before committing suicide: Coroner​

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Investigation officers at the carpark of Block 363 Bukit Batok Street 31, where Mr Teo An Nee was found dead in his home, in June 2022. PHOTO: LIANHE ZAOBAO FILE
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Shaffiq Alkhatib
Court Correspondent

Nov 29, 2023

SINGAPORE – For reasons unknown, a 15-year-old girl killed her grandfather in a Bukit Batok flat before jumping to her death from a nearby block in June 2022.
Coroner Christopher Goh said on Nov 29 that it appeared that besides the teenager no one else was involved in the death of Mr Teo An Nee, 84.
He was found with at least seven stab wounds on his torso in a flat at Block 363 Bukit Batok Street 31 on June 23, 2022, and was later pronounced dead by paramedics.
After killing her paternal grandfather, Ellis Teo, 15, went to the 25th storey of Block 115 Bukit Batok West Avenue 6 and jumped to her death.
The investigating officer (IO), Sergeant Quek Jun Cai, told the court on Nov 29 that following an investigation, the police could not determine what happened between the pair shortly before the tragedy.
This was because Mr Teo and Ellis were the only ones in the flat, as her parents were not home.
There were no witnesses, and there was also no closed-circuit television camera footage captured inside the unit.

Ellis’ diary was recovered, and the IO said that, based on her entries, she had felt no hatred and bore no ill intentions towards her grandfather.
Instead, the teenager had said she faced difficulties when she tried to teach Mr Teo how to use his phone as she was not proficient in Chinese.
She had stated she was lonely and had wanted to take her own life. However, investigators did not know why she wanted to do so.


Ellis had written in her diary that she had mental health issues, but there were no official medical reports that she had them.
The court heard she did not like loud sounds, and an unnamed relative had told investigators that Ellis could have been “triggered” by the ringtone of the elderly man’s phone.
The court heard that on the day of the tragedy, she did not leave her flat before killing her grandfather.
CCTV footage at the block showed that he came home at around 2.30pm, and Ellis left the premises shortly after 5pm with a plaster on her left hand.
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She called her mother, saying she did not wish to go home and that she had done something that would make her mum angry. Ellis took her own life soon after.
Ellis was found lying motionless at the foot of Block 115, and the police were alerted at 5.50pm.
At around the same time, her mother returned home and found that the family dog had a bloodstained mouth. The mother then found Mr Teo lying face up in the master bedroom, covered in blood, with a knife near him.
She called her husband before she picked up the weapon, washed it and put it away. It was not mentioned in court why she had done that.
Her husband alerted the police, and paramedics pronounced the elderly man dead at the scene.
Investigators examined the knife and found only Mr Teo’s DNA on it. Ellis’ DNA could not be found on the weapon and the IO said this could be because her mother had washed it earlier.
Ellis’ shirt, which was stained with Mr Teo’s blood, was found in a pail in the flat.
There was also no indication that anyone had broken into the family flat, said Sgt Quek.
Family members were not in court on Nov 29 during the inquiry.
 

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In short....more and more sinki are kee siao
That why we need our hands to take care of us
 

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Teen pleads guilty to killing schoolmate with axe at River Valley High School in 2021​

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He was originally handed a murder charge, but it was reduced in February to one of culpable homicide. PHOTO: ST FILE
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Selina Lum
Senior Law Correspondent

Dec 1, 2023

SINGAPORE – Suffering from depression, a 16-year-old student at River Valley High School bought several weapons, including a combat axe, between March and April 2021.
Now 18, he pleaded guilty on Dec 1 to killing a fellow student with an axe.
He had planned to commit suicide by slashing people in school, so the police could shoot him to death.
On July 14, 2021, he took the axe and a knife to school in a badminton bag, which he hid under a sink in the toilet, but failed to follow through with his plan.
He tried again on July 19, 2021.
At about 11.15am, he left his classroom and waited in the toilet, armed with the axe, and repeatedly slashed a 13-year-old student who entered the toilet. The two were not known to each other.
The assailant, who cannot be named under the Children and Young Persons Act, pleaded guilty to a charge of culpable homicide.

