Saturday, December 13, 2025

Friday, December 12, 2025

Ministry of Health: Access to public healthcare a key reason for changes to IP riders

*Ministry of Health: Access to public healthcare a key reason for changes to IP riders*

https://www.straitstimes.com/opinion/forum/forum-access-to-public-healthcare-a-key-reason-for-changes-to-ip-riders

2025-12-12

We refer to Dr Chua Jun Jin’s letter, “Cost matters in healthcare, but so does timeliness” (Dec 8). We are glad that Dr Chua shares the Ministry of Health’s concern on accessibility and waiting times in public hospitals.

Over the years, more private hospital patients have been shifting to public hospitals, which account for 80 per cent of total hospital beds and cater to 90 per cent of hospital patients.

One key reason is that private hospital bills have been growing significantly, which drives up private insurance premiums, especially Integrated Shield Plan (IP) riders. As a result, every year, 100,000 IP rider policy holders cancelled or downgraded their plans. These individuals would potentially move over to public hospitals.

The recent changes to new purchases of IP riders are to arrest this trend, to help make private healthcare more affordable, public healthcare more accessible and the healthcare system more sustainable in the long term.

The changes will increase cost discipline over minor episodes, and reduce over-servicing and over-consumption associated with non-essential hospital admissions or treatments. While the co-payment for patients will be higher, this will be subject to a cap, and with MediSave, the cash outlay will be significantly offset.

In the short term, some private hospital patients may now choose to seek care at public hospitals to reduce their co-payment, especially for lower-cost procedures. However, by putting private healthcare costs and private healthcare insurance on a more sustainable path, we can hopefully moderate the pace of migration of patients from private to public hospitals.

Dr Chua also mentioned long waiting times for serious illnesses, like cancer, in public hospitals. We would like to add that serious conditions such as cancer are always prioritised.

Waiting times depend heavily on severity and urgency but, in 2024, the median waiting times for new cancer specialist outpatient appointments at public healthcare institutions, including for subsidised patients, ranged between four and eight days.

