'Your son has special needs? So do my dogs'

Living with disabilities that are not visible

In building a more inclusive society, one group finds itself overlooked. Those with learning disorders or hearing loss may not seem obviously handicapped, unlike those with physical disabilities, but they need help and acceptance, too. Insight looks at the effects of having an invisible disability.
By Kok Xing Hui, The Sunday Times, 8 May 2016

When people think about disability, the image of a wheelchair comes to mind. Even the international blue-and-white symbol signalling easy access for the disabled is that of a stick figure in a wheelchair.

Yet, there are some whose plight is overlooked - those with disabilities that are not visible.

One in 68 children in Singapore has autism, a developmental disorder, for example. Conditions such as hearing impairment cannot be "seen" either.

The issue of those with invisible disabilities - who also need help, empathy and acceptance - is timely, as Singapore is working on its third masterplan to chart the development of policies and services for people with disabilities.

And there is much work to be done, going by my recent experience in a wheelchair. Just by sitting in this obvious symbol of need, I felt vulnerability.

Imagine, then, what it must be like when you look "normal", yet are inwardly struggling with day-to-day life.

For one hour, I - a healthy 28-year-old - became an elderly woman with impaired movement, bad eyesight and poor hearing, in a wheelchair.

I was fitted out with 6kg of ankle weights. The deafness was due to ear plugs, and the poor eyesight came courtesy of some foggy sunglasses.

I had no idea what was going on, what people were saying to me, and where we were going. Worse, I was entirely dependent on my "elderly caregiver", 21-year-old Seet Kai Li - even when I needed to go to the toilet.

I was taking part in a disability simulation with 40 Singapore Management University (SMU) students in a "Managing Diversity in Asia" course, held in March.

Students spent an hour navigating the sprawling campus, wearing props to simulate what it might feel like to have disabilities.

When I told my editors about the simulation, they were concerned it might seem like a token exercise. However, it was very worthwhile in terms of developing empathy.

Moving around campus was difficult and slow, despite my group mates being SMU students who knew the buildings' orientation.

Psychology and analytics student Justin Ong, 24, said: "To use the lifts, we had to go to many corners."

The experience was also isolating and scary. Being hard of hearing made me not want to talk, but not communicating meant I was clueless about what was going on.

Yet that was just for one hour. As course instructor Ho Jack Yong said: We didn't have to think about making a home, looking for jobs, or finding a romantic partner.

'Your son has special needs? So do my dogs'
Much social stigma still blights people with hidden disabilities such as autism, where a child's behaviour may be mistaken for naughtiness, as one MP found out. Insight reports.
By Janice Tai and Kok Xing Hui, The Sunday Times, 8 May 2016

Many people know that MP Denise Phua (Jalan Besar GRC) has a son with autism, a lifelong developmental disability that affects a person's ability to make sense of the world and relate to others. But as with all families struggling with mental health conditions, theirs is often a lonely journey made worse by society's lack of understanding.

Take an incident that happened 16 years ago to Ms Phua's son, who was four at the time.

The boy saw two golden retrievers in a park and, drawn by their exuberance, went and played with them. Suddenly the dogs' owner appeared and pushed the little boy.

He fell on his face and cried. Ms Phua was shocked and asked the man why he would hit a child, especially one with special needs. The "big, burly man", as she puts it, responded flippantly: "Your son has special needs? So do my dogs!"

More than a decade later, social attitudes towards people who look outwardly normal even though they have hidden disabilities still reflect "a lot of stigma", says Nanyang Technological University assistant professor Natalie Pang.

So much so that Nominated Member of Parliament Chia Yong Yong drew awareness to disability and, in particular, people with "invisible" disorders, in a speech to Parliament last month.

Ms Chia, who has a nerve and muscular disorder and uses a wheelchair, said: "Why, then, do persons with disabilities still not feel included in our society? It cannot be that our people are not kind. Could it be that we have a lack of awareness? Could it be that there are disabilities not visible, or not perceived as disabilities? Those are disabilities that are real and hurting."

