Till the Break of Day: A History of Mental Health Services in Singapore, 1841-1993

Till the Break of Day: A History of Mental Health Services in Singapore, 1841-1993 gives a comprehensive account of the development of mental healthcare in Singapore and provides a history of the Institute of Mental Health, formerly known as the Woodbridge Hospital. It documents the development of mental health services in Singapore over 150 years, starting from 1841 with the establishment of the first 30-bed “insane hospital”. From its humble beginnings, the small mental asylum progressively grew and was renamed Woodbridge Hospital in 1951. It continued to expand to the current 25-hectare premise and became the Institute of Mental Health in 1993. Its role has also morphed over time from solely providing custodial care to offering a multidisciplinary and comprehensive service that is focused on treatment, recovery and community integration.

The book consists of two sections. The first section mainly covers the colonial era. The first chapter focuses on depicting the history of mental health services in colonial Singapore in the first 100 years, and recounts how a state-supported system of mental hospital and an institutionally-based psychiatric profession were founded. In the following chapters, Ng attempts to capture the various aspects of the history as it has unfolded since colonial times. He shares the classification systems of mental conditions, physical illness and mortality patterns of the inmates, the use of mechanical restraints in the treatment of mentally ill in late 19th century in Singapore, asylum culture and shortage of attendants as well as different treatments between work and occupational therapy. Ng also narrates the interruption by Japanese Occupation and the struggle during the post-war years, as well as how the Mental Hospital changed when Singapore transited from colony to nation. Ng discusses how ethnic and cultural diversity influence the beliefs and behaviours of patients. With emergence of psychiatry as a medical discipline, the mental health laws also have undergone dramatic and radical changes to reform asylum management.

The second section focuses on the post-colonial developments of Singapore. Ng narrates the subsequent developments and expansion of mental health services, including service provisions for child and adult psychiatry, training of medical students and psychiatrists as well as multidisciplinary psychiatric treatments. Ng also goes beyond Woodbridge Hospital to explore the development of psychiatry in Tan Tock Seng Hospital and the National University of Singapore, and to chronicle the birth of private psychiatric practice and military psychiatry in Singapore. Lastly, it also briefly documents the origins of professional bodies, several voluntary welfare organizations and of a private nursing home for chronic mentally ill patients.

The author, Ng Beng Yeong, is the founding President of College of Psychiatrists, Academy of Medicine, Singapore. He was formerly Head of Department, Psychiatry, Singapore General Hospital (2006-2015) and President of Singapore Sleep Society (2006-2008). The 3 years of research and writing taken to finish the book was a proverbial race against time as many senior staff of the old hospital had retired and it was challenging to obtain historical anecdotes from them. It is truly a commendable effort to put this book together.

First published in 2001 and republished in 2016, the book is useful for historians and general readers who are interested in mental health history in Singapore and can serve as a reference guide in the training of young psychiatrists, medical students, psychologists, nurses, counsellors, social workers and other healthcare professionals.

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