Mental Health at a National Level

Opening Keynote Address, Wellbeing@Work Summit Singapore, 16 Sep 2020

Good morning everyone! I’m delighted to be here with you for this first Wellbeing@Work Summit in Singapore.

Since we are here to discuss wellbeing, why don’t we start off the day with doing a quick check-in with ourselves? What are you feeling right now?

Thank you for that, I encourage you to do this with yourself often and also when you hold meetings — it’s a small step towards acknowledging that emotions have a place in the workplace and our society. And that we are not alone in what and how we feel. This word cloud hopefully helps us all to see, and therefore feel, that we are coming together in this virtual room. It’s a visual assurance of our presence here together — and its going to stay here through my sharing.

And now, in the spirit of mental wellness, can I also invite you to take 3 deep breaths together with me?

I was holding deep gratitude in my meditation earlier. Because I would not have, in a million years, thought that that deep dark place that I was in 14 years ago from a broken heart, a broken marriage and a broken business leaving me with only $16 would set me off on an unexpected trajectory that would lead me to be here with you today.

Nor could I imagine being in the Parliament of Singapore as a parliamentarian for the last two years championing relentlessly for mental wellbeing to be a whole-of-government and whole-of-society priority, and for mental healthcare policies to address stigma and discrimination. Including keeping the mental health impact of Covid-19 front and centre in Parliament as we debated across so many issues to pass 4 budgets worth a $100bil within a space of 4 months!

Or that in May 2018, 25 C-suite leaders and I would come together to form the WorkWell Leaders Workgroup because we were convinced (and now prescient) that mental health must be a strategic priority at the workplace — and not merely about HR policies and programmes, if we are to be adaptive as organisations to an emerging future that’s increasing more volatile, more ambiguous and more uncertain.

We meet quarterly to share and co-create inclusive practices but I’m most heartened by our closed-door half yearly CEO dialogue series which really reinforces our mission to create change at the highest level. CEOs and leaders come together in a safe space to learn with, and learn from each other as well as take actions as a collective to influence systemic changes whether in their sectors and/or their organisations in mental health. These dialogues support the deep leadership work needed on the part of CEOs and leaders to go beyond discussing hard-nosed strategies (which we do too) to bring about the empathy and cultural shifts needed to address stigma and discrimination of mental health in the workplace.

In our last CEO Dialogue two months ago, we had almost 70 C-suite leaders — 35 CEOs and top leaders across the private, people and public sectors accompanied by their plus-ones who are COOs, CHROs and heads of diversity & inclusion. Including the likes of DBS Group CEO Piyush Gupta and business luminary, Hsieh Fu Hua.

Before I go further, let’s have a quick tour of the mental health landscape in Singapore before we come back to the workplace.

One in seven persons in Singapore experience a mental health condition in their lifetime, and this is a conservative figure because this 2016 national mental health study by Institute of Mental Health only focused on certain psychiatric conditions, and of course it was pre-COVID. Globally, this number is one in four persons. Will we head there? I think we already are with Covid-19, especially when we consider the higher risk groups such as youths, low wage workers, single mothers, caregivers, persons with disabilities and the LGBTQIA+. We saw more than one suicide daily and recorded a total of 400 suicides in 2019, with those in their 20s being the highest compared to other age groups. I have to caution here that not every death by suicide is reported as suicide — those whose families chose for different reasons to state their cause of death as ‘fall from height’ or ‘unnatural causes’ would not have added to the official suicide numbers. So the reality of suicide could be more dire.

What have we done as a country? Singapore thankfully shifted our narrative of mental health from a medicalised approach to a community-based one in 2012 with our Community Mental Health Master Plan. This meant that mental health clinics were added to polyclinics and primary care providers were trained to provide first level response. The Agency for Integrated Care (AIC) under the Ministry of Health was appointed in 2017 as the national first level response centre for mental health. A national anti mental health stigma campaign called Beyond the Label was launched in 2018 by the National Council of Social Sevice to help address the deep issue of stigma, discrimination and prejudice. Since 2019, the Tripartite Oversight Committee on Workplace Health co-chaired by the Minister of Health and Minister of Manpower have been including mental health in their workplace health promotion strategies. I am an appointed member of this Committee by the good ministers. The Ministry of Manpower will be relaunching a national work stress assessment tool called iWorkHealth sometime before the end of this year. Requesting a job applicant’s mental health history — an archaic practice that I raised in Parliament, was finally deemed discriminatory by the Tripartite Alliance for Fair Employment since Dec 2019. Suicide was also finally decriminalised as of 1 Jan this year. Our progress is laudable, especially in the last 3–5 years.

