Singapore—Upon investigating the death by suicide of a national serviceman, the coroner says that there is no evidence that 18-year-old Muhammad Ahad Lone had been bullied, but recommends that mental health experts be appointed to all Singapore Civil Defence Force (SCDF) camps.
Mr Ahad took a leap from his apartment on April 7, 2018, a mere two months after his national service (NS) enlistment. While he was a Singaporean citizen, Mr Ahad, who was born in Pakistan, had no other family here. Neither did he have any close friends in Singapore, one of his camp buddies said.
He also had a history of mental health issues, and a little more than a week before his death, a psychiatrist from the Institute of Mental Health (IMH) had issued a recommendation for Mr Ahad to be referred to SCDF’s psychological care center and counsellor.
However, State Coroner Kamala Ponnampalam pointed out that SCDF counsellors are “orientation officers” who undergo no formal training in mental health counseling. Furthermore, Coroner Kamala also cited the absence of a dedicated psychological care centre within SCDF, as there is only a behavioural sciences unit located at the SCDF headquarter.
The findings of the coroner were released to the press on November 20, Wednesday, wherein it was found that there is a lack in SCDF’s protocol and structure in helping recruits who experience troubles concerning mental health.
The coroner wrote, “It is recommended that the SCDF undertakes a review of its structure and protocols, and implements evidence-based measures, including, but not limited to, the appointment of trained mental health professionals to each SCDF camp.
Mental health literacy is generally not intuitive. It is a learnt skill. Often, good intentions alone are not sufficient to support those in crisis. They require support and intervention from trained professionals.”
It is therefore desirable to have professional counsellors present to support the recruits who face mental health issues.”
Two months ago, Coroner Kamala pronounced the death of Mr Ahad as a “deliberate act of suicide”.
The recruit, who had lived in Singapore for a few years when his father worked here, had been living in Pakistan since 2012, only returning in February 2018 for his national service duties. He had become a Singaporean citizen in 2009.
But when he returned here he had trouble sleeping and was lonely and homesick. He also experienced a number of physical issues, such as a lack of appetite and other stomach problems, and a slowing down of psychomotor skills.
During his two months in training, he was certified medically unfit for duty several times.
And while Mr Ahad had confided in Lieutenant Muhammad Amirza Mohd Zulfin, his platoon commander, concerning his problems, he declined the commander’s offer for a referral to counsellors.
Coroner Kamala said, “Not all recruits may exhibit overt evidence of distress or affective disorders like depression. It would take a trained professional to identify and diagnose the condition, as was seen in Ahad’s case.”
She reported to not finding any evidence that Mr Ahad was bullied, even if the stress triggers in his life were related to his camp experiences. Mr Ahad had been, however, diagnosed with adjustment disorder with depressed mood.
“While the causal stressors were found to be related to camp, there was no evidence to suggest that Ahad was bullied at camp. When he was identified to be a suicide risk, he was provided timely and appropriate treatment.”
Sometime before his death, Mr Ahad was brought to IMH’s emergency room via ambulance, suffering from low mood with suicide ideation. This occurred on March 29, 2018. Dr Joshua Teng, who had attended to Mr Ahad at least three times, said that his symptoms matched five out of nine criteria for a depression diagnosis.
Mr Ahad had previously told another doctor, the IMH’s Zheng Shushan, that he had no wish to commit suicide since he looked forward to studying in an Ivy League university, where he had been accepted, and that he was very close to his mother and the rest of his family.
Coroner Kamala said, “it is not possible to predict suicide in an individual and clinicians can only try to identify the suicide risk factors and respond with appropriate care and intervention”.
It would have been good for Mr Ahad to have been supervised by a trained counselor, she added.
“Assessing suicide risk is an inexact science requiring a judgement call.
National Service recruits are known to encounter many stressors related to training. They have difficulty adjusting to a more regimented lifestyle and often suffer disappointments from a perceived underachievement when they fail to attain a desired rank or vocation.
Mental health literacy is generally not intuitive. It is a learnt skill. Often, good intentions alone is not sufficient to support those in crisis. They require support and intervention from trained professionals.” -/TISG