Ms Chia also gave this moving first-person account of what life is like for a person with a less visible disability: "We hope for you to be accommodating when we make strange, loud noises. We can't control our muscles... Be kind to my parents when I throw tantrums. It is not because they did not teach me well. I simply cannot comprehend my external environment."

Her comments are timely as Singapore is expected to announce its third Enabling Masterplan - a five-year national plan to chart the development of policies and services for people with disabilities - by next year.

The 2007 and 2012 masterplans made inroads in ensuring that public transport and infrastructure are accessible to people with physical disabilities. Barrier-free routes were added to train stations and bus interchanges, and plans were made to have all public buses wheelchair-friendly by 2020.

Over the last five years, the Government added early intervention services that provide therapy and educational support for infants and young children with special needs, and added more capacity to residential facilities and day-care services for adults with disabilities.

But observers say that while infrastructure and services lay the foundation for an inclusive society, a key pillar is acceptance and understanding. One impatient glare or frustrated groan when a person with a learning disorder struggles with communication can undo the work of the best urban planners.

HIDDEN DISABILITY, LESS HELP

Unlike a person in a wheelchair, or one who uses a cane or wears a hearing aid, some conditions - such as autism, attention deficit hyperactivity disorder (ADHD) and intellectual or developmental disabilities - are not immediately apparent.

With a greying population, Singapore has more seniors with some form of disability due to dementia and other chronic conditions. There is also an increasing number of younger people with disabilities due to strokes or accidents.

These less visible disabilities are a double-edged sword, says research fellow Justin Lee of the Institute of Policy Studies. "The more visible they are, the more it attracts stigma, but it also means help is more forthcoming.

"The less visible it is, the less likely help will be forthcoming, and it may even take some time before a person or his support network realises he has a condition," says Dr Lee.

While a person with a less visible disability may pass off as being more "normal", not talking about it leads to lower awareness and greater stigma.

Those with invisible disabilities also seem to face more prejudice, which increases with how personal the contact is.

A 2009 study in Britain found that people were more comfortable with a person with physical disabilities than learning or mental issues. And while half of the respondents were comfortable about a person with learning disabilities moving in next door or being in the same club, only 29 per cent would consider marrying them.

This mirrors an exploratory study that Mr Ho Jack Yong, assistant director of diversity and inclusion at Singapore Management University, conducted on 10 participants here.

"People seem to be more open when considering a person with disabilities as political office-holders, as co-workers," he says.

"But when we asked if people were comfortable with having a person with disability in their families as a potential romantic partner, all of a sudden there would be some discomfort."

However, Mr Ho notes that his participants, when asked about people with disabilities, immediately thought of physical disabilities and forgot that disabilities include mental and sensory impairments.

The president of the Disabled People's Association (DPA), Mr Nicholas Aw, says: "Without widening our understanding of the range of disabilities, we will never be able to adapt our society to include all persons with disabilities, and those with invisible disabilities will continue to be left behind."

WHAT IS A DISABILITY?

One difficulty in getting people to recognise or be aware of less visible disabilities stems from a lack of consensus on what constitutes disability. Even the authorities previously did not acknowledge some conditions as disabilities when deciding who is eligible for financial services or other support.

The Enabling Masterplan defines persons with disabilities as "those whose prospects of securing and retaining places and advancing in education and training institutions, employment and recreation as equal members of the community are substantially reduced as a result of physical, sensory, intellectual and developmental impairments".

A Ministry of Social and Family Development (MSF) spokesman says: "This definition takes into account the level of functionality of the person, not only by medical standards, but more holistically with regard to his or her overall social functionality."

But this differs from that of the United Nations Convention on the Rights of Persons with Disabilities, because those with mental health impairments - such as depression, schizophrenia and bipolar disorders - are left out.

When asked about this, the MSF says not all mental illnesses result in disabilities, and with medication and treatment, patients are able to function well on their own.

"Today, the management of mental health issues falls under the purview of the Ministry of Health (MOH)," it says. "A person with disability, regardless of whether it is physical or non-physical in nature, will thus be supported by MSF and MOH, taking into account both his medical needs and his overall social-functional needs."

This means those with mental illness do not qualify for MSF disability schemes such as transport concessions, which MSF says is "primarily a scheme for persons with disability such as physical, sensory, intellectual disabilities and autism".

