Grief and prolonged grief

Grief is not an illness and most people who are grieving do not need treatment. They need time, and people around them who can bear to stay. A small number of people get stuck, and for them there is a name and a route. This page covers both, and keeps them apart.

What grief is

Grief is the response to losing someone who mattered. It is not only sadness. It shows up as exhaustion, anger, guilt, numbness, difficulty concentrating, disturbed sleep and appetite, and a physical ache that people often describe as being in the chest. Many bereaved people also report hearing or briefly seeing the person who died. That is common and it is not a sign of losing your mind.

It does not proceed in stages. The stage model that most people have heard of was drawn from observations of people facing their own dying, not from the bereaved, and decades of research since has not found that grief moves through an orderly sequence. Grief comes in waves, it is set off by ordinary things, and it gets worse before anniversaries and birthdays. Expecting stages mostly produces a second worry on top of the first: the feeling that you are doing it wrong.

How long it takes

Longer than people expect, and much longer than most workplaces and social circles allow for. Intense grief for several months is ordinary. Grief that still ambushes you at two years is ordinary. What usually changes over the first year or two is not the depth of the loss but the amount of the day it occupies, and whether you can function around it.

The useful question is not how sad you are. It is whether life is gradually widening again. Are you eating, working, seeing anyone, doing anything that is not about the loss? If the answer has been no for a long time and is not moving, that is the signal.

When grief becomes a condition

Prolonged grief disorder is a formal diagnosis. It was added to ICD-11, the World Health Organization classification, and to DSM-5-TR, the American diagnostic manual, in the early 2020s. The two set different time thresholds, and a clinician in Singapore may use either.

• ICD-11 sets the threshold at persistent, pervasive grief lasting at least six months after the death, clearly beyond what the person’s culture or context would expect.
• DSM-5-TR sets it at twelve months for adults, and six months for children and adolescents.

Both require more than duration. The picture is an intense yearning or preoccupation with the person who died, together with things like an inability to accept the death, intense emotional pain, feeling that part of yourself has died, withdrawal, emotional numbness, and a sense that life is meaningless, at a level that disrupts functioning.

Duration alone is not the diagnosis, and the thresholds are not a deadline. Missing someone at eighteen months is not a disorder. Being unable to put their things away, work, or leave the house at eighteen months is worth taking to a doctor.

Where to get help in Singapore

Bereavement support here sits mostly with the hospices and a small number of community organisations, and a fair amount of it is open to anyone, not only to families of their own patients.

• Assisi Hospice runs individual bereavement counselling, a bereavement support group for people at least six months after a loss, and a monthly Grief Cafe. It is open to anyone who has been bereaved, not only to families of Assisi patients, and it is free. Referral is by online form or email.
• HCA Hospice provides bereavement counselling and art therapy through its psychosocial services team, and runs a public grief information site at grief.hca.org.sg. Its services are free to patients and families.
• Viriya Community Services runs a Grief Support Programme with one-to-one counselling and support groups for bereaved adults, on 6286 8033.
• Wicare Support Group works specifically with widows and their children, with free counselling, structured grief groups and peer mentoring, alongside educational and financial assistance.
• Child Bereavement Support (Singapore) is a network for parents who have lost a child. Note the direction: it supports bereaved parents, not children who have been bereaved.
• Medical social workers at the public hospitals are an underused route. Tan Tock Seng Hospital lists grief and bereavement support explicitly. Singapore General Hospital provides grief support including for families after sudden or traumatic deaths; some therapy there is chargeable, with Medifund available to eligible patients.

If the death was a suicide

Samaritans of Singapore runs Local Outreach to Suicide Survivors, known as LOSS, for people bereaved by suicide, alongside two structured groups: Healing Bridge, which meets in person monthly, and Healing Within, a six-week online programme run twice a year. Both require sign-up and an intake conversation. All of it is free. Reach them on 1767, or CareText on WhatsApp 9151 1767, both 24 hours, or at community@sos.org.sg.

