The history of psychiatry in the island nation of Singapore if reviewed especially in the context of the psychiatric services offered in the last one and a half-century can be broadly subdivided into four specific phases that often overlap. These phases (in chronological order) are:
- growth and development of lunatic asylum
- disruption owing to annexation by Japan and disturbances during the periods following the end of World Wars
- guidance and grooming of psychiatrists in Singapore and psychologists in Singapore as well as the training of other related professionals
- development and evolution of general psychiatry that delineates the interactions between medicine, primary care, and psychiatry which pave the way for the advancement of community services.
Psychiatry as a distinct discipline of medical sciences developed and thrived in Singapore extensively under British rule. Additionally, modern psychiatry that witnessed rapid strides in the formulation of theories and hypotheses greatly influenced the discipline’s progress in the city founded by Sir Thomas Raffles.
The Early Years
Following the shifting of the head-office of the ‘Medical Department of the Straits Settlement’ from erstwhile Malaysia to Singapore in 1835, earnest attempts were made to establish a primary aftercare home for mental patients. This led to the establishment of Singapore’s first mental hospital in 1841 that had 30 beds. Treatment offered was extremely rudimentary and basically comprised keeping patients on morphine, purgatives, tartar antimony, and belladonna.
The Subsequent Years
Over the next forty years, more and more patients were admitted and in 1887, the asylum which was renovated several times (in order to accommodate the increasing number of patients) had a total of 300 lunatics. In 1889, a statute called the ‘Straits Settlement Ordinance No. VIII of 1889’ was promulgated for the first time under which a mentally ill (of unsound mind) individual could be kept under detention. Most of the admitted patients apart from being beset with depression, melancholy, and inertia also suffered from acute and chronic tropical diseases.
Also, the problem of overcrowding was somewhat mitigated by the deportation of terminally ill patients and steep mortality rates. Drugs such as sulphonal, paraldehyde, hoyden, morphine, cannabis indicia, potassium bromide, and chloral were mainly used in the closing decade of the 19th cent.
Evolution of Psychiatric Services
It was only in the year 1914 that psychiatry was included in the medical studies curriculum and the construction of the first modern mental hospital with more than 1,000 beds in 1928 facilitated the engagement of patients as farmhands in the grounds adjoining the asylum. Treatment was largely custodial as the psychiatrists in Singapore had no better option than to patiently wait for symptoms to wane gradually leading to the assuaging of the illness. The mental health of patients in the hospital suffered and deteriorated when the city was besieged by the Japanese in 1942.
After the British regained the territory in 1945, the hospital was rechristened as Woodbridge hospital in 1951. Psychiatric treatment at the hospital underwent a major revolution as it was accepted that to improve mental health of patients it was necessary to rehabilitate them to bring them back into the mainstream of society alongside medicinal management. The Ministry of Health under the Singapore Government is responsible for the provision of psychiatric services and maintaining mental health in Singapore.
Written By Adelphi Psych Medicine Clinic
Reference:
B.-Y. Ng & K.-T. Chee (2006) A brief history of psychiatry in Singapore,
International Review of Psychiatry, 18:4, 355-361, DOI: 10.1080/09540260600775355
