Pte Ganesh had been diagnosed with schizophrenia but still needed to serve NS. (ST Photo)
A recent Coroner’s report has ruled out foul play in the death of 22-year-old full-time national serviceman (NSF) Pte Ganesh Pillay, who served his NS last year.
He was found dead at the foot of his condominium in Sengkang last July (‘Mentally ill SG must do NS but able new citizens exempted‘).
Pte Ganesh was diagnosed with schizophrenia when he was 18 and had to take medicine daily to control his illness. Schizophrenia is a mental disorder characterized by a breakdown in thinking and poor emotional response. Common symptoms include delusion, paranoia, hearing voices or noises that are not there, disorganized thinking, and lack of emotion and motivation. In some cases, sufferers even see things that are not there, like “shadows” or “beings”.
Pte Ganesh ended his life after his superior, Captain Jessie Goh, had earlier issued him with 14 extra duties as punishment for, among other things, unsatisfactory work and improper bearing. After he returned from camp, he took his own life. The Coroner’s court heard that Cpt Goh had been informed about his condition, but she never tried to find out what it was or how to manage him. Instead, the Coroner heard, she was consistently strict and harsh towards him, seemingly aiming to make a better soldier of him.
Former SAF head of psychiatry Dr Christopher Cheok pointed out a “weak” link in the chain. He now leads the psychological medicine department at Khoo Teck Puat Hospital. He told the media that there is a lack of awareness about mental health issues among junior commanders such as NSF officers and specialists.
Cpt Goh, the officer in charge of Pte Ganesh, had been informed about his condition, but never tried to find out what it was or how to manage him. She was consistently strict and harsh towards the mentally-ill Pte Ganesh, seemingly aiming to make a better soldier of him. The Coroner said she was “out of her depth” in her treatment of Pte Ganesh. (ST Photo)
Dr Cheok urged the SAF to take a more “rehabilitative, rather than punitive” approach to discipline, saying “there should be special considerations when punishing soldiers with serious mental illnesses”. There is also a perception that soldiers who downgrade their PES status because of mental health issues are malingering.
Such stigma must be addressed, Dr Cheok said. He believes that SAF needs to invest more resources in its mental health services.
“This is not just about having more doctors, but also case managers who call to check on patients regularly,” Dr Cheok advised.
Straits Times senior writer Dr Andy Ho raised the question in an article today (‘Exempt these young men from NS’, 13 Apr) whether young men suffering from schizophrenia should be enlisted. He asked, “The key question this death raises is whether a youth with schizophrenia ought to be enlisted at all.”
“Pte Ganesh’s sad end suggests that known schizophrenics should be exempted from NS regardless of whether or not they display symptoms at the (medical) check-up.”
Dr Ho explained that a person with schizophrenia needs powerful drugs, which have severe side effects, to keep his condition in check. He requires medication for life and is never cured as drugs do not rewire the brain. Acute bouts recur if he stops taking his medication when he feels better, not least to avoid the side effects.
A patient may stop taking their medication because they may not want others to know about their condition if they are seen taking the drugs. Dr Ho is of the opinion that NS is not the ideal environment for those who must comply with drug treatment for schizophrenia.
Another reason he cited is that the patient needs lifelong support from family members who ensure, among other things, that he sticks to his drug regimen. “But NS removes him from his family,” Dr Ho said.
Once a schizophrenic stops taking his medicine, he may begin losing his temper, lacking focus, becoming anxious, neglecting himself and so on. In a military setting, this cannot but trigger disciplinary action, Dr Ho explained.
“It therefore seems to make good sense to exempt a youth with schizophrenia from NS, irrespective of whether or not he displays symptoms on the day of his pre-enlistment medical check-up. Better to let him remain in the care of his family and doctors, and in the community at large,” he said.
“Pte Ganesh’s suicide also raises the question of how young men diagnosed with other psychoses should be viewed regarding NS. That is a policy question deserving close and urgent scrutiny.”
Similarly, TRE readers are asking why MINDEF enlists mentally-ill Singaporeans for NS:
April 9, 2014 at 2:44 pm (Quote)
“Unsatisfactory work and improper bearing”…. those are outward manifestation of his condition so essentially he is being punished by Captain Goh for being ill. The poor young man ought to be exempted or placed in a situation where there is proper understanding and handling of NSMen with such conditions. While Mindef ought to come under fire for negligence on this case, I also think that the issue of mental health in Singapore is badly handled.
April 9, 2014 at 3:52 pm (Quote)
I’m pretty shocked that this young man Ganesh wasn’t fully exempted from NS given his medical background. Was his 2 years liability as a PES E soldier that important to Mindef?
Vicious MIW Liars:
April 9, 2014 at 8:44 pm (Quote)
This is a very vicious and devious MIW govt. How can a young man with a very severe mental disorder not be exempted from conscription service, but rather forced to serve out a conscription term with non combat duties. But still ended up at the mercy of abusive officers who know shit about their duties and responsibility and only eager to carry balls and suck c**ks for promotion. This is indeed a very sad day, both for the family of the dead young man and for Singapore.
A TRE reader asked why new citizens are exempted from NS, especially when born-and-bred mentally ill Singaporeans are not exempted:
April 9, 2014 at 1:58 pm (Quote)
I could remember that in the earlier batches of NS men, civil servants including teachers in their 39s and 40s had to serve full time NS in the army with. The other 20 year olds, These older NS men had no problem going through the vigorous trainings. Why new citizens of similar age groups are exempted, not fair isn’t it.? All these new citizens are converted merely because of the benefits that come with their conversion, after all most would be able to return to their country of origin if the desire to do so later on and I think our G should plug this loop hole.
Meanwhile, in response to media queries, MINDEF has pointed to a previous report on how it screens all servicemen before enlistment and assigns them a PES grade. Those with medical conditions – including mental health conditions – may be assigned a lower grade. The grades range from A – fit for all combat vocations – to F – which exempts the person from NS.
Pte Ganesh, who enlisted in October 2012, was given the E9L9 grade, the second lowest, because of his illness and became an administrative assistant in SAF.
With regard to the death of Pte Ganesh, MINDEF has declined to comment and instead referred to an earlier statement issued in response to the Coroner’s findings. It said it would “study the findings carefully to improve and tighten its procedures to ensure better compliance by SAF units in dealing with soldiers with mental problems”.