Still, Singapore's definition of disability does include developmental disabilities - in keeping with international trends, given the global rise in cases of developmental disorders such as autism.

HOW SOCIETY MAKES IT DIFFICULT

Disabilities that are not apparent are sometimes subject to harsher judgment, experts point out.

"Some might think you are out to get an unfair advantage if you don't look like you need that assistance, or to validate the use of that reserved parking space," says Mr Ho.

The DPA's Mr Aw knows of a lecturer with irritable bowel syndrome - Ms Christine Keung, in her 50s - who needs to use a toilet designated for the handicapped so she can clean herself. Such toilets usually have a basin or bidet spray. Yet on several occasions, she has been scolded by people who are cynical about her medical condition.

Even when symptoms of the disability are manifested, such as when an ADHD student fidgets with staplers in class, Mr Aw says not all teachers in mainstream schools recognise them.

"So the children are punished and made to go without recess for behaviours which are natural to them," he says.

Ms Anita Fam, who chairs the Enabling Masterplan committee, says: "Much of it stems from a lack of awareness or understanding of disabilities which are less visible.

"For example, when we see a child with autism having a meltdown, we may stare, or even video with our camera phone, or beat a hasty retreat because of fear."

HOW TO MAKE IT BETTER?

For people to better understand and support those with less visible disabilities, more research needs to be done to determine the extent of, and areas of, discrimination as well as the types of disabilities that are being discriminated against.

Not much data or findings are available yet, but more organisations are starting to look into this.

The National Council of Social Service has done a study involving 1,400 people to find out how they feel about those with disabilities, including less visible ones.

The study also aims to determine the perceived level of opportunities and inclusion towards people with disabilities, particularly in social interaction and access to services and facilities. The findings will be released next month.

The Lien Foundation has polled more than 1,000 people on attitudes and concerns Singaporeans have towards social inclusion, and inclusive education for children. Its findings will be out later in the year.

The DPA will also be studying barriers and discrimination in the workplace, and see if existing policies are enough to tackle the issues, or if further legislation is needed.

Some have suggested introducing laws, such as along the lines of Australia's Disability Discrimination Act, which protect those with disabilities against discrimination at work and school, and also protect their relatives, caregivers and co-workers.

For example, it is illegal in Australia to refuse a parent a job because he or she will need time off work to look after a child with a disability.

Others have called for children to have more interaction with their peers who have disabilities, to reduce stigma.

"Once children or people with disabilities become segregated and isolated, they risk becoming invisible, forgotten and discriminated by the wider society," says Mr Lee Poh Wah, chief executive of the Lien Foundation, which has funded a pre-school that promotes inclusion, where children with special needs learn alongside other kids.

"Physical barriers are the easiest to identify and correct, but to change attitudinal barriers - which stem from fears and often wrong assumptions - we must look at our society, our education system and within ourselves," he adds.

Mr Aw says all organisations should have a person whose responsibility is to ensure diversity and inclusion, to help integrate those with disabilities and raise awareness.

For example, Ms Fam notes that the police have trained volunteers under their appropriate adult scheme to help someone with an intellectual disability during interviews should they be arrested.

However, observers note that people with a "hidden" disability often choose not to declare it due to fear of discrimination.

Mr Ho says: "It can be a vicious cycle, with people with invisible disabilities choosing not to discuss the issues, and everyone being none the wiser."

He has learnt through interacting with disabled students in the course of his work that self-acceptance makes a difference.

Those with no option to conceal their disability tend to be more confident and sociable, he says.

"They have less qualms about speaking up, seeking assistance, using the accommodations offered to them and dispelling misconceptions about their conditions."

Autism

NUMBER AFFECTED

About one in 68 children. It is more common in boys, with a rate of one in 42.

NATURE OF DISABILITY

Autism affects a person's ability to make sense of the world and relate with others. It is known as a spectrum disorder as no two persons with autism are the same. People with autism differ in the severity of the disorder and intellectual abilities.

Children with autism do not outgrow it, but symptoms may lessen with intervention. Structured intervention and training will help individuals acquire living skills, like how to prepare food and to shower, but will not cure the condition.

