Signposts

This world has no signposts. We navigate by birth luck, by trial and error, or by some great wind carrying us across the sky, as an indigenous Ojibwe would say. Coping with our complex city lives in Singapore require more than just an unpredictable wind. From a mental health perspective, coping skills can be categorized into rest, relaxation and routine. Rest is sleep hygiene. Relaxation of the mind can mean counting backwards, or doing a noodle dance to loosen up the body. Routine is a simple discipline that can straighten up the rest of a messy life. What does Singapore do with its youth mental health problem? It sets up a signpost - Creative SAY! - a drop-in centre for Sports, Arts and Youth, where I am currently a programme executive. The signpost doesn’t say mental health, because we are trailblazing into preventive work, and the undiagnosed will not step foot on the territory of the ill. People read “mental health” and understand “mental illness” all the time. But vitamins and drugs are not the same.

They enter the centre Creative SAY!, mother before son, although the son is old enough to have children of his own. She is seeking, well-dressed, but her shifty downward-looking eyes betray the optimistic certainty of her black high-heeled shoes. He follows, nonchalant, a hole in his shirt, some stains making it his. Depressed, anxious, maladjusted, looking for somewhere to “get better”, he mumbles, glancing at his mother. My colleague comes forward. He has a copy of the son’s hospital referral form in his hands.

They enter too, the group of them in school uniform, rowdy, tentative, brave. “What’s this place?” A boy eyes me, considers trusting. His companions tow his line, their attention venturing beyond, into the music corner, the gym, the coloured walls, the pantry. I recite the menu, a buffet of visual arts, performing arts, water sports, land sports. Want to learn sailing? How about getting your friends together for a game of floorball? She likes drawing and he wants to be a singer. Rock climbing sounds cool. But, “who’s he,” they whisper, about the maladjusted man who had stepped in just before them, sitting in a corner with my colleague. I tell them they can ask, once he’s done with the meeting.

Another he enters, this time a gentleman in a clean white shirt, tanned, nobly-built, speaks broken English with Bahasa accent. A very nice watch. You never actually own a Patek Philippe. You merely look after it for the next generation. He tells us about his daughter. He loves her very much. She’s beautiful, perfect, normal, once upon a time. Now she hears people talking behind her back and doesn’t want to go out. They fly from Jakarta to Singapore twice a month for better psychiatric treatment. The hospital recommended us. “Money no object,” he says, long before I share our monthly charges. I write a note on our flyer addressed to his daughter. He doesn’t stop thanking me.

Is the help we seek, vitamins or drugs? Drugs have side effects, like Risperidone, medicine for schizophrenia, but causes photosensitivity, involuntary muscle twitches and weight gain. I look around the centre, lively like a colourful bottle of Vit-C gummy bears. It’s a shame people don’t pursue their hobbies as they do with career progression. Use – no, risk – all means necessary to stay at the table, climb the ladder of mastery and achievement. A group of youth jam together on donated guitars, a keyboard and some cajons. “You shoot me down, but I won’t fall, I am titanium.” David Guetta’s fight song. Connection, laughter, life satisfaction. Community is formed. A girl looks away into the distance. I come up to her and sit beside. A side-hug, searching eyes and then, two grateful smiles. She un-suspends my weary heart.

“Miss Amelia?” she says.

“Yes Humaira?” I say.

“Nothing… nevermind,” she says.

Humaira is thirteen, the eldest of six siblings. She has three younger sisters, who look up to her and come to her when they have problems. After school, her mother entrusts her to care for her baby brothers and their household, while she goes to work as a house cleaner. Humaira drops by the centre occasionally to catch a breath, when her aunt is able to visit and relieve her of her duties temporarily. Her family is under the government’s Financial Assistance Scheme.

“How did you do on your mid-terms?” I ask.

“Not good. How will I get a good job in the future?” she says.

“We’ll get you a tutor,” I say, knowing I will need to convince her mother to allow her regular time away from housework, so as to attend the tuition classes.

I spend six months trying to get a signpost erected where the road turns a corner to Creative SAY!, our youth drop-in centre. We launched the same year Singapore’s Prime Minister announced a special fund for mental health initiatives. There are so many levels of government – Urban Redevelopment Authority, town council, Housing Development Board. They have all just approved my request but I must find my own contractor to make the signpost. Who makes these things? What started out as kindness becomes a complicated web of political considerations and social implications. The best audit is competition between parties. Integrity over efficiency anytime. Strawberries bruise easily, and nobody knows with certainty how to increase the resilience of the strawberry generation, but suggestions abound. The old guards created this entitled generation. We prescribe.

Just like the fertility doctor I see. She presumes to know all about me because I walk through her doors. Problem: no baby. Prescription: make baby. But I would like to conceive via natural means please, in an embrace and not a test-tube. Can you help me still? Comes her soliloquy on probabilities and window periods, making me wonder if I should seek help from a spiritual director instead. Yes, children are gifts and not entitlements. Yes, I have sought medical advice, from doctors with walls full of red stamps and proud acclamations. No, I haven’t found the help I need. 

One year ago Prime Minister cried out, “Please have more babies.” This cry can actually be traced back to year 2008, when he detailed in his National Day Rally, how we have gone from 6 children per woman in 1960, to 2.1 children in mid-70s, to 1.3 children. This year it is officially 1.16 children. “Each time there is a crisis, people put off having babies. Crisis passes, numbers bounce back up, but never quite go back to where it used to be,” I remember him saying.