Lam Meng Chon (Dr)
Director, Hospital Services
Ministry of Health

More On This Topic

Forum: What readers are saying

Wednesday, December 10, 2025

How to stop HDB Gas Supply ( GasSupply) HDBHDB 2025-12-10

To stop your HDB gas supply, you must 
engage a Licensed Gas Service Worker (LGSW) through City Energy or SP Group to ensure the work is done safely and legally. Do not attempt to disconnect the piped gas supply yourself, as it is a significant safety hazard and requires professional handling. 
Steps to Terminate HDB Piped Gas Supply
  1. Contact City Energy/SP Group: The turn on and off of piped town gas supply can only be performed by City Energy or its appointed agents. You can submit a request through the SP Group website or app, or by calling them.
  2. Schedule an Appointment: You will need to arrange an appointment for a technician to come to your flat to physically terminate the supply. It is advisable to book this in advance, up to 30 days prior to your desired termination date, as appointments are subject to availability.
  3. Technician Visit: A licensed technician will perform the termination, which involves isolating the gas supply at the meter (usually located outside your unit or in a service cupboard) and plugging the internal pipes to ensure no gas leaks.
  4. Settle Final Bill: The termination fee will be charged to your final utilities bill. Any remaining security deposit will be used to offset outstanding charges, and any credit balance refunded to you within a few working weeks. 
Key Safety and Regulatory Points
  • Safety First: Gas is invisible, and any amateur handling can lead to dangerous leaks or incidents.
  • Legal Compliance: Only LGSWs licensed by the Energy Market Authority (EMA) are legally permitted to carry out gas installation or alteration works.
  • Renovations: If you are stopping the supply for renovation purposes (e.g., switching to an induction hob), inform City Energy to arrange a temporary termination of the gas supply and proper capping of the pipes before work begins. 
22 Sept 2025 — In case of a gas leak: * Shut the gas meter control valve. * Open all windows and doors for ventilation. * Extinguish any cigarettes or flames. * Do...
Dive deeper in AI Mode
SP Group
https://closeaccount.spgroup.com.sg
Close Utilities Account - SP Group
City Energy charges a fee for termination of gas supply /gas appliances disconnection. Please refer to Installation and Contract Services - City Energy for more ...
Discussions and forums
Removing/Moving a gas pipe in an old HDB
Reddit · 
r/askSingapore
 · 4 comments
 · 1y
People also ask
Feedback
Before commencing renovation works within your premises, the gas supply needs to be temporarily terminated for safety reasons by having the gas meter ...
People also search for
Energy Market Authority (EMA)
https://www.ema.gov.sg
Gas Safety - Singapore
23 Sept 2025 — As an additional safety measure, you are advised to arrange with City Energy for a temporary termination of the gas supply before carrying out ...
The piped town gas provided by City Energy is safe. Piped town gas, which is primarily hydrogen gas, is lighter than air therefore it easily dissipates into ...
Open Electricity Market
https://www.openelectricitymarket.sg
PDF
Termination of Utilities Supply Form
* For termination of gas supply, City Energy charges a termination fee. ... The premises is a unit in a shopping centre or JTC/HDB industrial premises.
1 page·70 KB
gasservices.com.sg
https://gasservices.com.sg
HDB Gas Pipe Termination Fast & Safe, #1 Certified Gas Work
5 Aug 2025 — Safely remove the gas pipe from the living room to kitchen. After that close the termination point with the end cap. ✓ Final Pressure Test To ...
SP Group
https://www.spgroup.com.sg
PDF
Town Gas Connection Policy and Procedures - Singapore
This document sets out the connection policy and procedure for Town Gas supply. 1.2. Singapore Gas Transportation System. PowerGas owns an extensive gas ...
19 pages·419 KB
Yahoo News Singapore
https://sg.news.yahoo.com
Utilities in Singapore 2025: SP Services Hotline and Step-by- ...
30 Oct 2025 — SP Services Hotline: 1800-2222-3333 (general inquiries). · Emergency Lines: Gas leaks: 1800-752-1800. Power supply: 1800-778-8888. Water supply: ...
Facebook · SP Group
40+ reactions · 6 years ago
The gas meter control valve is an important safety feature for piped gas ...
The gas meter control valve is an important safety feature for piped gas meters. Here's what you should note. Find out more on gas safety.
People also search for
Results are not personalised
Singapore
AI overview is ready

Tuesday, December 9, 2025

Suicide: Let’s talk about suicide

Let’s talk about suicide 

https://www.straitstimes.com/singapore/health/lets-talk-about-suicide-do-not-avoid-it

2025-09-29

By--- Joyce Teo is senior health correspondent at The Straits Times and the host of ST podcast series Health Check.

And

Lee Li Ying is a correspondent on the health beat at The Straits Times. She has a keen interest in mental health, health technology, ageing and reproductive care.

=====

SINGAPORE - Suicide is a subject which is often avoided – but that could be the last thing that someone who is expressing suicidal thoughts needs.

“When someone says, ‘I’m going to kill myself’, the usual response would be: ‘You shouldn’t say that’ and it shuts them down,” said Rui (not his real name), who is in his 30s and has struggled with suicidal thoughts.

Helplines
Mental well-being
National helpline: 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)
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
Online resources
mindline.sg/fsmh
eC2.sg
tinklefriend.sg
chat.mentalhealth.sg
carey.carecorner.org.sg (for those aged 13 to 25)
limitless.sg/talk (for those aged 12 to 25)
shanyou.org.sg
Rui, who attends meetings with the Light in the Dark support group launched by Samaritans of Singapore, said he wishes people understood that suicidal thoughts are a painful, overwhelming reality for many, and not attempts at seeking attention.

“People who say ‘I’m going to end it’ are asking for help in the only way they can,” he said.

Experts say the key is to treat ideation as a signal that support is needed.

People often think that asking loved ones in distress if they are suicidal might plant the idea in their heads, when the truth is that it might actually protect them, say experts. 

There are many misconceptions around suicide, including that suicidal thoughts affect only individuals who have mental illnesses.

However, they can also occur in people who have not been formally diagnosed with a mental health condition, or, at least, are not known to have had a mental illness before their deaths, said Associate Professor Mythily Subramaniam, assistant chairwoman of the Institute of Mental Health’s (IMH) medical board for research.

“In these cases, the trigger may be a major life event like humiliation, loss, failure or conflict, combined with poor coping resources, social isolation or a sense of being utterly overwhelmed,” she said.

The risks may be even greater for adolescents.