A previously imposed gag order on the name of the victim, Ethan Hun, was lifted by the High Court at his parents’ request.
The accused was originally handed a murder charge, but it was reduced in February to one of culpable homicide.
The teen, who has been in remand since the incident, took his O-level examinations as a private candidate while in custody.
The Singapore Prison Service had said the teen sat the exams in 2022 as a private candidate.
After the incident, the school was given additional counsellors, and mental well-being awareness talks were conducted for its students.
During earlier court proceedings, the court heard that the accused had attempted suicide in 2019, and was assessed at the Institute of Mental Health.
Ethan’s parents were not in court, but their lawyer Mervyn Cheong was present on a watching brief.
In a statement through Mr Cheong, Ethan’s parents said: “We are heartbroken. We believe many who know Ethan will be too.
“Yet, we want to encourage everyone to remember Ethan fondly instead. Remember him for his goodness, his kind heart, and his peace-loving nature. Remember that he would want us to be happy.”
 

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River Valley High School death: Teen sentenced to 16 years’ jail for killing schoolmate with axe in 2021​

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He was originally handed a murder charge, but it was reduced in February to one of culpable homicide. PHOTO: ST FILE
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Selina Lum
Senior Law Correspondent

Dec 1, 2023

SINGAPORE – Suffering from depression, a 16-year-old student at River Valley High School bought several weapons, including a combat axe, between March and April 2021.
Now 18, he was sentenced to 16 years’ jail after pleading guilty on Dec 1 to killing a fellow student with an axe.
He had planned to commit suicide by slashing people in school, so the police could shoot him to death.
On July 14, 2021, he took the axe and a knife to school in a badminton bag, which he hid under a sink in the toilet, but failed to follow through with his plan.
He tried again on July 19, 2021.
At about 11.15am, he left his classroom and waited in the toilet, armed with the axe, and repeatedly slashed a 13-year-old student who entered the toilet. The two were not known to each other.


The assailant, who cannot be named under the Children and Young Persons Act, pleaded guilty to a charge of culpable homicide.

A previously imposed gag order on the name of the victim, Ethan Hun, was lifted by the High Court at his parents’ request.
The accused was originally handed a murder charge, but it was reduced in February to one of culpable homicide.
The teen, who has been in remand since the incident, took his O-level examinations in 2022 as a private candidate while in custody.

On Dec 1, his lawyer, Mr Sunil Sudheesan, told the court that the teen has a significant family history of mental illness on his father’s side.
He said the boy made two attempts to commit suicide in 2019, but his family did not realise the severity of his condition. He was then assessed by the Institute of Mental Health (IMH) to have an adjustment reaction.
Deputy Public Prosecutor (DPP) Sean Teh told the court the teen started having suicidal ideations in February 2019.
In April 2020, the boy started watching videos depicting actual scenes of human death.
In January 2021, he felt overwhelmed during the new school term and thought about killing himself. “The accused’s mood was low, and he did not want to interact with people or deal with school responsibilities,” said the prosecutor.
Having failed in his previous suicide attempts, he felt the only way he could overcome the psychological barrier of taking his own life was by getting someone else to kill him.
He eventually decided to go on a killing spree in school, so the police would have to shoot him.
Between February and March 2021, he wrote two poems which alluded to mass killings conducted in a school.
Between March and July 2021, he did numerous online searches for stabbings, school shootings and attacks, and suicide.
He also wrote a note on his mobile phone dated July 5, 2021, which stated his intent to commit suicide.

