This approach is part of a police partnership with IMH, piloted in March 2021, to better ensure cases of attempted suicide get the right kind of help more quickly.
Attempted suicide was decriminalised at the start of 2020. Dr Ng noted that the focus has “very much shifted” to healing, recovery and getting rid of the stigma related to suicide and the criminal justice process.
“In the past, when the person attempted suicide, we arrested them, brought them back to the police station and after that they might be brought to IMH, and that process takes a long time,” he said.
“And if this person was mentally ill, I think that it is really not very fair to the patient, not very patient-centred. The person would already be in distress, and we have got a lot of feedback that their condition got worse because of the experience that they had.”
Under the new approach, police officers attending to a case with signs of attempted suicide – without it being attempted – can call a dedicated hotline manned 24 hours by IMH nurses and counsellors.
This IMH crisis response team will be briefed by officers and can speak to the distressed person and their caregiver over the phone to conduct a suicide risk assessment. This includes questions about their mental state and circumstances around the planned act.
“We want to establish a safety plan, whether it’s safe to discharge the person to the caregivers, friend or things like that,” Dr Ng said, adding that the team can also check the person’s medical records if they were an IMH patient.
“After that, when we are reasonably sure that it is safe, then we will advise the police to release the person back to the caregiver. If we think that the risk is too high and the person will necessitate a more thorough psychiatric evaluation, we will actually advise police to convey them to IMH where we will do the evaluation.”
This process would only apply to cases where, for instance, the person had sent a text saying they wanted to end their life. If the person is already standing on a ledge or has hurt themselves, the priority for police is to secure their safety.
Singapore reported 452 suicides in 2020 – the country’s highest count since 2012 – amid the isolation and psychological distress due to the pandemic, according to the latest figures from the Samaritans of Singapore.
The IMH crisis response team gets about eight to 10 calls a day on the police hotline. It is manned by six nurses and 14 counsellors who are also in charge of IMH’s own crisis hotline.
The team was piloted at the two police land divisions of Bedok and Jurong with encouraging results and expanded islandwide in December 2021, said Superintendent of Police (SUPT) Tan Yong Liang, assistant director, frontline policing division, operations department.
Out of the more than 2,000 calls police made to the crisis response team, 14 were on-site activations, police said.
In more than 80 per cent of the remaining cases, the team’s advice was to take the individuals to the IMH emergency room. This was due to reasons like suicide risk, need for further treatment of underlying mental health conditions, or a lack of adequate supervision and care at that point in time.
The rest received other forms of intervention, including being referred to other hospitals’ accident and emergency department, or being discharged back to their caregivers after the IMH team made safety plans involving the individuals and their caregivers.