Trend of Migrant Workers Staying in Dormitories Seeking Mental Healthcare

Mr Speaker, Sir, as we have shared in our replies to Members Ms He Ting Ru and Mr Louis Ng's questions on migrant workers' mental well-being earlier, the Ministry of Manpower (MOM) is committed to supporting the mental well-being of our migrant workers. We are sparing no efforts to strengthen the mental health support ecosystem for them.

Since last November, when we initiated the Project DAWN task force, DAWN has worked with our non-government organisation (NGO) partners, healthcare partners, employers and dormitory operators to develop such an ecosystem to look out for migrant workers, to listen to their concerns, to identify those who need more support, as well as link them with the appropriate care channels.

First, we are raising the awareness of mental health issues and we are broadening the outreach of training in basic mental health and psychological first aid, or PFA. Second, we are working with our NGO partners to make counselling and para-counselling more accessible. Third, mental healthcare has been made even more accessible. Any migrant worker identified to have need for or to benefit from mental healthcare will be linked up with the appropriate services, including the counselling hotlines. In particular, an escalation pathway with the Institute of Mental Health (IMH) has been developed to ensure timely care for more severe cases when necessary.

Between January and September 2021, 98 work permit holders were admitted to IMH. This was lower as compared to the same period in 2020, but was higher as compared to 2019, during the pre-COVID-19 era. An earlier study, which was conducted by Yale-NUS on migrant workers' mental health from June to October 2020, showed no notable difference in stress, anxiety and depression levels amongst locals and migrant workers, although there were indications of higher levels of stress amongst migrant workers with movement restrictions.

Nonetheless, any easing of movement restrictions will need to be done in a careful and calibrated manner, so as not to trade one stress for another. In particular, as you have heard in Senior Minister of State Janil Puthucheary's Ministerial Statement yesterday about our healthcare system, we have to be mindful that we do not treat the stress of one where there is some restriction of movement for our migrant workers, to overwhelming that of our healthcare system.

Since August last year, we have allowed dormitory residents to visit recreation centres, or RCs. We recently increased the frequency of RC visits to thrice or three times a week, up from once a week.

We have also removed pre-visit testing requirements for vaccinated migrant workers, which benefits more than 98% of the dormitory population.

Concurrently, we are working with RC operators and community partners to introduce programmes and new offerings to make the RC visits more engaging.

We have also recently expanded community visits from 500 to 3,000 vaccinated migrant workers per week. We have expanded to include Geylang Serai or Joo Chiat, in addition to Little India. We have also extended the visit duration to eight hours at each time.

Members of the House, we remain committed towards caring for our migrant workers' mental well-being through a good support system, as well as to continue to ease measures safely. MOM will continue to monitor the mental health of migrant workers by working closely with our partners.

Thank you, Speaker. I would like to ask the Minister one supplementary question with regard to training. Minister mentioned that we are ramping up psychological first aid training. Specifically, is this peer support training for migrant workers to provide support for each other, or is this support for employers to provide a more supportive workplace environment, in terms of mental wellness, or is it both?

I thank Mr Edward Chia for his supplementary question. Indeed, we approach this training on a very holistic manner because mental health awareness, the ability to be able to identify and escalate very quickly and to do constant surveillance and constant monitoring and engagement is a multi-disciplinary, multi-pronged approach that is needed through the support of dorm operators, by our FAST ambassadors on the ground, by the employers, by the NGOs, the partners and, of course, ultimately, the tertiary healthcare providers, including IMH.

We have a multi-pronged approach when we started Project DAWN last year. DAWN is an acronym. "D" stands for depression, "A" stands for awareness, "W" is wellness and the "N" stands for normalisation, how do we help the migrant workers normalise back. The DAWN task force started with seven core initiatives. They are grouped according to primary prevention, secondary intervention and the third part, not really tertiary, but where we help them to rehabilitate back into society.

As a result of that, we have got buddies, we have also worked with volunteers. They become the friends of ACE. We call that the FACE network. So, it is a multi-pronged approach to reach out to all of our migrant workers who need help.

I am happy to go deeper into the details, perhaps if we have time. But I think, given the amount of Parliamentary Questions (PQs) that we have to cover today, I will leave it at that. I hope it answers the question.

I have one supplementary question for the Minister. Minister spoke about the pilot, which saw an increase in numbers from 500 to 3,000. Can the Minister share with the House what were the considerations that determined that number 3,000? Why not 2,000 or 4,000, because that will give the public and those who are looking at this issue more closely some ideas as to when further opening can potentially take place or, at the very least, when certain foreign workers who may need a little bit more assistance can be attended to by the relevant agencies and individuals?

I thank Mr Pritam Singh for his question. The question of easing the restrictions for our migrant workers to go out into the community is constantly on our minds, not just all of us in MOM, particularly the ACE Group. They are also at the back of — well, not at the back of our minds, but on an almost daily basis, we contemplate. We planned for the easing of the restrictions as early as December last year; this was about a month after we formed the DAWN task force.

At different times when we planned, with the drawer plans that we have in place, each time, we were hit by different curve balls. You would have read about the Delta variant. At any particular point in time where we try to ramp up, easing the restrictions, there were new and significant turns of events that did not allow us to do so. We then focused on the singular approach of ensuring that all of our migrant workers are protected through vaccination. The vaccination centres were set up and our focus was really making sure that we protect them.

When we were able to bring them up to a high level of vaccination within the dorms, again, we tried to work on a mechanism for easing. In my earlier interview with The Straits Times and with the media, I said, "The key thing was finding a safe and a very calibrated manner". And I think that there were obviously subsequent events that have overtaken us. In spite of that, once we have achieved that high level of vaccination, and we also had enough evidence to show that those of us who have received and completed the two doses of the vaccination, the incidence of complications was significantly less than for those who are unvaccinated. With that, we took on that pilot in mid-September to allow 500 to go out.

We also sought feedback through our survey with the migrant workers to ask them what would be important for them when they go out to visit these community areas. Many of them wanted to go to a religious place of worship. So, our ACE Group then engaged the Hindu temples, the mosques, as well as churches to see how we could accommodate them to let them fulfil their religious needs. We also worked with the shopkeepers and so on. We identified shopkeepers, the retail shops to make sure that social distancing was adequately maintained. We reached out to the churches, the temples, the mosques to get them to support us and we started that pilot visit.

We also had to ensure, as we move towards endemicity, at some point, we were concerned about, given the space that they are living in, to ensure that the infection, if it comes into the dorm, it does not spread. So, we took all the necessary precautions in terms of pre-event testing before they left. And after coming back, we also tested them.

When we were able to ascertain that the entire visit was safe, that we were able to adequately address the physical, mental and social needs; on top of that, keep them medically well-protected, we then ramped up from 500, increasing it sixfold to 3,000. And we also increased the areas.

At each step of the way, there were quite a fair bit of logistical arrangements that we had to make, including arranging for the buses to bring them there; also making sure that the itinerary, the programmes planned for them were adequate. In the beginning, we even had to nudge employers, because even though we opened up 500 a week, we found that, for a while, we were only getting about 50% to 60% of them coming on board. There were also migrant workers who signed up, only to cancel at the last minute. So, these are all the logistical issues and so on that we had to plan through. Once we were able to smoothen out all of these different gaps and so on, we then moved on to increasing the number to 3,000.

The plan, hopefully, in the ensuing weeks and months ahead, is that as we move to this new normal, is not to restrict but to open up even more. At this particular point in time, because we had just started the 3,000 last weekend, just about three days ago, we will maintain and watch it for a while. I hope that answers the questions.