TREATMENT/SUPPORT

The Early Intervention Programme for Infants & Children provides therapy and educational support services for infants and young children with special needs. Some voluntary organisations provide therapy for youngsters, teaching skills in mobility, play and socialising and helping them better adapt to the environment.

RESOURCES: www.autism.org.sg / www.sgenable.sg

Boy with autism has few playmates
By Kok Xing Hui, The Sunday Times, 8 May 2016

Nine-year-old Umar Haziq loves going to the playground and interacting with other children. But he finds it hard to understand play rules and unwittingly alienates himself from the rest.

What the children do not understand is that Umar has autism. It affects his learning development and impairs his social interaction and communication skills.

His father, Mr Mohamed Jusri Bangi, 48, says: "When he's not following rules, they run away from him. As a parent, when you see children running away from your child, it's quite disheartening."

Once, Umar - who was diagnosed when he was four - hit a girl, and her grandparents scolded him. They did not understand Mr Jusri's explanation about autism spectrum disorder, and he received an earful for not controlling his child.

Autism affects one in 68 children and one in 42 boys, but public awareness is low.

"He still cannot mingle with the normal kids," says Mr Jusri. So Umar spends most of his playtime with his cousins, especially the younger ones whose play rules are easier for the boy to follow.

Taking him on outings can be difficult. Children with autism can find noises, crowds and experiences outside their routines overwhelming, and can have meltdowns.

"You get stares, rude comments. Because they think that you're not a good parent. Sometimes, it is difficult to control them so they run around," says Mr Jusri. He takes his son to less crowded places, and to movies where there are other children so he is not the only noisy one.

But Mr Jusri says public understanding has improved, and sometimes kind strangers come up to talk to Umar instead of shunning him.

During the hour-long interview and photo session at Eden School, which he started attending last year, Umar was well-behaved, although restless. The school specialises in helping children with autism.

He communicated well, telling his father he wanted to play outside, and answering questions about his favourite cartoon SpongeBob SquarePants, and was cooperative during the photo shoot.

Mr Jusri credits Eden School with giving him tips on how to keep Umar calm and cooperative. For example, showing Umar a schedule so that he knows what happens next removes his anxiety. Umar has learnt how to ask for help, so he no longer throws tantrums when he feels helpless and frustrated.

Learning to manage Umar better has given the single father a measure of relief, he says. Mr Jusri divorced his wife last year and singlehandedly juggles managing Umar and two older children, and his job at the Land Transport Authority, with household chores and finances. Every morning, he takes Umar to Eden School in Bukit Batok from their Woodlands home. Then he travels to work in Sin Ming Drive, and goes back to Eden at lunchtime to pick up Umar and drop him off at a private daycare centre for children with special needs. After work, he takes Umar home and prepares dinner. Sometimes he leaves Umar in the care of a family member, to have time for himself.

He advises parents of children with autism: "You need to take care of yourself. If not, you'll go crazy."

His greatest worry is Umar's future. "I don't know if his sisters will want to take care of him or not. I don't know if my ex-wife will take him or not."

Class pranksters forgot he could bleed to death
By Janice Tai, The Sunday Times, 8 May 2016

His classmates knew he could bleed to death if he was injured, but that did not stop some of them from tripping him up during lesson breaks, or pulling away a chair when he tried to sit down.

For four years in primary school, Ang Kai Jun, now 12 and in secondary school, endured the antics of fellow pupils who failed to comprehend the severity of his illness.

Kai Jun has severe haemophilia, a rare genetic condition in which the blood does not clot properly. There is no cure. Victims bruise easily when they fall, and suffer bleeding into their muscles and joints.

His prankster pals were not being nasty; they sometimes simply forgot he had a disorder.

Kai Jun, who learnt to be more alert to protect himself, says: "It is good that this illness is not visible because I feel like a normal person, but it is also bad because when people can't see it, they forget I have it."

Though he has severe haemophilia, which means he does not have any blood-clotting factors and requires regular injections of clotting agents, he is fortunate to be able to benefit from medical advances.

