Commentary: Conversations with a 69-year-old man showed me the despair among elderly who self-harm

SINGAPORE: Growing up, it was not uncommon to notice cuts on the wrists of my schoolmates. Some even posted about it online. 

A popular music video at the time - featured a teenage girl and her struggles with school, friends and parents - showed how it is done.

But a recent conversation with a partially blind 69-year-old man showed me a different side to the issue. 

The senior, who only gave his name as Mr Wong, did not have the same troubles as the young girl in the music video. The fear that consumed him was of dying alone in his one-bedroom flat, keeping him awake at night.

He'd been prescribed a daily dosage of one-and-a-half sleeping pills. When the prescribed dosage didn't work, he started taking more pills. This went on for weeks. One night, in an attempt to end his life, he swallowed about 50 tablets.

Unfortunately, Mr Wong's case is not uncommon, caregivers and social workers told me. 

DIFFERENT METHODS OF SELF-HARM

People above the age of 60 usually self-harm in two ways, said Dr Yao Fengyuan, senior consultant and chief of the Geriatric Psychiatry Department at the Institute of Mental Health.

“One is by cutting themselves. The other is by overdosing. We think it is because they have more medication as compared to youth,” he said.

When I visited Mr Wong’s house, pills were stored in transparent containers and placed in different areas throughout the one-bedroom flat. It reminded me of my grandparents’ apartment, which had a three-tier trolley full of medication.

I could not help but think if having access to months’ worth of pills was risky for patients, even though it might be necessary for some.

Mr Wong, for instance, is partially blind and has trouble getting around. According to him, he wanted an escape from worries of being isolated and dying alone. 

Such concerns are potential triggers for those over 60 to commit self-harm, said observers.

But having someone to talk to in person has given Mr Wong a lifeline. For the past six years, social workers from non-profit organisation O’Joy have been visiting him fortnightly.

I would imagine my conversation with Mr Wong had inklings of some of those chats, as he frequently peppered his stories to me with, “I told them that as well".

LANGUAGE BARRIER

The hour-long interview I had with Mr Wong was one of the hardest I have ever done, mostly because of the language barrier.

He spoke mainly in Hokkien and could communicate in Mandarin, both of which I could not speak with the tact needed for a subject as sobering as self-harm.

As I prepared for the interview, I realised the only questions I could articulate in Hokkien were: “Why did you want to commit suicide?” and “Why did you try to harm yourself?”

Too confrontational? I thought so and requested for a Hokkien-speaking cameraman to assist me. A social worker who could speak the dialect also sat in.

A social worker at O’Joy told me that it is challenging to find people who can work with the elderly, especially those who can speak dialects fluently.

Agencies such as Samaritans of Singapore are enlisting the help of frontliners such as hawkers and delivery drivers, for example, to reach out to people in distress and point them to the right resources. 

HELPING ELDERS OPEN UP

Despite my limitations, Mr Wong was very open with his story. At several points, he offered me poignant glimpses of his life – private accounts that he has only told one other person. That included snapshots of his love life and his troubled childhood.

I guess my concerns about the language barrier were unnecessary. But I wonder if I would be brave enough to talk to a stranger showing signs of distress. It does not exactly make for light conversation. 

It might also seem like our elders feel less inclined to talk openly about their issues, preferring to tough it out.

That may be true for some. But for those like Mr Wong, especially those who live alone, it seems like all they are searching for is a friend to talk through their issues. Having a good rapport with them face to face can break down more barriers than an unfamiliar voice on the phone can.

Or if they’re like my grandmother, a simple hand hold can make her cry and tell you she’s sad.

The topic of self-harm among elders is curiously elusive. A clear picture is hard to capture as there is no official data on this. It is hard to find information on it, which is not the case for youth.

Of course, there is the possibility that self-harm in this age group might not be a ubiquitous issue. But as Singapore’s population ages, I think this is something worth looking into.