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More than one in seven people in Singapore will experience mental health issues at some point in their lives — depression, obsessive compulsive disorder (OCD) or anxiety disorder — to name a few.

These are medical conditions that require appropriate intervention from professionals. But professional help isn’t always available 24/7. Often, a large part of the recovery process for a person dealing with mental health issues falls on their caregivers, such as family members and friends.

But caregivers themselves need support in a journey that could be long and exhausting. So, who will care for the caregivers?

Caregivers Alliance (CAL) is a non-profit organisation that supports caregivers of people with mental health issues. It does this through education, support networks, crisis support, tailored services and self-care enablement.

For example, CAL runs many free Caregivers-to-Caregivers (C2C) programmes to equip caregivers with the knowledge and skills to care for their loved ones and themselves. Many of the caregivers who benefited from this support have, in turn, become volunteers themselves.

Today, volunteer trainers and volunteer peer-support leaders lend their experience towards helping caregivers look after themselves.

From victim to volunteer

Caregivers Alliance Limited
Image source: Oorja Menon

Oorja Menon was a victim of bullying when she was in secondary school. This affected her self-image and self-esteem and she developed long-term effects of depression, such as irritability, constant poor moods and insomnia. At the same time, she found herself having to support her peers who were also experiencing anxiety and depression.

Now 22 and in her third year at university, Oorja recounts about her life then: “I had some friends who were dealing with issues like gender identity, depression, anxiety and eating disorders. They would text and talk to me. But I was also dealing with my own issues, and needed time and space to process my feelings.”

She says she considered seeing the school counsellor but decided against it because of the stigma, turning instead to online sources of help.

“Initially, I managed on my own. I did my own research and got help from social media, where there was a lot of self-help content available. I took small steps to help myself. Having a positive foundation helped give my mind that mini boost to keep improving.”

Oorja shares about how she dealt with her depression: “I did not want face-to-face sessions, so I turned to online counsellors, self-help content and trauma work practices like journalling and re-writing narratives.”

Nevertheless, she admits that there’s no one-size-fits-all solution to dealing with mental wellness issues and it wasn’t an easy path that she chose.

She says: “It can be really hard and lonely to help yourself out of depression, and some people might not have the ability to do it especially if their trauma is even stronger, which is why it is so important to seek help, even if you think you don’t need it.”

Caregivers Alliance Limited
Image source: Oorja Menon

Going through her mental health challenges and learning about it gave her a passion about mental health.

“I saw opportunity in helping people, spreading awareness about mental health conditions, and wanting to be there to share and learn more from both similar and different experiences.”

When she was 20, Oorja joined Youth Corps Singapore. She was involved in a leadership programme there when she found out about CAL. With the help of some friends, she started a C2C programme for youths.

“At CAL, we developed lessons in our roles as caregivers. To prepare to be trainers, we underwent programmes to learn about mental health conditions and coping strategies.”

She has been volunteering at CAL since 2019, training others in the C2C youth group, which caters to people from ages 17 to 35.

“CAL has equipped me to respond to others more effectively. I have a passion to help youths like myself. It can be really lonely when you think that no one understands you. Sometimes, people need a listening ear more than they need a solution to their problems.”

So, who attends the C2C classes that Oorja volunteers at?

She explains: “Most attendees have loved ones with mental health issues. They want to understand why their loved ones are behaving the way they do, and what they can do as caregivers. Most youths don’t know how to respond to people with mental health conditions. The programme at CAL offers a lot of strategies to help in this area.”

And helping out at these classes has taught Oorja the importance of self-care.

She tells The Pride: “I have learned to recognise and accept it when I have a problem. This leads me to the next step of finding a way to manage it. If I need a break, I set aside time for myself. This self-care helps me be a better peer supporter.”

Looking back at the time in secondary school when she was reluctant to seek help from a counsellor, Oorja says: “There is still a stigma associated with admitting to having mental health issues but youths are becoming more comfortable with talking about it.

“Those I’ve met at CAL are keen to learn and not afraid to share their own stories and experiences with mental health issues. Seeking help is not a weakness. When you seek help, it shows strength of character and it helps you become a better version of yourself.”