A February study by KK Women’s and Children’s Hospital (KKH) found that young patients who had tried to hurt themselves typically did not have serious mental health disorders, but instead had psychosocial problems and emotional regulation difficulties.

The study looked into the psychosocial stressors and risk profiles of adolescents who visited KKH’s emergency department for suicidal or self-harm attempts from January to December 2021. The authors reviewed 221 medical records of patients aged 10 to 19.

The most frequently observed mental health challenges were stress-related and emotional coping difficulties, which were present in 50.7 per cent of patients, and mood and anxiety symptoms, present in 53.4 per cent of patients.

Left unassisted, their mental health distress can rapidly escalate and manifest in behaviour that is a risk to themselves, the authors of the study said.

Awareness and prevention a whole-of-society effort
Bringing the topic of suicide into the open has become paramount, as it remains the leading cause of death among young people aged 10 to 29 for the sixth consecutive year. 

It is one of the most urgent public health challenges for Singapore, said Prof Mythily.

The issue requires a whole-of-nation approach, with a lead agency to coordinate proven prevention efforts, training for the community to recognise warning signs, and continued research funding to find better ways of preventing it, she said.

Both Prof Mythily and Professor Chong Siow Ann, a senior consultant at IMH’s Research Division and Department of Psychosis, said that those who come into contact most often with youth, such as teachers, national service (NS) officers, human resources staff and community volunteers, should be better trained to recognise the warning signs if someone is at risk.

More On This Topic
The day an 11-year-old did not come home from school
Views From The Couch: Singapore’s digital generation and the contagion of despair
Schools, NS units and workplaces should also provide stronger support to those affected by a suicide to reduce risk and promote healing.

Prof Mythily and Prof Chong recently concluded a study where suicide survivors were interviewed.

They said mental health hotlines such as the Samaritans’ hotline 1767 and the national mindline 1771 should have youth-friendly chat and text options, as these are young people’s preferred communication channels. Currently, the two hotlines offer a text option only through WhatsApp.

National efforts must also address stigma, so that young people feel they can seek help without fear, the healthcare professionals added.

Ms Chan May Peng, lead counsellor and senior manager at the Samaritans, said suicide ideation is more common than many realise.

It can stem from stressors and traumatic experiences at different stages of life such as childhood trauma or abuse, relationship breakdowns, employment or financial struggles, or living with a chronic illness.

Those who are vulnerable could also be suffering from social isolation and loneliness, mental health conditions, a lack of support systems, and cultural or societal stigma that discourages them from seeking help.

There could be broader influences, such as neurological or genetic vulnerabilities, or social media, in the form of cyber bullying, online harassment or platforms that may unintentionally normalise or romanticise suicide, Ms Chan said.

“The more people are aware of and willing to talk about suicide, the wider the community safety net becomes, so that no one falls through the cracks,” she said.

In Singapore, there were 434 suicide deaths in 2023, and 476 in 2022.

In 2024, the provisional number of suicide deaths was 314, but the final number will likely be higher after investigations into cases are concluded.

For instance, the provisional number of suicide deaths in 2023 was 322, a figure that was then widely reported as the lowest in two decades. However, the final figure turned out to be 35 per cent higher, at 434.

Project Hayat, the group behind Singapore’s first suicide prevention White Paper in 2024, has launched a study to better gauge the true number of suicides as a better guide for policies.

Critically, these numbers tell just part of the story.

According to the World Health Organisation, more than 720,000 people die by suicide every year, and for each suicide, there are an estimated 20 suicide attempts.

Project Hayat has called for a coordinated approach to suicide prevention, with a central body to spearhead efforts.

More On This Topic
Many of those who died by suicide showed warning signs like mood changes in week before death: IMH
The 30s are heavy: Understanding suicide among Singapore’s young adults
Spotting the warning signs
IMH, which conducted face-to-face interviews with suicide survivors for a recently concluded study, said in a Sept 17 press release that key risk factors include previous suicide attempts, having a mental health condition, ongoing physical health challenges such as greater functional limitations and insomnia, and relationship breakdowns.

Prof Mythily, the study’s principal investigator, said a significantly higher number of acute warning signs tends to appear in the week before death. These include substance abuse, a sense of purposelessness, heightened anxiety and social withdrawal.

Other signs could include changes in sleep patterns – either sleeping too much or too little – and saying things like “You’d be better off without me”, said Ms Charlene Heng, deputy director of SOS Academy, the training wing of the Samaritans.