On March 6, 2021, he bought a tomahawk axe from a store.
On March 17, he bought a Cold Steel Trench Hawk axe measuring 50cm by 22cm and a sharpener from a second store.
In April that year, he bought a bushcraft stainless steel knife measuring 23.5cm by 4cm from a third store.
The names of the stores were not mentioned in court.
He sent the axes and knife for sharpening at a store offering sharpening services at least once, and bought a badminton racket bag to hide the weapons.
On July 14, 2021, he arrived in school earlier than usual, with the Trench Hawk axe, the knife and the badminton racket bag, as well as a roll of “caution tape” with black and yellow stripes in his backpack.
He headed for one of the toilets in the school, and cordoned off the corridor with the tape to prevent other students from going in.
He then placed the badminton bag containing the weapons under a sink, and returned to his classroom.
He waited in a cubicle for an opportune time to attack someone, but could not bring himself to do so.
On July 19, 2021, he again left the bag of weapons under a sink and pasted the “caution tape” across the corridor before returning to his classroom.
When he returned to the toilet at about 11.15am, the tape was hanging only from one side of the wall, and there were students in the toilet.
He waited for them to leave, then closed the toilet door and windows to prevent the prospective victim’s screams from being heard.
At about 11.30am, after Ethan entered the toilet, the accused went out briefly to paste the tape across the corridor.
He then attacked Ethan and said, “I’m sorry”.

DPP Teh said the assailant claimed he felt catharsis and regret after the attack, and decided not to kill anyone else.
At about 11.35am, the teen left the toilet with the axe and approached other students to call the police, but they ran away.
He complied when a female teacher asked him to drop the axe, which she then kicked away from him.
When the teen told her he had killed someone and asked her to call the police, she asked to see the body to confirm what he had told her.
When she saw Ethan on the toilet floor, she ran to seek help and bumped into a male teacher who was on his way to the scene after he received a call from a student.
While the female teacher was contacting the school authorities, the teen called the police and reported: “I just killed someone. With an axe. I don’t know who. Are you going to send someone or not?”
The male teacher then called the police when he saw the body.
Paramedics and police officers arrived at about 11.50am, and the teen was arrested.
A psychiatric report from Dr Kenji Gwee from the IMH on Aug 18, 2021, said the teen was suffering from major depressive disorder (MDD) around the time of the killing.
Factors that contributed to the killing include the onset of depression, which accentuated the teen’s fatalistic thinking.
The consumption of the videos desensitised him to the physicality and gore when taking a life, said the report.
DPP Kumaresan Gohulabalan said this case of homicide was one that was truly unprecedented.
He sought between 12 and 16 years’ jail, saying that the killing was meticulously planned in the months prior to it.
“The facts show that the deceased, a young boy, was killed in cold blood as part of the accused’s detailed and methodical plan,” he said in sentencing submissions.
Mr Sudheesan sought five years’ jail. He said the teen has made proactive efforts to be more open in his conversations with his family, sharing more about his attitudes, problems and emotions.
The teen’s mother has completed a graduate diploma in youth work offered by the Singapore University of Social Sciences, while his father is currently going through the same course.
The teen’s mother also left her previous job to join the Health Promotion Board to have some access to influencing healthcare policy concerning youth mental health, while his father has committed to retire from his job to take care of his son upon his release.
Their son’s sentence has been backdated to July 19, 2021, when he was arrested.
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A previously imposed gag order on the name of the victim, Ethan Hun, was lifted by the High Court at his parents’ request. PHOTO: FAMILY OF ETHAN HUN
Ethan’s parents were not in court, but their lawyer Mervyn Cheong was present to follow the case on their behalf.
In a statement through Mr Cheong, Ethan’s parents said: “We are heartbroken. We believe many who know Ethan will be too.
“Yet, we want to encourage everyone to remember Ethan fondly instead. Remember him for his goodness, his kind heart, and his peace-loving nature. Remember that he would want us to be happy.”
 

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He burnt his A-level cert and drank his own pee in manic meltdown: 27-year-old man shares his rebound to resilience​

He burnt his A-level cert and drank his own pee in manic meltdown: 27-year-old man shares his rebound to resilience

(Left) Kevin Wee as a speaker now and (top right) at a time when he struggled with his mental health.
PHOTO: Kevin Wee
Candice Cai
PUBLISHED ON JANUARY 21, 2022

Kevin Wee is a picture of calm and easy confidence when we speak to him through Zoom for this interview.
In fact, he shares with us that he's in a good mood because his prior meetings that day had gone well.
But nine years ago, one would have seen a very different side to the 27-year-old, who turns 28 in July.
Between the ages of 18 and 19, Kevin went through a bout of depression, followed by what he believes to be mania, characterised by a period of intense "high".
The episode culminated in the former Raffles Junior College student recording and posting a four-hour-long YouTube video of him performing bizarre acts, including drinking his own urine and eating dog excrement.
Ironically, it was his sudden intense desire to share his "epiphany" on mental health that led him to create the video in the first place.

