Thoughts on World Mental Health Day 2024

Historically, lunacy and imbecility were seen as primary forms of insanity. Persons understood as lunatics, and then patients, have been incarcerated and made to labour, then transformed into objects of diagnosis and treatment. As a person with lived experience in Singapore, I wish to take a moment to remember my predecessors on World Mental Health Day 2024, to remember those who came before. Today we talk about working BetterTogether in mental health. Let us not forget important lessons that we may glean from the past.

My predecessors were subject to incarceration and punishment for the crime of being mad. Prior to the establishment of the first asylum in colonial Singapore, madness was understood in terms of badness: the “wandering lunatics and imbeciles” were disturbers of the public order and seen as unproductive, unlike their peers who were labouring on with work meant to benefit the colonisers. My predecessors were incarcerated with the Indian convicts and made to work, building palatial buildings and other structures as a form of punishment for their behaviour. At that time, criminality and insanity were closely linked.

My predecessors were thought to be immoral and irrational. For the British, the humane treatment of the mentally ill at the York Retreat was seen as pioneering and enlightened, notwithstanding earlier humane treatments of the insane in the Islamic bimaristans as early as the 8th century. The British then transplanted the asylum model with a view to furthering the humane treatment of the insane. Medical knowledge viz moral therapy from Britain was brought to colonial Malaya and Singapore as best practice technology characterised by rationality, while indigenous therapies and native epistemologies were seen as irrational.

My predecessors were made to do unpaid work in the asylums that served to reduce the running costs of the institution. Specific types of work were apportioned as befitting the colonised inferior races and classes—many of them were coolies who lived in overcrowded areas. Making rope and weaving blankets were as such, appropriate work for natives who were labourers but not appropriate for their European counterparts who played board games and tennis, amongst other more leisurely activities. In response, my predecessors showed their agency and resistance through utilising weapons of the weak—attempts to escape, non-cooperation with assigned tasks, and even suicide.

The physical bodies and mental states of my predecessors were studied and observed by colonial administrators such as Hugh Clifford and Frank Swettenham that fed into medical perceptions of specific races as prone to particular types of mental conditions. Natives were thought to be prone to amok and latah—this shaped the development of psychiatry and notions of culture-bound syndromes. Colonial understandings reinforced the civilising mission and in this way, knowledges of bodies were utilised to build and develop bodies of knowledge in the motherland.

My predecessors were made into objects of diagnosis and treatment. In particular William Gilmore Ellis is remembered today for abolishing the use of the straitjacket in Singapore. But he also concretised the medical gaze onto the insane, first calling them patients rather than lunatics. The bodies of inmates were clinically observed and subject to experiments in the name of science. He further created an admissions case book that would record and document individual features of bodies that could be classified and compared and analysed. Records of admissions, deaths, and diagnoses were lending to the legitimacy of psychiatry as an emerging field.