Prof Chong, the co-investigator of the IMH study, said: “Look out for someone talking about death, feeling like a burden, or saying they have no future. Notice if they are searching online for ways to harm themselves, withdrawing from friends, school or work, or showing severe insomnia, agitation or reckless behaviour.

“Red flags include extreme agitation, or, paradoxically, a sudden calmness after a period of great distress, which can mean they have made a decision to kill themselves.”

Mr Alex Yeo, executive director of suicide prevention charity Caring for Life, said that one warning sign is the act of posting farewell messages on social media.

These can be very short. For instance, someone might send a message to his friends on social media, expressing gratitude for their support, and ending it with “but I think it’s time for me to rest”.

“How many people actually realise that this is an indirect cry for help and you need to do the right thing to prevent a potential attempt,” Mr Yeo said.

“At the end of the day, when it comes to suicide ideation, it’s really a presenting symptom of a deeper root problem.”

A mother who lost her child
A mother in her 40s, who lost her 12-year-old daughter to suicide in 2024, said the happy-go-lucky and feisty child had shown mostly very general signs of stress, apart from one sign that she found out about only after the girl had died.

After her daughter’s death, the mother sought out her notebooks and a suicide note, and realised her child had developed a highly critical inner voice that was not expressed outwardly.

Her daughter had loved to draw and write stories, but the girl later discredited them, even writing “failed” in a huge font across one of them.

Despite being of average height, the child lamented that she was short, and her lethargy, likely due to depression, fuelled her belief that she was lazy. She did not own any devices, but would secretly sneak the common phone or tablet into her room to read manga or watch anime at night.

She looked tired in the day and would doze off, which was something that did not happen before, said the mother, who started attending counselling sessions by the Samaritans, as well as its support groups, after the organisation reached out to her through its suicide survivors programme.

The mother noted from her daughter’s writings that the child would binge to “take care” of her mental health, but she had thought her child’s good appetite was a sign that she was growing.

A school journal showed that she would draw a lot when she was sad or angry, and she produced her most vivid drawings in the months before her death.


Going through that book after her child’s death, the mother found writings about how she did not seek help for a big challenge because she thought that she could manage on her own, and had doubts that talking to others would help.

And so, the child hid her struggles from her family well.

“The challenge is how we, as parents, can discern between signs of depression and behavioural traits typical of children of her age,” said the mother.

“(For the child), there is a difference between (the) feeling (of) being loved and (the) feeling (of) being unneeded – which surfaced recently in a conversation with a suicide survivor and also my daughter’s suicide note; not sure how to address the latter, but, nonetheless, (awareness of) these aspects can be strengthened,” said the mother.

More On This Topic
1 in 4 adults in Singapore experiences mild symptoms of depression, anxiety: Study
No health without mental health: Your guide to staying well
Conversations must be held; everyone can help 
Caring for Life’s Mr Yeo emphasised that new stresses such as being scammed can lead to suicidal thoughts. He said people under severe stress may no longer be capable of seeking help, and it would be up to those around them – family, friends, colleagues and superiors – to step up.

The people closest to them can help them to re-anchor themselves and find a reason to live, and to seek help to address the deeper issue that had led to the suicide ideation, said Mr Yeo.

Action should be taken the moment suicidal thoughts are disclosed. Even if there is no plan, early intervention in the form of listening with empathy, linking the person to support, and reducing his or her isolation can dramatically lower the risk of an attempt, said Prof Chong.

The Samaritans’ Ms Heng said that, as a society, all of us can learn to spot risks earlier, and create spaces where people feel safe to talk about their struggles without judgment.

“For members of the public, it can be as simple as checking in with your community and network,” she said.

“Struggles are not always obvious, but providing an empathetic listening ear can help your friends and family feel safe about sharing these hidden troubles.”

SOS Academy offers community-based programmes, such as Be A Samaritan, where the public can learn how to support someone in a suicide crisis, Ms Heng said.

Ultimately, the key to reduce stigma around suicide is to have open discussions about it, so it becomes as normal and acceptable as talking about any other health concern, said Prof Mythily and Prof Chong.