More patients can now go for preventive treatment like injections that make a difference to joints. Joint damage is a common problem, caused by uncontrolled internal bleeding. It can lead to crippling joint disease. In the past, treatment was given only when the patient noticed he was suffering a bleed.

The last time Kai Jun had a bleed was two years ago, and with his condition under control, his parents think he will be better able to assimilate into society when he grows up.

For older haemophiliac Y.S. Sum, 55, who walks with a limp due to joint damage, life is not so rosy. He was sacked from his last job -working in a warehouse - in 2012 for taking medical leave two to three days a week to manage his illness. He is still jobless. He says: "I don't blame people who are unkind to me, because many Singaporeans don't know about the illness."

Haemophiliacs overseas also face discrimination. Last year, a student in Beijing sued his university after he was allegedly expelled for having haemophilia, although the disease is not contagious. Under an Education Ministry rule in China, universities can refuse to admit students with serious blood diseases.

Kai Jun's mother, Madam Khim Chua, 37, says it is not practical for her only child to go around telling strangers he has a disability. "When he takes the bus home, I just remind him to find a seat quickly - but if he can't, to grab the handlebars in case the bus jerks," says Madam Chua.

But she makes it a point to educate people in frequent contact with him. Every year, she gives out guides on the condition to his teachers. During home economics lessons, knives are kept away from him to prevent him from being cut.

"As I grow older, my friends understand and are supportive," says Kai Jun. "Still, not many people are aware of what it is, and they often give me the 'blur' look."

Haemophilia

NUMBER AFFECTED

About one in 10,000 people is born with it so there are about 500 haemophiliacs here; 250 are members of the Haemophilia Society of Singapore (HSS).

NATURE OF DISABILITY

A rare inherited blood disorder in which blood does not clot properly. Signs include large bruises, bleeding into muscles and joints, sudden or prolonged bleeding. Generally affects males. Sufferers should avoid physically demanding activities; strenuous sex may trigger bleeding.

TREATMENT/SUPPORT

Treatment involving regular injections of clotting agents to prevent spontaneous bleeding costs $3,000 to $4,000 a month, before subsidies. But with subsidies from the Government and HSS, the treatment costs under a quarter of the original price. HSS also organises educational talks and fundraising events.

RESOURCES: haemophilia.org.sg

I not stupid - I have dyslexia
By Kok Xing Hui, The Sunday Times, 8 May 2016

Today, 59-year-old Dr Richard Kwok is a successful engineer with a doctorate, happy marriage and two children.

Such is his acumen that the Chief Technology Officer at Singapore Technologies Kinetics guides PhD candidates.

Yet, as a youngster, he was regarded as stupid by teachers, parents and neighbours because he could not keep up in class.

Copying notes from teachers' blackboards was especially difficult.

"I had to copy word by word, instead of sentence by sentence," says Dr Kwok.

It turns out that Dr Kwok suffers from dyslexia, a learning disorder in which it is difficult to make sense of the written word, among other aspects.

Remarkably, Dr Kwok found this out only later in life, when one of his sons - Kwok Ting Yu, now 20 - was diagnosed with dyslexia in 2000. "He told us that the words moved about when he tried to read them," says Dr Kwok. "After my son's diagnosis, I realised that I faced similar problems and found out that I am dyslexic too."

His son did not have to struggle alone like he did. After his diagnosis, the young Mr Kwok received intervention training at the Dyslexia Association of Singapore, which helped him pick up reading skills. Now, he is studying actuarial science - a discipline that applies mathematical and statistical methods to assess risk in, for example, insurance - at Monash University in Australia.

Such early intervention, Dr Kwok says, is crucial for young children who might think they are stupid.

"Every child, every individual likes to have positive reinforcement, instead of people thinking that they are not smart."

Dr Kwok says that his own diagnosis, and how his life has turned out despite the disorder, has had a positive impact on his son.

"Knowing that I can cope gives my son a more positive outlook in life. It is important to keep looking on the positive side," says Dr Kwok.

He admits that it was actually a relief to learn he was dyslexic, and that he was indeed not "stupid", as everyone had thought.

Of his struggles at school, he recalls: "It was quite demoralising. Your parents, neighbours - they think that you'll definitely not make it."

