Hansard Explorer

Ms Jessica Tan Soon Neo asked the Coordinating Minister for Social Policies and Minister for Health with the redesignation of the Institute of Mental Health as the National Centre for Mental Health Singapore in 2027 (a) what other policy gaps remain in protecting youths and adults seeking mental health support, particularly around disclosure practices in schools, workplaces and insurance contexts; and (b) how safeguards will be strengthened to reduce stigma and deter care avoidance.

The Coordinating Minister for Social Policies and Minister for Health (Mr Ong Ye Kung): Concerns about confidentiality, stigma and possible discrimination are barriers to individuals seeking mental health support. Young people, in particular, may hesitate to seek help because they fear being judged or disadvantaged. They are concerned that it would leave a permanent mark on their records which may, in turn, affect their future employment or educational opportunities.

Public Service agencies do not ask applicants about their mental health conditions, unless the nature of the job requires this, such as for a Republic of Singapore Air Force (RSAF) pilot or a uniformed serviceman, which specifically require a medical assessment of whether the applicant can carry out his or her duties safely.

The Workplace Fairness Act, which will come into effect later next year, will strengthen protections across more employers. The Act will disallow employers from making adverse employment decisions based on one's mental health conditions, unless there are genuine, job-related requirements.

The same principle applies to healthcare and schools. Medical and counselling records are kept for a professional reason, to help healthcare professionals and school counsellors understand the young person's history to provide better care and better support. Our healthcare institutions and schools will continue to rigorously safeguard patient and student confidentiality, and the information will not be used to disadvantage the patient in academic or employment pursuits or when buying insurance.

Parental consent is closely linked to confidentiality, which is another important consideration when young people seek help. Today, practices around parental consent vary across schools, community services and healthcare settings. Schools provide counselling support to students with consent from their parents. The national mindline 1771 allows callers to stay anonymous. Young people who seek help from community care organisations can request for parents not to be informed, although counsellors will always advise that parents will need to be involved at some point of the treatment and recovery journey. So, the practices are not uniform across settings.

For some young people, concerns about involving their parents may make them hesitant to seek counselling support. The Ministry of Health (MOH) is therefore developing a set of guidelines to provide clearer guidance on this. The aim is to give a young person a safe way to seek initial help, while involving the family at the right time as care progresses. A young person stepping forward to seek help should not have to worry that their parents will be informed immediately.

Our key consideration must always be the well-being of the young person. We will be seeking the public’s views on our proposed guidelines. Our aim is to ensure that concerns about confidentiality do not become barriers to seeking appropriate mental health support.

Mr Speaker: Ms Tan.

Ms Jessica Tan Soon Neo (East Coast): I thank the Minister for the answer and assurance. I do have some supplementary questions. Can the Minister elaborate on whether there are remaining gaps in disclosure requirements across schools, workplaces and insurance applications that will inadvertently discourage individuals from seeking help early, and whether the Government is reviewing these practices? I do hear you that there will be guidelines that will be proposed, but could the Minister just share his views if there are still existing gaps?

At the same time, will the Minister consider strengthening the safeguards around collection, use and disclosure of mental health information to ensure that such information is only requested when genuinely relevant and proportionate to the circumstances?

And my final supplementary question is can more be done to encourage schools, employers and insurers to adopt evidence-based approaches that focus on an individual's current functional abilities and recovery, rather than relying on broad assumptions arising from a history of mental health treatment? I think this is one of the biggest concerns that many young people have in terms of seeking treatment early, because of the possibility of the implications of the information being used later.

Mr Ong Ye Kung: Thank you. All three supplementary questions are related, so I will try to answer them together. I mentioned some of the gaps, which is the Workplace Fairness Act, that will come into force only at the end of next year. So, in the meantime, we have a gap.

But I would say the biggest gaps, there are a few. One, I would say is assurance, and whatever answer I just gave just now may hopefully sound assuring, but out there people do not know all this. People do not know that the Public Service, as a practice, do not ask for mental health conditions. That has been the practice and I checked with the Public Service Division.

The Monetary Authority of Singapore, for example, has also assured us when we spoke to them, that actually a high percentage of insurance applicants, despite declaring that they have a mental health condition before, have gotten their life insurance and critical illness insurance. This information is also not out there.

So, I think the assurance and the information dissemination is one gap that I would say we need to work on.

The other gap is what I mentioned in my reply. Parental consent is actually a gap. Today, there is no uniform practice across settings. I think we need the entire support community, including schools, community care organisations, hospitals, clinics to come to a consensus that there has to be a set of guidelines that we can all adhere to.

I think once we achieve that and we can communicate that with young people especially, it will provide a higher-level assurance that it is safe to step forward.

It is not that young people do not want to get better. They are sometimes just afraid and worried that they do not want their parents to know first. They want to seek help at the initial stage, and then at the right time, involve their parents. And I hope parents can understand that too. That consensus, I think, is a significant gap that we must close.