Driven to succeed​

Kevin describes himself as the standard "Type A personality" who could never stand losing or being second-best. He was driven to excel in whatever he did and as a student, that meant striving to do well academically.
But although he graduated from top schools, he reveals that he wasn't a straight-A student "like everybody seems to think".
"I was more of a hard worker, rather than someone who's extremely smart when it comes to studies."
The talented athlete also had lofty goals for himself in the sports arena. He shares that "at one point, I even wanted to be an Olympian".
But the stress of preparing for the A-levels somehow took its toll, and by the time he sat for his General Paper (GP) in late 2013, Kevin suddenly found himself in the midst of a meltdown.
The mental paralysis he experienced during his examinations was so severe that he ended up handing in blank papers for his math exam.
Incredibly, Kevin scored an A for GP — the very subject he thought he didn't do well in and sparked off his spiral into depression. He ended up scraping by with grades B, B and D for his other subjects (math was ungraded).
At its worst, Kevin's depressive episode plunged him into a dark, emotionless void that caused him to have violent and suicidal thoughts.
"There were thoughts of death, thoughts of me being hanged or chopped up into pieces, just very gruesome thoughts that I couldn't control anymore," says Kevin, sharing that at the same time, he also experienced a loss of emotions.
"I became a hollow human being basically and I'd lost my emotions completely. I felt like a zombie," says Kevin of the "scariest moment" of his life.
He begged his parents to take him to the Institute of Mental Health, which they did. He was given tranquilisers and put on anti-depressant medication.
Kevin shares that what helped him to turn the corner eventually, however, was when he began volunteering, at the suggestion of his parents.
"When I took small actions [to help others], there was some respite. I realised people didn't care whether I got straight A's or not.
"In those moments, I realised that my worth is not just tied to whatever I had built my life on and I had to let go [of that belief] in order to progress," he explains.
But the switch in his mindset also had an unintended effect.
"The epiphany came to me one day that I don't have to go to university to be successful. I could define my own success and be whatever I want to be," Kevin recalls vividly.
And it was a message that he wanted to share with the world. In hindsight, Kevin believes that it was this sudden 180-degree shift that signalled the start of what he self-diagnosed as mania.
"A thought infected me that I was going to be a saviour, an avatar of Singapore's mental health scene," he adds of the reason for creating the four-hour video.
The intense high and the feeling of being a ball of "pure energy" was unlike anything he'd ever experienced. "I didn't sleep for four days," he shares.
In the clip which he has since removed from YouTube, Kevin filmed himself burning his A-level certificate in his room, and scrawling in red paint "grades will not define me" on his bedroom wall.
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Kevin in the video setting fire to his A-level cert in his bedroom. PHOTO: Kevin Wee
Even more extreme was a part where he danced in his mother's nightgown and re-enacted a segment from reality television show Man vs. Wild, where he "drank [his] own pee and ate dog s***".
Unsurprisingly, the video went viral, and "people really thought that I had lost it", says Kevin in a recent podcast where he was a guest. And as a result of the episode, Kevin says he scared some of his friends away, for which he takes full responsibility.
Rewatching the video as an adult (he still has a copy saved somewhere) however, Kevin points out that the person he sees in the video is not completely unrecognisable.
"It seemed like I was possessed, but it was still me, just that my traits were amplified," reflects Kevin of the manic episode. For fans of Spider-Man, he likens it to when the superhero is taken over by Venom, the alien symbiote that wreaks havoc after binding itself to a host.
It took Kevin another six months before he "came into balance", and he credits his parents and mentors in his life for the adjustment to mental well-being.
"My parents are the closest thing to love I've experienced in my life. They empathised and they never judged me. They gave me the emotional support and space that I needed."
Despite the hurtful comments he received from his schoolmates then in response to the controversial video, looking back, he has gratitude for the criticisms as "it's also what made me who I am today".
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A criticism directed at Kevin from the RJ Confessions page on Facebook. PHOTO: Screenshot/Facebook
"It allowed me to build resilience, and allowed me to process my pain."
Believing that it's only natural to be motivated "by our private voids", for Kevin, it was this pain and the perceived lack of empathy in society for mental health issues that ignited a fire in his belly to try and make a change and help others be understood.