To catch up with his schoolmates, Dr Kwok put in long hours, doing night classes and came up with his own studying techniques.

Through sketching out concepts and mind maps, Dr Kwok trained himself to memorise information.

"It was out of determination. I had to learn how to cope and develop methodologies. We have problems memorising certain things, but we do have our strengths. We visualise things better," he says.

In secondary school, although his results were not good enough for admittance, he appealed to the principal to take pure physics, chemistry and additional mathematics.

He was allowed to do so - but only if he could pass the exams on his own without school tutelage.

With night classes and notes borrowed from his classmates, Dr Kwok managed to do just that.

This taught him the value of collaboration and persistence, he says, which has helped him in the workplace. He notes:"Until today I cannot memorise the multiplication table", and he has trouble spelling.

Asked what kept him working hard when many would have given up, Dr Kwok says with a smile: "Everybody thought that I was not so clever, but I thought that I was not so bad."

Dyslexia

NUMBER AFFECTED

An estimated 10 per cent of any population are likely to have dyslexia; 4 per cent of cases are severe enough to warrant intervention.

NATURE OF DISABILITY

Difficulties with language learning and cognition. It primarily affects the skills in accurate and fluent reading and spelling. Characteristic features are difficulties in phonological awareness, verbal memory and processing speed.

There may also be difficulties in aspects of language, motor co-ordination, mental calculation, concentration and personal organisation, but these are not, by themselves, markers of dyslexia.

TREATMENT/SUPPORT

The Dyslexia Association of Singapore has psychologists, speech and language therapists and educational therapists. It offers screening, psychological assessments and specialist teaching to children between six and 17 years old. Tests are also offered to pre-school children.

RESOURCES: www.das.org.sg

LIVING WITH INVISIBLE DISABILITIES | TACKLING SELF-STIGMA

Facing their fears, at sea
Combating stigma is key in raising the level of public understanding and acceptance towards those with less visible disabilities, and ensuring that they get equal opportunities in employment and access to services and facilities. Insight reports on the unique efforts taken by various groups to tackle self-stigma and that from the community. Research has shown that the effect of self-stigma can be worse than that of stigma from the public. Change starts from within.
By Janice Tai, The Sunday Times, 8 May 2016

The 22-year-old woman stood transfixed under a palm tree, seemingly oblivious to a sailing instructor in the sea off Pasir Ris Beach gesturing for her to board a boat. Her parents hovered nearby, trying to persuade her to go in the water.

Sarah (not her real name) has schizophrenia and is prone to moments when she freezes and does not respond to anyone.

After 10 minutes, she had still not joined the instructor.

Then, her parents shoved her forward - and she moved a few steps. Nearly 20 minutes later, she made it to the boat.

Once on board, however, Sarah came alive. As the wind direction changed, she effortlessly switched seats with the instructor to maintain the boat's balance.

"At first I didn't feel like doing this, but when out at sea, I don't regret coming. I like how the wind blows," Sarah says.

Sarah was part of a group of 10 people from the Singapore Association for Mental Health (SAMH), a voluntary welfare organisation that supports people with mental illness, who took up the challenge of getting certified in sailing.

The project is the brainchild of Ms Jane Goh, SAMH's head of creative services.

"Research has shown that the effect of self-stigma is worse than that of stigma from the public. When you do not believe in yourself, the lowered expectations have deep psychological and emotional implications," says Ms Goh.

She wanted the 10, who have schizophrenia, depression or anxiety issues, to overcome some of their fears and gain resilience by learning how to sail. They are also part of a mental health research study she is conducting that aims to gauge the impact of sports and art therapy on confidence levels and ability to cope with relapses.

The three-day sailing certification course for people with mental illness is run by the People's Association (PA). It is the first time PA has partnered a charity to run such a course.

From the way things were going, however, some bystanders wondered if the undertaking was too ambitious. Most participants seemed confused about how to rig the boats' ropes, and stood watching instructors do so. Out at sea, screams were heard as sailboats got in each other's way.

Ms Amanda Low, 27, who has depression, started wailing when her boat nearly tipped over. Unruffled, her instructor tried to calm her down by removing his sunglasses and getting her to look into his eyes as he reassured her.