Bereavement by suicide carries a particular weight: the searching for reasons, the guilt over what was or was not said, and the silence of people who do not know how to mention it. Talking to others who have been through it is one of the few things that reliably helps.

Two things this country does not have

There is no dedicated service here for a child who has lost a parent or a sibling. Wicare covers fatherless children, and beyond that a family is working with what exists for everyone: the hospital medical social worker, the school counsellor, or a GP or polyclinic referral to a child psychologist. If your child has been bereaved, start with the school. They see the child every day and they can refer.

There is also no named clinic or pathway for prolonged grief disorder. That does not mean you cannot be assessed; it means you will be assessed the ordinary way. Go to a polyclinic or a CHAS GP, ask for a referral, and you will be seen at IMH or a hospital psychological medicine department, or privately if you prefer. Say how long it has been and what you can no longer do. Those are the two things that get taken seriously.

If you are supporting someone

The most common mistake is going quiet, usually out of a fear of saying the wrong thing or of reminding them. You cannot remind someone of a death they think about all day. Silence is read as not caring, or as the death being unmentionable.

What helps is specific and repeated. Turn up. Say the person’s name. Offer one concrete thing rather than asking what they need, because deciding is hard when you are grieving. Keep doing it after the first month, when everyone else has stopped and the bereaved person is finally out of the administrative fog and into the loss itself.

Support for the people doing the supporting is listed on the caregiver support hub.

You are not the only one

26,499 deaths were registered in Singapore in 2025. Behind every one of them is a household going through some version of this. Whatever it feels like at the moment, you are not doing something unusual.

What help costs

Start with what is free, because a good deal of it is.

• National mindline 1771, 24 hours. Phone 1771, WhatsApp 6669 1771, or webchat at mindline.sg. No cost, no referral.
• Samaritans of Singapore on 1767, and CareText on WhatsApp 9151 1767. Also 24 hours, also free.
• Community Outreach Teams (CREST) are the general first stop. Community Intervention Teams (COMIT) go further, with counselling, case management and psychosocial support from qualified mental health professionals. Both are government funded and free to you. The wayfinding tool at aic.sg will match you to a team near where you live.
• Family Service Centres take walk-ins and there are 49 of them across the island. They handle counselling and money trouble in the same conversation, which is often exactly what is needed.

None of these asks you for a diagnosis, a referral or a card.

Subsidised treatment

Four mental health conditions are on the Chronic Disease Management Programme: anxiety, major depression, bipolar disorder and schizophrenia. Being on that list is what lets you claim CHAS subsidies at a GP and use MediSave for outpatient treatment. Dementia is on the programme too, handled as an ordinary chronic condition rather than under the mental illness heading.

At a public specialist outpatient clinic, including the Institute of Mental Health, subsidies run from 30 to 70 per cent for citizens depending on household income per person, and a flat 25 per cent for permanent residents. The referral is what unlocks that rate. Get one from a polyclinic, or from a CHAS clinic if you hold a CHAS card. Turn up without one and you pay private rates.

MediSave

You can use MediSave for outpatient treatment of those four conditions. The limit is $500 a year, or $700 if your case is complex. Both rise, to $700 and $1,000, in January 2027. Until then the lower figures are what you have to work with.

A 15 per cent co-payment normally applies. It is waived if you use MediSave at the clinic you enrolled with under Healthier SG. Ask your clinic whether that is you.

If someone is admitted

MediShield Life pays $230 a day for psychiatric inpatient care, for up to 60 days a policy year. For a standard ward stay that is not psychiatric it pays $830 a day. That difference is built into the scheme, and it matters if a long admission is a possibility.

What people actually pay

Once subsidies are applied, most people being treated for these conditions pay somewhere between $300 and $500 a year, depending on how complex the treatment is.

If money is the thing standing between you and treatment, say so at the clinic rather than quietly stopping. Medical social workers at the public hospitals assess for further help, and Family Service Centres and Social Service Offices deal with the financial side alongside everything else.