Singapore to hit goal of training 1,500 SGSecure Responders in psychological first aid by 2026

Key Concepts

• Psychological First Aid (PFA): An evidence-based intervention designed to reduce trauma-based stress and help individuals recover emotionally after an emergency.
• SG Secure Responders: Individuals trained as part of Singapore's national security initiative to respond to emergencies.
• Mental Resilience: The ability to cope with and recover from difficult experiences.
• Total Defense: Singapore's comprehensive defense strategy, which includes Psychological Defense as one of its six pillars.
• The Three L's: A framework for administering PFA: Look, Listen, Link.
• Downward Shift: A state where the mind is "switched off" or overwhelmed during distress, making body-based calming techniques more effective.
• Box Breathing: A specific breathwork technique for calming the body and mind.
• Havening: A self-soothing technique involving gentle touch and positive affirmations.
• Grounding: Techniques used to help an individual reconnect with the present moment and their body.
• SkillsFuture Credits: Government-provided credits in Singapore for citizens to offset training course fees.
• Sympathetic and Parasympathetic Nervous Systems: Parts of the autonomic nervous system responsible for the "fight or flight" response and "rest and digest" functions, respectively.

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National Push for Psychological First Aid (PFA) Training

Singapore is actively pursuing a national initiative to build mental resilience, aiming to train 1,500 SG secure responders in Psychological First Aid (PFA) by the end of the current financial year. Currently, approximately 1,300 responders have already completed this training. Beyond responders, the demand for PFA training has seen a nearly 20-fold surge in the past five years, with more youths, workers, and caregivers seeking to learn how to identify and support individuals in distress.

Specific training figures highlight this growth:

• Last year, the Singapore Red Cross trained about 7,500 people, including 475 SG secure responders.
• The Singapore Emergency Responder Academy (SERA) trained another 10,000 individuals.
• In 2024, around 7,500 individuals were trained in PFA, ranging from first responders to grassroots volunteers.

Understanding Psychological First Aid (PFA)

PFA is defined as an evidence-based intervention designed to reduce trauma-based stress and facilitate emotional recovery after an emergency. The concept originated in the mid-20th century but gained significant global momentum following the 9/11 attacks, which underscored the critical need for structured emotional support during crises.

In Singapore, PFA is integral to national security, with psychological defense being one of the six pillars of Total Defense. This emphasizes that national resilience encompasses mental readiness as much as physical security. The COVID-19 pandemic also played a crucial role in raising awareness about mental well-being, highlighting issues like social isolation and uncertainty.

Emotional distress is not limited to major crises; everyday emergencies such as accidents, sudden loss, or unexpected disasters can also profoundly affect individuals. To address this, Singapore operates a 24/7 national helpline staffed by trained counselors offering free support. The primary users of this helpline are young working adults, followed by teenagers.

Effective Communication and Common Pitfalls in PFA

When supporting someone in distress, it is crucial to avoid phrases that dismiss their feelings, such as "Don't cry," "It's not that bad," or "Cheer up." Recovery is neither immediate nor linear, and individuals cope in diverse ways. A common mistake is assuming what someone needs without first listening. As the transcript notes, "We talk too much and we listen too little," often feeling uncomfortable with silence and rushing to fill it. However, silence can be precisely what the distressed individual needs. Another error is "digging into the details of the distress," which can inadvertently cause re-traumatization.

The "Three L's" Framework for Administering PFA

The transcript outlines a practical, three-step framework for administering PFA:

1. Look: Assess the situation to ensure safety and identify who needs help.
2. Listen: Introduce yourself, inquire about their concerns, and attend to their immediate needs.
3. Link: Connect survivors with appropriate resources such as medical care, legal aid, or help in reuniting with loved ones.

The benefits of this approach are significant: it "shortens the time between distress and getting the help that they need," potentially preventing issues from spiraling. Importantly, it "reduces the sense of isolation," making the person feel "seen and safe and they are not alone." This early intervention helps build resilience in schools, workplaces, and communities, addressing issues before they escalate into more serious problems like aggression or suicidality.

Challenges and Solutions in PFA Adoption

Despite its growing traction, PFA faces several challenges in broader adoption:

• Misconception of First Aid: Many still associate "first aid" solely with physical injuries, not emotional ones.
• Professional-Only Perception: There's a misconception that only trained professionals can administer psychological first aid.
• Prioritization for Working Adults: For working adults juggling multiple responsibilities, PFA training often takes a backseat unless it is subsidized or linked to workplace requirements.

Organizations are implementing solutions to overcome these hurdles:

• The Singapore Red Cross leverages government initiatives like SkillsFuture Credits to make PFA courses more affordable.
• The Singapore Emergency Responder Academy offers flexible training modes, including e-learning, live online sessions, and industry-specific scenario exercises, to enhance accessibility.
• Both organizations are collaborating with companies, schools, and grassroots communities to position PFA as a practical life skill applicable to anyone supporting others in distress.

Expert Insights: Adrian Lim Ping An, Family Counseling Psychologist

Adrian Lim Ping An, a family counseling psychologist, provided further insights, emphasizing the critical need for early and widespread PFA training. Having worked for three decades in the school system as a social worker and counselor, he observed that untrained individuals often become "over excited, hysterical, or crunch" during emergencies, which is unhelpful. He argues that PFA training should start "very young in schools," even for students, not just teachers.

PFA vs. Therapy: Lim clarifies that PFA functions as the "first line of support," akin to an emergency room visit, after which individuals are channeled to specialized departments for follow-up therapy. Its purpose is to equip many people with the skills to "connect, engage, to link" those in distress with necessary help. He draws an analogy to CPR training, stressing that PFA is an essential life skill for everyone, especially in "turbulent times."

Body-Mind Connection and Calming Techniques: Lim highlights that when someone is in distress, the mind can experience a "downward shift" and become "switched off." In such cases, it is "more effective for the person to use the body to calm the mind than the mind to calm the mind." He advocates for proactive learning of these skills, comparing it to knowing emergency exits in a new building.

Practical calming tips include:

• Breathwork: Simple techniques like taking deep breaths slowly through the nose and out through the mouth, known as "box breathing." This physiological process helps shift the body from a "kung site" (sympathetic nervous system) to a "relaxed site" (parasympathetic nervous system).
• Havening: A self-soothing technique involving gentle touch (e.g., rubbing hands together) while repeating positive affirmations like "I'm okay, it's going to be okay." This mimics the soothing actions of a caregiver.
• Other techniques (to be discussed further): Energy flow, triple karma, and grounding.

These techniques are simple, clinically proven, and applicable in a wide range of situations, from managing exam anxiety to coping with an emergency. Lim stresses the importance of teaching these skills from a young age, particularly given that the age group between 10 and 29 has the highest suicide rates.

Conclusion

Psychological First Aid is presented as a vital tool for fostering mental resilience in Singapore, extending the concept of first aid beyond physical injuries to encompass emotional well-being. While significant progress has been made in training and reducing the stigma around mental health, challenges persist in ensuring broader adoption. Expert insights underscore the necessity of early, widespread training, emphasizing body-based calming techniques and PFA's foundational role as a "first line of support" that complements professional therapy. The overarching goal is to empower everyday Singaporeans with practical, clinically proven skills to support themselves and others, thereby preventing the escalation of distress and cultivating a more resilient and compassionate community.