A historical analysis of mental health policymaking in Singapore
Examination of the development of community-based mental healthcare in Singapore
This talk is based on a study that examines the evolution of mental health systems in Singapore from the early 2000s to the present. It draws on ten oral history accounts with policymakers, industry practitioners, and community advocates with up to 22 years of involvement in the mental health sector, alongside a systematic analysis of Singapore's Parliamentary Debates (Hansard) and publicly available policy documents. It examines the drivers behind the development of a community-based system of mental health care.
Interpreted through the lens of Sabatier's Advocacy Coalition Framework, it argues that the system of community-based mental health care in Singapore evolved incrementally from an institution-centric, illness-driven model towards one with community-based infrastructure. This process was largely driven by the ground-up efforts of bureaucrats based in the community. Likewise, an ethos of patient-centredness was not the product of top-down direction. Instead, it emerged primarily through ground-up policy brokerage led by these community-based bureaucrats, reflecting Sabatier's concept of advocacy coalitions (1988) and consistent with Lipsky's account of street-level bureaucracy (1980). As societal and political priorities evolve over time, the state has increasingly assumed a more direct role in Singapore’s mental health landscape. A defining contemporary challenge facing Singapore’s community mental health systems will therefore be to preserve patient-centred care amidst other contesting top-down priorities.
Speaker
Dr Cheryl Sim
Instructor, Saw Swee Hock School of Public Health, National University of Singapore
Cheryl Sim is a Qualitative Public Health Researcher with a focus on Health Systems, Mental Health and Medical Humanities. Her interdisciplinary scholarship bridges public health, social policy, the humanities and social sciences, including history and sociology. She has a special interest in participatory and narrative-based methods, particularly among vulnerable populations. Cheryl has recently completed her PhD in Public Health at the National University of Singapore (NUS) and is currently an Instructor at NUS’s Saw Swee Hock School of Public Health. She has an MSc Social Policy from the University of Pennsylvania and a Master in Public Policy from the Lee Kuan Yew School of Public Policy, NUS. Prior to her PhD, she had significant professional experience in public policy formulation in the Singapore Civil Service, focusing on industry ecosystem development, legislation and regulatory frameworks.
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