Health and Well-being: Youth Suicide in Singapore and Ottawa Charter

This report examines the critical health priority of youth suicide in Singapore, highlighting its significant impact on individuals, communities, and the nation. It defines the issue, presents relevant statistics, and identifies key determinants such as family history, mental health conditions, and social stressors. The report analyzes how youth suicide affects various aspects of well-being, including social and psychological dimensions. To address this, the report proposes a health promotion strategy involving a mindfulness-based iPhone app, emphasizing its potential to provide emotional support, mental health advice, and mindfulness exercises. This suggestion is grounded in the principles of the Ottawa Charter for Health Promotion, particularly in building healthy public policy, creating supportive environments, developing personal skills, strengthening community actions, and reorienting health services. The app-based intervention aims to enhance youths' coping mechanisms and reduce the risk of suicidal behavior, ultimately contributing to improved mental health outcomes.

Running head: HEALTH AND WELL-BEING
Health and well-being
Name of the student:
Name of the University:
Author’s note

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Introduction:
Youth suicide has become a major health issue in Singapore evidenced by the high rate of
suicide and the implementation of the #ThroughTheNight mental health promotion campaign by
Samaritans of Singapore (SOS). The social media campaign aimed to provide a message of
support to youths who go through tough times and this understood by the increase in number of
calls by teenagers to the SOS (Samaritans of Singapore, 2018). The main purpose of this paper is
to analyze the health priority of Youth Suicide in Singapore and discuss about the reason for
focusing on this group. The essay presents different issues related to youth suicide, evaluate
health determinants related to the issue and suggest strategies to improve health outcome of
target population group.
Definition of the heath priority:
According to the WHO definition, health promotion involves implementing the process
to enable people to take control over their health. It helps in protecting health and quality of life
of people and preventing the main cause behind ill health. The three key elements necessary for
health promotion includes good governance, health literacy and healthy cities (World Health
Organization, 2016).
Impact of the health priority on Singaporean
The chosen health priority area for this report is ‘youth suicide’, which is a major burden
for Singaporeans as it has impact on all levels such as individual, community and the nation.
Rate of suicide is the indicator of health of a nation and the burden of the issue is understood by
suicide as the leading cause of death among youths aged 10 to 29 years. In 2017, the death rate
due to suicide was 2.5 times compared to deaths due to transport accidents in 2017 (Samaritans

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of Singapore, 2018). Such rate of deaths among teenager has impact on individual family
members and the productivity of countries too. For family members, suicide and bereavement is
associated with negative psychological symptoms and risk of mental disorders and mental health
related complications (Spillane et al., 2017). This has also affected the economy of Singapore as
more number of suicide leads to loss of productivity and high burden for mental health service
staffs. The WHO report supports that work related stress and experiences of psychological
harassment contributes to low productivity and increases staff turnover (World Health
Organization, 2019). For individuals coming to visit mental health services for suicide risk and
mental health, use of mental health service was linked to family history and unemployment.
Hence, as the chosen health directly influences the community, there is a need to take urgent
action regarding it.
Target group for the health priority:
For the health priority area of preventing suicide risk and mental health issue, youths
have been chosen as the main target audience for health promotion. This is said because all
deaths due to suicide is seen in people aged 10 to 29 years. Hence, by targeting youth and
identifying the factors contributing to such risk for them, adequate support and guidance can be
provided to the youths. Prolonged exposure to stress creates the condition for use of lethal mood
to end the stressors. In addition, lack of access to mental health services and awareness about
symptoms of suicide risk further increases such incidence. Hence, Singaporean population group
between 10-29 years need to be targeted to address the chosen health priority (Loh et al., 2012).

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Overview of the topic
In response to the issue of youth suicide in Singapore, the SOS launched
#ThroughTheNight campaign. The main goal of this campaign was to create a platform of hope
by encouraging the people to post message on instagram channel. The message could be posted
in several forms such as songs, videography, poetry and calligraphy. Although the campaign is
useful for people looking for comfort and motivation, however this campaign is not enough to
reduce the burden of suicide in Singapore. There is a need for improvement in the campaign so
that youths can be targeted in a better way than before.
Determinants of the issues:
There are several determinants or risk factors contributing to high rate of suicide in
Singapore. These factors include family history of suicide, diagnosis of mental health condition
or serious illness, distressing life events like divorce and death of loved ones and exposure to
prolonged stress factors like unemployment and bullying (Samaritans of Singapore, 2018). The
report by Ministry of Social and Family Development (2016) reports that teen suicides in
Singapore occur because of interpersonal and family issues and presence of several social
stressors. As the cause of suicides is complex, using unique approach to deal with suicide and
reduce the rate of suicide is essential.
Elements of well-being affected by the condition
According to the Knight & McNaught’s construct of well-being, the four domains of
well-being includes individual, family, community and societal well-being. The other key
constructs that plays a role in perceiving well-being includes the locality, activities and
psychological resources. Level of housing support and economic resources, physical safety and