Volunteer trainer James Leong, 56, who is with PA Water Venture - a unit under PA that offers outdoor water activities to the public - jollied her along, as well.

Says Mr Leong: "Our goal is to help them enjoy themselves. We believe they can do it, even for Sarah who responds slower. (In fact), when she actually does the moves such as turning the boat, she does it better than some trainers."

Participants have picked up life skills. Says Ms Low: "I have learnt how to better control my emotions. I find that difficulties get easier as you go along, so it's about taking things one step at a time."

One 40-year-old participant, who has been struggling with depression for the past three years, learnt that it is all right to accept help from others.

The former sports executive, who declined to be named, says: "Because of my condition, I used to look down on myself and keep my emotions to myself for fear that I would be judged by others. But now, I think it's okay to tell others how I feel when I need help."

Against the setting sun, Mr Leong guided a teenage girl onboard to head for the last buoy of a navigation exercise. She reached out and gave the buoy a triumphant tap.

In the end, only four out of the 10 participants graduated with the certificate required to sail in future. But to Ms Goh, passing was not the point: "The experience is our aim and destination."

LIVING WITH INVISIBLE DISABILITIES | TACKLING STIGMA FROM THE COMMUNITY

The art of making friends
A charity has come up with an unusual way to tackle social stigma surrounding those with mental disorders. It has been getting members of the public to sign up for art therapy classes without telling them that several participants have some form of mental illness, be it anxiety issues, depression or schizophrenia.
By Janice Tai, The Sunday Times, 8 May 2016

Through this, the Singapore Association for Mental Health (SAMH) hopes people will get to interact without any preconceived notions, and come to realise that those with mental disabilities are no different from others, especially when their conditions have stabilised through treatment.

The art therapy sessions, run by SAMH since 2011, are at its Creative Hub at Goodman Arts Centre.

Student Rachel Chay, 20, attended a session because she was curious about the benefits of art therapy. "I didn't know I was sitting next to someone with mental illness and because of that I could talk more freely with her," she says. "Otherwise, I would have held back and been careful about what I said in case some words triggered off something in her."

She adds: "But nothing happened and I realised there is no need for me to be so cautious and, in doing so, inadvertently propagate stigma."

It is such fears held by others that Ms Amanda Tan (not her real name), 26, has to battle with every day. She has schizophrenia and depression, and often loses sleep at night, worrying what others think of her.

"I hear voices in my head calling me crazy or telling me that they dislike me," says Ms Tan, softly.

During the art therapy session, she interacted with others as they used craft materials to decorate bottles and then later shared what the items in the bottles reminded them of. The task of the day was to create a jar of memories that was symbolic of the sum of their past experiences.

An elderly woman, who had earlier talked about how she felt depressed when her husband came down with dementia, pasted a picture of a car on her bottle. It reminded her of happy days when her father had a second-hand car, which was rare then, and could take her to the seaside.

Ms Chay tied a black ribbon around her bottle, to symbolise how she bottles up her emotions when upset.

Another participant, retired accountant Jessica Lim, 55, says: "Through the interaction, I found that the people here are friendly, less inhibited and they can get along with others well."

Previously, she had the impression that those with mental illness lived in their own world, and that it would be hard to get through to them, based on past experiences with colleagues and friends with mental illness.

It is to generate this kind of awareness and empathy among the community that Ms Jane Goh, SAMH's head of creative services, pushed for the sessions to be open to the public.

Most mental health organisations here run programmes only for their own clients who have been clinically diagnosed with an illness.

She feels strongly about social inclusion because people with mental illness are often isolated.

"Those with mental illness tend to hardly talk and their social life dwindles. It is important for them to feel accepted by the community so that they build up their self-esteem," says Ms Goh.

After years of running such sessions, she says SAMH has begun seeing the fruits of its labour.

"Members of the public become friends with our clients and they have meals together. Some even go on tours together. It is little things like these that keep us going," she says.

For Ms Tan, that day she made a new friend. She says: "I am happy because she is 19 years old. Usually the only people who befriend me are the aunties in church."