More On This Topic
How to stop being so hard on yourself
How S’pore is transforming the mental health landscape to stem a crisis
If someone tells me he or she is feeling suicidal, what should I do?
First, do not react with panic or threaten to call the police. Stay calm and listen without judgment. Acknowledge that he or she has trusted you enough to disclose this. Ask gently if the person has a plan or the means to self-harm.
If the person has a plan or access to means, or refuses help, stay with him or her and call 995 for an ambulance, or take the person to the nearest emergency department. Call the police on 999 if safety cannot be ensured.
If there is no immediate danger, link the person to support right away: Call the Samaritans’ hotline on 1767 (24/7), or the national mindline 1771.
Ask for the person’s consent to involve his or her next of kin, refer the person to professional mental health providers, such as the Samaritans, or encourage the person to see a doctor or counsellor as soon as possible. The Samaritans offer free counselling and have free support groups for anyone who is thinking about, facing or affected by suicide.
Avoid minimising the person’s pain by saying “I have gone through much worse” or offering quick fixes (“This will pass before you know it”). The most powerful thing you can do is stay present and keep the person safe until professional help is in place.
When a child or elderly person expresses suicidal thoughts, keep him or her safe, do not leave the person alone, and get urgent professional assessment – through a general practitioner or polyclinic, or directly at IMH or the children’s emergency department. For older adults, involve caregivers and check for treatable contributors such as pain, grief or dementia.
(Source: IMH, Samaritans of Singapore)


Joyce Teo is senior health correspondent at The Straits Times and the host of ST podcast series Health Check.
Lee Li Ying is a correspondent on the health beat at The Straits Times. She has a keen interest in mental health, health technology, ageing and reproductive care.

Let’s talk about suicide


Let’s talk about suicide 

https://www.straitstimes.com/singapore/health/lets-talk-about-suicide-do-not-avoid-it


2025-09-29

SINGAPORE - Suicide is a subject which is often avoided – but that could be the last thing that someone who is expressing suicidal thoughts needs.

“When someone says, ‘I’m going to kill myself’, the usual response would be: ‘You shouldn’t say that’ and it shuts them down,” said Rui (not his real name), who is in his 30s and has struggled with suicidal thoughts.

Helplines

Mental well-being

  • National helpline: 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)

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

Online resources

Rui, who attends meetings with the Light in the Dark support group launched by Samaritans of Singapore, said he wishes people understood that suicidal thoughts are a painful, overwhelming reality for many, and not attempts at seeking attention.

“People who say ‘I’m going to end it’ are asking for help in the only way they can,” he said.

Experts say the key is to treat ideation as a signal that support is needed.

People often think that asking loved ones in distress if they are suicidal might plant the idea in their heads, when the truth is that it might actually protect them, say experts. 

There are many misconceptions around suicide, including that suicidal thoughts affect only individuals who have mental illnesses.

However, they can also occur in people who have not been formally diagnosed with a mental health condition, or, at least, are not known to have had a mental illness before their deaths, said Associate Professor Mythily Subramaniam, assistant chairwoman of the Institute of Mental Health’s (IMH) medical board for research.

“In these cases, the trigger may be a major life event like humiliation, loss, failure or conflict, combined with poor coping resources, social isolation or a sense of being utterly overwhelmed,” she said.

The risks may be even greater for adolescents.

A February study by KK Women’s and Children’s Hospital (KKH) found that young patients who had tried to hurt themselves typically did not have serious mental health disorders, but instead had psychosocial problems and emotional regulation difficulties.

The study looked into the psychosocial stressors and risk profiles of adolescents who visited KKH’s emergency department for suicidal or self-harm attempts from January to December 2021. The authors reviewed 221 medical records of patients aged 10 to 19.

The most frequently observed mental health challenges were stress-related and emotional coping difficulties, which were present in 50.7 per cent of patients, and mood and anxiety symptoms, present in 53.4 per cent of patients.

Left unassisted, their mental health distress can rapidly escalate and manifest in behaviour that is a risk to themselves, the authors of the study said.

Awareness and prevention a whole-of-society effort

Bringing the topic of suicide into the open has become paramount, as it remains the leading cause of death among young people aged 10 to 29 for the sixth consecutive year. 

It is one of the most urgent public health challenges for Singapore, said Prof Mythily.

The issue requires a whole-of-nation approach, with a lead agency to coordinate proven prevention efforts, training for the community to recognise warning signs, and continued research funding to find better ways of preventing it, she said.

