Learning to be a caregiver after son develops anxiety and selective mutism

Ms Wang Yoke Choo and her husband Alex are caregivers to their teenage son who has an anxiety disorder and selective mutism. PHOTO: COURTESY OF WANG YOKE CHOO

SINGAPORE - Nearly three years ago, at the height of the Covid-19 crisis, Ms Wang Yoke Choo’s mother died after a six-week fight with pancreatic cancer. Her teenage son, then 15, lost not just a constant and comforting presence at home but also a close confidante. 

Ms Wang began receiving calls from his secondary school teachers telling her that he was exhibiting “some behavioural problems”.

“He was not able to communicate with his teachers. When they asked him a question, he couldn’t respond. Basically, he couldn’t move physically and was in a frozen state,” Ms Wang, a regional vice-president of sales in an IT firm, told The Straits Times.

Then, her son’s best friend since primary school died in an accident within a week of his grandmother’s death.

That was when he became too anxious to go to school. She and her husband Alex Cheong, a global strategy director in a multinational firm, engaged the school counsellor for help, and their son was referred for assessment by a public sector psychologist.

However, they chose to seek help in the private sector as the waiting list in the public healthcare sector was too long. Their son was then diagnosed with an anxiety disorder and selective mutism.

“It was very difficult to keep up with the (school) curriculum. You need a lot of special arrangements with the school and that was not easy... The schools are neither really trained nor equipped to deal with special conditions like this,” Ms Wang said, although the teachers were more understanding after her son was diagnosed.

Ms Wang was on a caregiving panel at the inaugural National CARECarnival and Conference, which was held virtually on Wednesday to recognise and support caregivers.

The event was organised by the Agency for Integrated Care (AIC), CaringSG – a caregiver-led initiative for special needs caregivers and the community, the National Council of Social Service, and SG Enable, which helps persons living with disabilities.

On the panel, Ms Wang said that she had chanced upon a 12-week caregivers-to-caregivers programme for persons caring for those with mental health issues at Caregivers Alliance a year into her caregiving journey, and found support in that community.

“One of the things that I took back is that you’re not alone. It was very liberating,” she said.

Caregivers often find themselves thrown into their new role. When Ms Wang’s son was first diagnosed, she and her husband busied themselves with learning about his condition and finding a solution.

“Everybody advised us to go for private help (to avoid the long waiting time for public healthcare) but you then become the case manager. You have to coordinate between the different therapists and the school,” said Ms Wang, who would wait near his school every school day, in case he needed help.

To care for him, she took a year and a half off work, and she and her husband saw a counsellor to cope with the changes in the family, which includes a younger daughter.

They later pulled him out of the public school system and sent him to a private school, where the staff had experience with students with mental health conditions. In 2023, they agreed to their son’s request to stop school and focus on recovery.

She said: “There is no need to conform to the (education) timeline, because everybody moves at a different pace. That’s one thing that we have to accept – and the other thing would be that recovery is not a linear journey.”

She is hopeful that he will recover, but no longer has an expectation of when that will happen or when he will be ready to return to school. “It’s really about accepting the fact that he has a condition and that he needs time to work through it,” said Ms Wang, who went back to work in 2023.

At the caregiving conference, new resources were launched, including a learning guidebook by AIC and SG Enable that offers tips for those caring for seniors, persons living with mental health conditions or persons living with disabilities, and a learning roadmap for those caring for persons living with disabilities.

“Based on our interactions with caregivers, we found that the other challenge they face, aside from how to deliver the physical care to their care recipient, is how to plan, organise and coordinate the care for their loved one,” said Ms Carol Yeung, senior assistant director of AIC’s caregiving and community mental health division.

The guidebook, which features examples of common situations faced by caregivers and the relevant resources available, was developed to help navigate the complexity of caregiving, including the need to manage relationships and communications with family members and for self-care, she said.

The conference will be followed by three island-wide carnivals, held across November, to raise awareness of support available for caregivers and their care recipients. There will be talks, booths on caregiving resources and an exhibition of caregiver stories.

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