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interpersonal relationship determines how physical, social, psychological and spiritual outcome
of people are affected by the condition (La Placa, McNaught & Knight, 2013). Mental stressors
are major risk factors of suicide and this has an impact on different factors such as social aspects
of well-being. Social risk factors like bullying and negative life experiences results in suicidal
behavior (Amitai & Apter, 2012). Hence, to introduce protective factors against suicide attempt,
there is a need to find ways to improve the campaign.
Health promotion suggestion:
To improve the #ThroughTheNight mental health promotion campaign by SOS, it is
proposed that SOS use a mindfulness based iPhone app to not only just provide emotional
support to youths, but also give advice on mental health issues and practice mindfulness exercise
to prevent the risk of suicidal behavior. The key advantage of this suggestion is that use of
mindfulness approach ensures that solution to the present moment is provided. According to
Mani et al. (2015), the meaning of mindfulness is to pay attention to the present and non-
judgmentally unfold experiences moment by moment. Hence, by utilizing this approach, it is
possible to promote awareness, acceptance and self-regulation to negative experiences among
youths. The key advantage of using apps to provide mindfulness based training is that these apps
have a wider reach and by downloading such apps, vulnerable youths can easily get the support
required to cope with life stressors and avoid the negative behavior of suicide in the future.
Application of the five areas of the Ottawa Charter:
The significance of the improved suggestion is that it is based on the principles of the
Ottawa Charter for Health Promotion and Knight and McNaught’s construct of well being. The
link between the improvement suggestion and the Ottawa Charter is explained in details below.

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According to the Ottawa Charter, the five action areas of health promotion includes building
healthy public policy, create supportive environments, develop personal skills, strengthen
community actions and reorient health services (World Health Organization, 2019). The first
action areas suggest putting health on the agenda of policy makers so that policy makers bring
appropriate community wide changes such as legislation, taxation and fiscal measures to
promote health. The new suggestion applies this in the mindfulness based app intervention by
using media advocacy to ensure that such apps are implemented for youths in Singapore. In
addition, the new proposed suggestion creates supportive environment for change by utilization
of technology to provide benefit to youths. The use of iphone apps to deliver mindfulness is
useful approach that is likely to reduce cost and transport related barriers for vulnerable youths in
Singapore. The guided meditation tracks and mindfulness training in iphone is likely to enhance
the efficacy of the mental health intervention. Choo and Burton (2018) gives the evidence that
internet based interventions like use of app is efficacious for mental health issues, providing
enhanced support to youths, increasing their overall motivation and helping them to cope with
stressors. It is expected to obtain the same benefits for youths of Singapore at risk of suicide.
Other two action areas of the Ottawa Charter include strengthening community action,
developing personal skills and reorienting health services. The app based intervention is a good
example of reorienting health services and this is said because it gives attention to other broader
environmental component that can play a role in promoting mental health of youths (Perry et al.,
2016). Hence, app based intervention gives an alternative service which can be easily accessed
by youths. Apart from this, the new proposal implements the idea of strengthening community
action by involving SOS members to raise awareness regarding the mindfulness based app. The
initial process of posting message in instagram can be used to raise awareness regarding the app

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and make youths aware about it apart from giving message on hope. Lastly, the new proposal is
effective in developing personal skills related to responding to life stressors. Youth adapt
negative behavior like suicide attempts to deal with stress (Shain, 2016). However, with
mindfulness training, SOS can play a role in modifying the coping style of Singaporean youths.
Hence, this new change should be incorporate by SOS in their campaign.
Conclusion:
From the overall discussion, it can be concluded that youth suicide is a major challenge in
Singapore that has resulted in loss of productivity and increase in utilization of mental health
services. The #ThroughTheNight mental campaign focused on implementing a platform of
support for young people could express their views related to mental illness and suicide ideation.
However, because of some limitation, the paper suggested the use of SOS based mobile phone
apps so that the mindfulness therapy can be provided to promote awareness, acceptance and self-
regulation to negative experiences among youths at risk of suicide. As majority of the Ottawa
Charter health promotion principles is fulfilled by the new recommendation, it can play a role in
modifying coping styles of youths.

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References:
World Health Organization (2019). Mental health in the workplace. Retrieved from:
https://www.who.int/mental_health/in_the_workplace/en/
Amitai, M., & Apter, A. (2012). Social aspects of suicidal behavior and prevention in early life: a
review. International journal of environmental research and public health, 9(3), 985-994.
Choo, C. C., & Burton, A. A. (2018). Smartphone Apps for Mindfulness Interventions for
Suicidality in Asian Youths: Literature Review. JMIR mHealth and uHealth, 6(6), e139.
La Placa, V., McNaught, A., & Knight, A. (2013). Discourse on wellbeing in research and
practice. International Journal of Wellbeing, 3(1).
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Mani, M., Kavanagh, D. J., Hides, L., & Stoyanov, S. R. (2015). Review and evaluation of
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Ministry of Social and Family Development (2016). Whole-of-government approach to deal with
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with-suicides-in-the-young.aspx
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Canadian Academy of Child and Adolescent Psychiatry, 25(2), 73.

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Samaritans of Singapore. (2018) Learn about Suicide Facts. Retrieved from:
https://www.sos.org.sg/learn-about-suicide/quick-facts
Shain, B. (2016). Suicide and suicide attempts in adolescents. Pediatrics, 138(1), e20161420.
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World Health Organization (2016). What is health promotion? Retrieved from:
https://www.who.int/features/qa/health-promotion/en/
World Health Organization (2019). The Ottawa Charter for Health Promotion. Retrieved from:
https://www.who.int/healthpromotion/conferences/previous/ottawa/en/index1.html