Both Prof Mythily and Professor Chong Siow Ann, a senior consultant at IMH’s Research Division and Department of Psychosis, said that those who come into contact most often with youth, such as teachers, national service (NS) officers, human resources staff and community volunteers, should be better trained to recognise the warning signs if someone is at risk.

Schools, NS units and workplaces should also provide stronger support to those affected by a suicide to reduce risk and promote healing.

Prof Mythily and Prof Chong recently concluded a study where suicide survivors were interviewed.

They said mental health hotlines such as the Samaritans’ hotline 1767 and the national mindline 1771 should have youth-friendly chat and text options, as these are young people’s preferred communication channels. Currently, the two hotlines offer a text option only through WhatsApp.

National efforts must also address stigma, so that young people feel they can seek help without fear, the healthcare professionals added.

Ms Chan May Peng, lead counsellor and senior manager at the Samaritans, said suicide ideation is more common than many realise.

It can stem from stressors and traumatic experiences at different stages of life such as childhood trauma or abuse, relationship breakdowns, employment or financial struggles, or living with a chronic illness.

Those who are vulnerable could also be suffering from social isolation and loneliness, mental health conditions, a lack of support systems, and cultural or societal stigma that discourages them from seeking help.

There could be broader influences, such as neurological or genetic vulnerabilities, or social media, in the form of cyber bullying, online harassment or platforms that may unintentionally normalise or romanticise suicide, Ms Chan said.

“The more people are aware of and willing to talk about suicide, the wider the community safety net becomes, so that no one falls through the cracks,” she said.

In Singapore, there were 434 suicide deaths in 2023, and 476 in 2022.

In 2024, the provisional number of suicide deaths was 314, but the final number will likely be higher after investigations into cases are concluded.

For instance, the provisional number of suicide deaths in 2023 was 322, a figure that was then widely reported as the lowest in two decades. However, the final figure turned out to be 35 per cent higher, at 434.

Project Hayat, the group behind Singapore’s first suicide prevention White Paper in 2024, has launched a study to better gauge the true number of suicides as a better guide for policies.

Critically, these numbers tell just part of the story.

According to the World Health Organisation, more than 720,000 people die by suicide every year, and for each suicide, there are an estimated 20 suicide attempts.

Project Hayat has called for a coordinated approach to suicide prevention, with a central body to spearhead efforts.

Spotting the warning signs

IMH, which conducted face-to-face interviews with suicide survivors for a recently concluded study, said in a Sept 17 press release that key risk factors include previous suicide attempts, having a mental health condition, ongoing physical health challenges such as greater functional limitations and insomnia, and relationship breakdowns.

Prof Mythily, the study’s principal investigator, said a significantly higher number of acute warning signs tends to appear in the week before death. These include substance abuse, a sense of purposelessness, heightened anxiety and social withdrawal.

Other signs could include changes in sleep patterns – either sleeping too much or too little – and saying things like “You’d be better off without me”, said Ms Charlene Heng, deputy director of SOS Academy, the training wing of the Samaritans.

Prof Chong, the co-investigator of the IMH study, said: “Look out for someone talking about death, feeling like a burden, or saying they have no future. Notice if they are searching online for ways to harm themselves, withdrawing from friends, school or work, or showing severe insomnia, agitation or reckless behaviour.

“Red flags include extreme agitation, or, paradoxically, a sudden calmness after a period of great distress, which can mean they have made a decision to kill themselves.”

Mr Alex Yeo, executive director of suicide prevention charity Caring for Life, said that one warning sign is the act of posting farewell messages on social media.

These can be very short. For instance, someone might send a message to his friends on social media, expressing gratitude for their support, and ending it with “but I think it’s time for me to rest”.

“How many people actually realise that this is an indirect cry for help and you need to do the right thing to prevent a potential attempt,” Mr Yeo said.

“At the end of the day, when it comes to suicide ideation, it’s really a presenting symptom of a deeper root problem.”

A mother who lost her child

A mother in her 40s, who lost her 12-year-old daughter to suicide in 2024, said the happy-go-lucky and feisty child had shown mostly very general signs of stress, apart from one sign that she found out about only after the girl had died.

After her daughter’s death, the mother sought out her notebooks and a suicide note, and realised her child had developed a highly critical inner voice that was not expressed outwardly.