Course prepared her to help her own parents

Caregivers Alliance Limited
Image source: Shutterstock / kazoka

Han Bi Guang, 49, recognises that everyone is susceptible to mental health issues.

In 2018, when a friend told her about a course for caregivers to persons with mental health issues (PMHI) at CAL, Han decided to attend it to further equip herself.|

She wasn’t a caregiver then, but Han, who is taking a course in health coaching, is no stranger to volunteer work.

Not long after that, her 81-year old father was diagnosed with Alzheimer’s.

Her 72-year-old mother was his primary caregiver and this took a toll.

Says Han: “People around them saw that she was burning out. She was irritable and grew impatient easily. She would call my siblings and start crying over the phone, and she was uncharacteristically harsh with her words. Covid made things worse because my parents were cooped up at home — it was just the two of them.”

Seeing that her mother was experiencing burnout, Han decided to step in as a secondary caregiver to relieve her mother as well as help give her father the care that he needed.

Fortuitously, Han had completed the C2C course before things escalated at home, which allowed her to care for her father and support her mother properly.

This included identifying caregiver support groups for her mother to attend. Instead of taking on the caregiving load herself, Han also kept her two brothers updated on the situation with their parents and shared tips on how she thought they could contribute.

Caregivers Alliance Limited Dementia Programme
Caregivers attending the C2C-Dementia 8-week programme at CAL’s office in Feb 2021. Image source: Han Bi Guang

She also suggested they go for caregiver training, thus increasing the number of people in the family who could help care for her father. All these steps helped to lighten the load on their mother.

Caring for her father gave Han a firsthand experience of what many caregivers go through when supporting loved ones with mental health issues.

She says: “My dad’s behaviour changed. He would forget what he said a short while ago and would repeat his comments many times within a short period.”

This can be extremely stressful and frustrating for the caregiver but her training at CAL kicked in. “I recognised that these are some of the challenges that both parties would face,” she explains. “My dad did not even realise that he had asked the questions many times. I had to remind myself that he is having a difficult time, and as the caregiver, I am in the position to support him.

“Instead of getting upset with him, I would prompt him, ‘Dad, what did you just ask? What was my reply?’ I believe he has the capacity and ability to answer my question and when he is able to remember, he feels encouraged.”

Han, who is now a volunteer trainer for CAL’s 12-week C2C PMHI programme and the 8-week C2C Dementia programme, shares about how she grew in her caregiving journey.

She tells The Pride: “Caregiving can be a rewarding journey. Growing up, my dad would talk to me about life. Now that he has Alzheimer’s, he is more willing to listen to what I have to say. I’ve had deep conversations with my dad, adult to adult, and he shares his inner feelings with me. This invitation into his life is something we could not have had years ago.”

“It’s a process that changes us. It isn’t about us changing the patient.”

Caring for her adult daughter with OCD

Caregivers Alliance Limited
Image source: Shutterstock / Asia Images Group

Christine Lim, was taken aback when her middle child displayed a perfectionist streak in school when she was young. She was eventually diagnosed as having obsessive-compulsive disorder (OCD) after secondary school.

After her daughter’s O-levels, she fell into a funk and Christine had trouble understanding her condition at first.

The 61-year-old recalls: “We’d always emphasised to our children that they are loved for who they are. There was no pressure to be perfect.”

Christine later found ways to help her daughter, now 26, by first understanding what lies behind her concerns and her behaviour. She recently found out about the courses at CAL.

She tells The Pride: “CAL helped a lot. I learned about why my daughter is the way she is and how her brain functions. I learned about needing to respect her and her space, and to work with her in what she is going through.”

Christine and her other two children — a 28-year-old daughter and 24-year-old son — do what they can to accommodate her daughter’s OCD.

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It isn’t always easy but Christine credits her trainer at CAL, who has gone through similar experiences, for helping her. “CAL training gives me information and self-knowledge to put my experiences in context. I recognise signs and symptoms highlighted during training in my own situation. This equips me to address my situation and be more effective as a caregiver.”

From feeling anxious over her daughter, Christine now feels more prepared. She says: “It is a learning process. What I learn at CAL gives me the foundation and ability to help my daughter. Knowing how to help my daughter is a breakthrough in my caregiving ability and this gives me relief in my role as a caregiver.”

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