Yet, we spent only 3% of our healthcare operating budget on mental healthcare in FY2017 compared to 11% for diabetes. We are one of the high income member countries of WHO that have not committed to a national suicide prevention strategy. Unlike countries such as Germany, Australia and Finland, we do not include psychological health and safety in our Workplace Safety & Health Act. A systemic change in mental health insurance has been slow to come to Singapore which we know will have a direct impact on affordability of mental health care and support, as is the disparity we still have in our Medisave and Medishield claims for psychiatric treatment compared to physical health treatments which we must rectify urgently. Much to be done, why I’m heartened that in response to my recent budget speeches on mental health, the Government has promised that it will be doing a whole-of-government review of mental health policies before the end of this year.

So what can we do as leaders and employers? I won’t go into discussing the many inclusive practices and innovative programmes because I’m sure you will hear and learn about these from my fellow speakers today.

Instead, I would like to honour this opening keynote by challenging you with two big questions to imagine new possibilities for wellbeing at work as leaders. (Truth be told, this is my way of telling you I’m no expert and I’m a big fan of big questions for wicked problems as a leadership coach!)

First, what is the personal change that you would commit to make as leaders in supporting the wellbeing of your employees?

Our reflex response is often to look at solutions outside of ourselves, but what if we are also the solution?

In a recent study by Profile Asia, nearly one in two working in Singapore reported that their mental health had been adversely affected by COVID-19. This point to change needed, to a new workplace culture for a new wellbeing norm.

If I could see you and ask you who wants change, I am very confident that most of your hands will be raised! But what if I ask you who wants to change?

It’s a bitter pill to swallow but I know we are astute enough to acknowledge that, as leaders, we contribute to that culture that’s still not safe for vulnerabilities to be shared, that’s still not encouraging help-seeking and that’s probably still not mental health-friendly.

It was with this in mind that we designed our last CEO Dialogue to ask these hard questions. Countless leadership models focus on a leader’s role as setting visions and priorities, driving strategies, influencing others and making things happen (well, we do get paid to do all that!). But Gallup’s extensive research across 10,000 employees worldwide found that what followers need from their leaders are quite different from what leaders think they should be. These needs are: trust, compassion, stability and hope.

Yes, as employers, we would understandably focus on downstream measures such as tertiary interventions like EAP and counselling therapy or secondary interventions like stress management or mindfulness training. But when we don the hat of leaders, then it becomes plain clear that meeting these four needs of our followers especially in the face of Covid-19 would be a critical upstream (or primary) intervention that will help bring about mental wellbeing for our people.

This is hard to do because we ourselves would then have to change! What or who do we need to be to build trust, show compassion, provide stability and inspire hope? What makes us lose sight of these as leaders?

A senior partner in a global consulting firm I know who leads a US$1bil business bravely shared his experience with generalised anxiety disorder in a company town hall. At a session prior to the CEO dialogue, Piyush Gupta, CEO of DBS Group openly offered his personal experience with mental health difficulties, how he sought professional help. He made significant changes in his life especially in self care and translated this mental health journey into how he now leads the largest bank in Asia with mental wellbeing at the top of his mind.

Change requires courage, vulnerability may be the only true gauge of strength. I think coming forward and sharing our own experiences really help open up that space of trust for our employees to know that having mental health difficulties doesn’t mean they are less. We help break the stigma, give hope and encourage help-seeking. But I also think we become better leaders in the process as we become more at ease with who we are. Yes, I strongly believe that we are at our most powerful the moment we no longer need to be powerful.

The other big question for you is this. Instead of passively accepting that the workplace is the cause of stress, anxiety and mental ills and finding solutions around this problem definition, what would it look like if we reframe it is a source of positive mental health for our society?

No, I’m not referring to billiard tables and well-stocked pantries that are in themselves commendable in instilling fun at the workplace and creating a sense of community. I’m challenging us to paradigm-shift from incremental workplace adjustments to seeing every employee as a whole person beyond what they do and who they are in the workplace. In other words, how can we proactively support every employee in the different roles that they play in their families and communities so that they leave work with the best of themselves to give to their world, not what’s left of them? This means they are in the best state of mental health when they are with their loved ones because of their time at work and the workplace.

Sounds far-fetched? Maybe not. Some of the CEOs I know are beginning to embrace with this mental wellbeing paradigm shift. They focus on the ‘human’ part of human resources and human capital, not ‘resources’ or ‘capital’. At the height of Covid-19 lockdown when schools moved online, one large multinational energy company started providing workshops on home schooling skills and specific counselling support for employees with young children, including the children. They plan to continue this beyond Covid-19 with parenting capacity programmes for new parents and parents with young children. Another global consulting firm has also begun designing and implementing comprehensive support structures for employees who are caregivers of elderly with special needs. And one of the world’s largest pharmaceutical companies (and many others too) engaged Hush TeaBar to do a regular series of silent tea reflection sessions led by our Deaf/hard of hearing facilitators and supported by persons living with mental health conditions to cultivate self care and empathy. So coming to work becomes a source of positive mental health for these employees as the workplace supports them to better show up for the other aspects of their lives, beyond work. (A quick plug — Hush is a social enterprise I’m involved with, and we have a virtual booth here in this summit so please drop by and say hello to my teammates)

A recent study in the January/February 2020 issue of The Journal of Clinical Psychiatry confirmed that respondents who believed they had meaning in their life had better physical and mental health scores and higher cognitive function compared with those who didn’t. As I’m saying this, I am reminded of the poem by Khalil Gibran — work is love made visible. I see this to mean that we should be able to define our work as a visible product of our personal passion. This doesn’t mean we necessarily have our dream jobs but it does mean that we can carve out the space in what we do to express our passion within the workplace. In other words, how can we enable employees to realise, beyond career goals, their deeper human aspirations of meaning and purpose?