Her daughter had loved to draw and write stories, but the girl later discredited them, even writing “failed” in a huge font across one of them.

Despite being of average height, the child lamented that she was short, and her lethargy, likely due to depression, fuelled her belief that she was lazy. She did not own any devices, but would secretly sneak the common phone or tablet into her room to read manga or watch anime at night.

She looked tired in the day and would doze off, which was something that did not happen before, said the mother, who started attending counselling sessions by the Samaritans, as well as its support groups, after the organisation reached out to her through its suicide survivors programme.

The mother noted from her daughter’s writings that the child would binge to “take care” of her mental health, but she had thought her child’s good appetite was a sign that she was growing.

A school journal showed that she would draw a lot when she was sad or angry, and she produced her most vivid drawings in the months before her death.

Going through that book after her child’s death, the mother found writings about how she did not seek help for a big challenge because she thought that she could manage on her own, and had doubts that talking to others would help.

And so, the child hid her struggles from her family well.

“The challenge is how we, as parents, can discern between signs of depression and behavioural traits typical of children of her age,” said the mother.

“(For the child), there is a difference between (the) feeling (of) being loved and (the) feeling (of) being unneeded – which surfaced recently in a conversation with a suicide survivor and also my daughter’s suicide note; not sure how to address the latter, but, nonetheless, (awareness of) these aspects can be strengthened,” said the mother.

Conversations must be held; everyone can help 

Caring for Life’s Mr Yeo emphasised that new stresses such as being scammed can lead to suicidal thoughts. He said people under severe stress may no longer be capable of seeking help, and it would be up to those around them – family, friends, colleagues and superiors – to step up.

The people closest to them can help them to re-anchor themselves and find a reason to live, and to seek help to address the deeper issue that had led to the suicide ideation, said Mr Yeo.

Action should be taken the moment suicidal thoughts are disclosed. Even if there is no plan, early intervention in the form of listening with empathy, linking the person to support, and reducing his or her isolation can dramatically lower the risk of an attempt, said Prof Chong.

The Samaritans’ Ms Heng said that, as a society, all of us can learn to spot risks earlier, and create spaces where people feel safe to talk about their struggles without judgment.

“For members of the public, it can be as simple as checking in with your community and network,” she said.

“Struggles are not always obvious, but providing an empathetic listening ear can help your friends and family feel safe about sharing these hidden troubles.”

SOS Academy offers community-based programmes, such as Be A Samaritan, where the public can learn how to support someone in a suicide crisis, Ms Heng said.

Ultimately, the key to reduce stigma around suicide is to have open discussions about it, so it becomes as normal and acceptable as talking about any other health concern, said Prof Mythily and Prof Chong.

If someone tells me he or she is feeling suicidal, what should I do?

  • First, do not react with panic or threaten to call the police. Stay calm and listen without judgment. Acknowledge that he or she has trusted you enough to disclose this. Ask gently if the person has a plan or the means to self-harm.
  • If the person has a plan or access to means, or refuses help, stay with him or her and call 995 for an ambulance, or take the person to the nearest emergency department. Call the police on 999 if safety cannot be ensured.
  • If there is no immediate danger, link the person to support right away: Call the Samaritans’ hotline on 1767 (24/7), or the national mindline 1771.
  • Ask for the person’s consent to involve his or her next of kin, refer the person to professional mental health providers, such as the Samaritans, or encourage the person to see a doctor or counsellor as soon as possible. The Samaritans offer free counselling and have free support groups for anyone who is thinking about, facing or affected by suicide.
  • Avoid minimising the person’s pain by saying “I have gone through much worse” or offering quick fixes (“This will pass before you know it”). The most powerful thing you can do is stay present and keep the person safe until professional help is in place.
  • When a child or elderly person expresses suicidal thoughts, keep him or her safe, do not leave the person alone, and get urgent professional assessment – through a general practitioner or polyclinic, or directly at IMH or the children’s emergency department. For older adults, involve caregivers and check for treatable contributors such as pain, grief or dementia.

(Source: IMH, Samaritans of Singapore)

  • Joyce Teo is senior health correspondent at The Straits Times and the host of ST podcast series Health Check.
  • Lee Li Ying is a correspondent on the health beat at The Straits Times. She has a keen interest in mental health, health technology, ageing and reproductive care.