Two years ago Prime Minister mentioned “disruptions” during his National Day Rally speech. "Old models are not working, new models are coming thick and fast, and we're having to adjust and to keep up, because of technology and globalisation," he had said. But not everyone can keep up. Just yesterday a new youth came into the centre telling me he needs to download Whatsapp into his phone for school, but has a dilemma.

“Should I choose Google, or Huawei?” he asks, a question which doesn’t entirely make sense to me at first. When I probe further, he leans in, whispering something about meeting a hacker online and being tracked by this hacker even at school.

“If I choose Huawei, I will lose all of you, everyone I love. If I choose Google, I will lose myself,” he explains. “My friend thinks I should choose Huawei.”

When he starts behaving like the hacker is also tracking him through the surveillance cameras installed in the centre, I suspect he is having delusions and may eventually be diagnosed with schizophrenia. It had been the same with me, but he is so young! I feel deep sorrow thinking about his long road to recovery ahead, hoping my work in mental health now will give him a bright and non-stigmatized future.

What makes a person choose left over right, marriage over companionship, children over freedom? Are the signposts we follow, accurate? Viktor Frankl believes all men search for meaning, Sigmund Freud says we seek pleasure and avoid pain, William Glasser posits our choices are driven by five genetically driven needs – survival, love and belonging, freedom, fun, power. I think we navigate by birth luck, by trial and error, or by some great wind carrying us across the sky. It is the great wind I often pray for. I long to be carried.

The depressed, anxious, maladjusted son sits among the rowdy, brave, school- uniformed youths. I tell them an Indonesian girl may be joining us soon. She speaks better Bahasa than English so I appoint a Malay boy and girl to be her first friends. They are excited to have an overseas visitor. I too wonder if she will end up helping us more than we help her. Her father’s watch tells me he could solve some of our centre’s funding needs. My compassion for her becomes impure. I struggle to purify intentions, and then wonder what difference it would make to the quality of help I provide. A boy bursts out of the art therapy room, comes up to me, says, “Ey ‘cher, can I use the treadmill?” He’s on the edge. I say OK. Maybe I’ll use it too when the work day is ended.

When her husband and her father-in-law passed away prematurely, Hanisah could not say goodbye. Nothing was good about her being in Singapore, a Malaysian citizen living in a government flat that no longer belongs to her, left to take care of three young children, the youngest only four years old. After an appeal was made for her through Madam Halimah, then Member of Parliament and now Madam President of Singapore, Hanisah will get custody of the flat so that six years later, at the age of eighteen, her eldest son will become eligible to inherit their home. The flat transits from her father-in-law, to her husband and in six years time, to her son. It will never be hers.

When I saw her she told me they were rummaging through rubbish bins for food. To see her children this way - hungry, desperate and stripped of all human dignity - breaks even the woman in a mother. The day after their first rummage, Hanisah woke up with eyes red and puffy, having stayed up the whole night crying. There was no way out. She packed a change of clothes and her passport and made to leave her children behind. They would be better off without her. They were Singapore’s children, and Singapore, wealthy, benevolent and resourceful, will parent them better than she can. But Qira, her dearest daughter, saw her going towards the door and let out a scream. Qira ran out of her bedroom, begging her mother to stay. Amrin and his baby brother Ahmed, stirred by their sister’s shrieks, stumbled teary-eyed and horrified to find their mother at the front door, about to leave them behind. 

“Everyone has left us,” Amrin shouted and sobbed, “and now you leave us too. What kind of mother are you?”

Qira continues to chant in exhausted whisper, “Don’t go, don’t go.”

And Ahmed sits on the floor, crying inconsolably without really knowing why. Even with the best intentions, there is never any good in goodbye.

Hanisah did not leave her children to Singapore, as rich a country as it is, and as poor a mother as she is. Instead, she found strength over and over again in the helpfulness of her children’s teachers, and in her daughter Qira’s obedience and willingness to help with household chores. From time to time she reminisces over her early days in Singapore, when her husband had loved her and their family well. But this warm fuzziness often turns to hate. Hating that he has left them for a better world. Hating that she was left behind. Hating that she got the short end of the stick. But hate was never the opposite of love. Indifference is.

“You must leave him behind,” her therapist says. “Trust that the future can be good, for yourself and your children. Because it can. It just takes time.”

Sometimes she succeeds in saying goodbye. Other times, she lets emotions take over. After all, with love there is never an end. I try to remember this as I stare at the single red line on my pregnancy test kit. Two red lines indicate pregnancy. One red line means try again. I am tired of trying, tired of month after month of grieving, because there is grief involved when you work for something without any glimmer of success. Why can’t we just adopt? Why can’t we treat my children at work like they are the children I can’t seem to have?

“Not yet,” my husband says. He isn’t prepared to give up yet. We decide the signpost for adopting, or not, is further down along the road. In the meantime, we work, diligently at our health, at tracking vaginal mucus, at having sex on alternate days within a window period each month. The work becomes routine and I am more detached, less emotionally volatile. Maybe this is what is needed to carry on. After all, companies often last longer than families. 

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