Becoming a speaker​

Kevin shares that in the decade that has passed, his moods have not come close to the low and high that he experienced during that period from 2013 to 2014.
And while the intensity of his fervour to share his message on mental health has abated, it is still the path that he has chosen to tread, albeit "in a more balanced way".
For the record, he eventually did graduate from university, getting into Nanyang Technological University's Wee Kim Wee School of Communication and Information through discretionary admission. With a singular focus on setting up a training company, Kevin used his final-year project as a testbed for his plan.
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Kevin with his parents at his convocation. PHOTO: Kevin Wee
"At the core, I still had the desire to build a compassionate and resilient society," he states.
Kevin now speaks publicly about his experience through his social media platforms and the business he started, delivering lessons on resilience to schools here.
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Kevin speaking to students as a final-year student NTU for his FYP. PHOTO: Kevin Wee
His talks aim to help students cope with the inevitable stressors of life, although they're no magic pill.
"I can't prevent people from going through struggle, but what I'm trying to do is to prepare them for it," he says, stressing the difference between prevention and preparation. "I'm not protecting them, but preparing them for when it comes."
However, he recognises the irony, "that I'm advocating to prevent the very thing that has made me who I am".

We ask if he fears losing grip and slipping into depression or mania again someday.
"I don't necessarily fear it, but I've been very humbled by the experience, and I know that I'll never be complacent and will always prioritise my mental health," he replies simply.
Kevin lets on that some followers on Instagram have questioned if a recent challenge that he took up on social media to be a "homeless hiker" for three days was a sign of instability.
In a series of Instagram Stories last December, Kevin documented himself walking from Bedok to Woodlands, sleeping outdoors and subsisting only on the kindness of strangers or discarded food.
Sharing that he took up the challenge because he's someone who "needs discomfort to grow", the effort was also in part to help raise funds for Project Green Ribbon, a non-profit organisation that helps disadvantaged communities in Singapore.
He adds: "I wanted to do it to let people see that there's more to life."
Aside from chomping on strangers' leftover food [Covid-19!], the experience was also an eye-opening one for himself, thanks to some helpful and colourful individuals whom he met along the way.
One of them was a Rolex-wearing octogenarian with whom he struck up a conversation at the Marina Bay Sands foodcourt.
The elderly man treated Kevin to a plate of economic rice and gave him $10, but not before chiding: "You must be struggling to make money. No woman will want you."
Rather than be offended, however, Kevin was intrigued.
"He told me he is a rich man and he's not in touch with his kids, and that he has a girlfriend whom he buys condos for," Kevin recounts.
"His whole paradigm about life is measured only by his wealth and his things. I find it so fascinating that at 80 years old, he is still adamant that this is how he lives his life and he will die happy. It was very eye-opening for me, because I never thought an old man would think this way."
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People whom Kevin met on his hike across Singapore, from the octogenarian at Marina Bay Sands to the hawkers at Chinatown who gave him free food when they saw that he was eating leftovers. PHOTO: Kevin Wee
Sharing that his mental health journey has made him redefine success, he admits that he has had to let go of his past ideals in order to move on.
"What I want people to know is that the greatest reward for success is not what I get from it, but who I've become through it and what I give back to others.
"I was born with nothing, and leave with nothing. There's nothing to lose and everything to give."
It's a line that has become his mantra of sorts, and something that he turns to whenever he feels lost or anxious in life.
Pointing to the sports medals adorning his bedroom wall in the background of our Zoom chat, Kevin shares: "At the end of the day, nobody cares [about them].
"What remains are the memories you treasure, the character that you've built and the lives that you've touched."
And his message to others is not to let one event define the rest of your life.
"If that's the case, then there's no point doing anything else. The fact is, life is a series of events, and how you choose to respond to them is what makes your life."
 
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