How audacious, you might say, to imagine this possibility that we could have workplaces where meaning can be found! But why not? Why can’t workplaces be where individuals thrive as whole persons? My team mate at A Good Space was suggesting this paradigm shift to me the other day: instead of ad-hoc food or goodie bag distribution to charities, why can’t a large fast food chain invest in and empower their low-wage employees to come up with solutions for their own communities — the workplace then offers not just a job, but meaning and dignity and therefore better mental health outcomes? A Good Space, by the way, is Singapore’s first co-operative of community changemakers where we also work with employers to inspire their employees to be changemakers in solving community problems.

It’s always impossible until it is done. So what personal change will you make as part of the solution to this complex challenge of workplace mental wellbeing, and what would the workplace look like if it is to be a source of positive mental health for our society? These two big questions might seem audacious and impertinent now but I would remind us all to recall how convinced we once were that flexible work arrangements could never be mainstreamed for productivity and other reasons until this tiny virus called Covid-19 showed us otherwise.

That night 14 years ago, as I laid down on the floor with only $16 in my bank account, I was so awashed with shame and despair that for a fleeting moment, I even contemplated the distance between the big windows of my 18th floor apartment and the ground below. It seemed impossible then to get out of that deep dark place but I did because of the support system and inner resources I had, and still have. Everybody deserves that but not everyone has that.

There is no health without mental health. We are responsible for each other’s mental wellbeing which is not a fixed state but a continuum, because well, we are humans and life gives us different experiences through the course of our time here. In Covid-19 and beyond, mental health is workforce health.

Because every employee is a member of society, the position we have as leaders is therefore a privilege and a responsibility to build the kind of society we want to live in by how we support our employees to thrive as whole persons at work and in their community. This is more important today than ever because how we lead through disruptions in the face of Covid-19 will determine how we can support our employees and organisations, and therefore our society, to emerge stronger, and build back better.

May we commit to being unwavering on wellbeing as our fundamental responsibility — to ourselves, our employees and our community. May I wish you a fruitful conference ahead.

Thank you for having me, Chris and thank you all kindly for listening. May you stay safe and be well. _/\_

Anthea Ong is the former Nominated Member of Parliament for the 13th Parliament of Singapore. In her term as NMP between 2018–2020, she spoke on behalf of youth activists and sex workers, proposed a national suicide prevention strategy, conducted a public consultation on the mental health landscape, made recommendations for closing our digital divide and advocated for greater work injury compensation and other forms of support for migrant workers (you can find all her speeches on her Medium account and the Wikipedia that her supporters set up for her :)).

Anthea is also a full-time social entrepreneur, having founded and co-created several ground-up initiatives/impact businesses, including Welcome in My Backyard, Hush TeaBar, the WorkWell Leaders Workgroup, A Good Space, Playground of Joy, and Project Yoga-on-Wheels. She also served as the president of the Women’s Initiative for Ageing Successfully (WINGS) from 2010 to 2017, which helps women embrace ageing with confidence, and was the Founding Board Member of Daughters of Tomorrow, a registered charity that provides individualized coaching to vulnerable women.

Prior to social entrepreneurship, Anthea held leadership roles with multinational organisations including Pearson Plc, New York Institute of Finance, The Terrapinn Group and United Overseas Bank, where she expanded and solidified market leadership positions. She founded the Singapore-based education and technology consultancy, Knowledge Director Group, which advised governments in developed Asian economies on education transformation and innovation strategies in addition to being an inventor for an award-winning educational technology application. Most recently, she was the regional Managing Director with Omega Performance Inc., a strategy consulting group for banks & financial institutions based in Washington DC, where she double-hatted as the Asian Lead of the Global Corporate Responsibility Board for its parent company, Informa Plc.

She is a published author for the anthology “My Story. My Life” by National Library Singapore, and author of 50 Shades of Love, a unique wood-cover book memoir with life coaching questions and trees.

Anthea is also a professional certified coach with the International Coach Federation, and has served over 50 clients from all around the world. She is also a certified yoga instructor and reiki practitioner, and an avid traveller to off beaten tracks like Antarctica, Mt Everest Base Camp and Siberia.

A full-time human, and part-time everything else.