Should male Singaporeans suffering from Schizophrenia serve national service?

Private Ganesh Pillay Magindren, aged 23, who suffered from schizophrenia (diagnosed and on treatment by Dr Paul Ngui, a senior consultant psychiatrist in private practice), was found dead at the bottom of his Sengkang condominium in July 2013. As the coroner’s inquiry is still on, I will avoid commenting on the specifics of the case.

However, some of my friends have asked me this general question: Should male Singaporeans suffering from Schizophrenia serve national service?

The answer is No if the person has been suffering from Schizophrenia for a period of time and still has got symptoms of the illness at the time of his medical check-up at the Medical Classification Centre (MCC) of Central Manpower Base (CMPB). Such a person is usually given PES F. (please note that PES A and B are for those who are combat fit; PES C and E are for those with medical or psychiatric illnesses and are considered non-combat fit; PES D is for those who are temporary unfit due to medical illnesses which are still being treated. PES F is for those medically unfit and is exempted from national service)

The answer is Yes if the Schizophrenia is diagnosed and treated and the person is free from symptoms at the time of his medical check-up at MCC. The person can be considered for enlistment as a non-combatant (most probably as a PES E personnel) to serve as a clerk or store-man.

This decision to enlist a male person suffering from Schizophrenia is on a case-by-case basis; there is certainly no one size-fits-all policy. Sometimes, the SAF psychiatrist may consider the person with Schizophrenia fit for PES E enlistment but because of the risk of relapse whilst serving NS, the psychiatrist may decide to exempt the person by giving him PES F instead. Sometimes, family members may request the SAF psychiatrist to enlist their son with Schizophrenia for a trial of PES E because they feel that a stint of NS may be useful for their son to get mentally stronger. If the person fails to adapt after a period of time, the SAF psychiatrist will then medically discharge him by giving him PES F.

What is important is that when the person with well-controlled Schizophrenia is enlisted, the camp Medical Officer and Manpower Officer must be notified so that they would make sure that the person is well supervised and taken care of. The work allocated to such a person and his stress level should be monitored closely.

The moment there is evidence of abnormal behavior or change of behavior because he is unable to handle the stress of even PES E type of work, the person’s immediate family members must be notified so that preventive steps (e.g. bringing the person to see his psychiatrist earlier than his scheduled appointment etc) can be taken. And if the person continues to have difficulties adjusting to the military environment, the Manpower Officer must notify the unit Medical Officer who will then inform the SAF psychiatrist. A medical board can be convened to medically discharge (PES F) the person so that he can continue to receive treatment without the additional stress of having to serve national service.

Dr Ang Yong Guan

Dr Ang Yong Guan is a medical doctor. He graduated from the National University of Singapore in 1979 and did his postgraduate training in psychiatry at the University of Edinburgh between 1984 and 1986. He served as a psychiatrist with the Singapore Armed Forces between 1986 and 2003 and retired from the SAF (with the rank of Colonel) as Head of Psychological Medicine. He ran in GE 2011 under the ticket of Singapore Democratic Party.

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