During a routine call from her Institute of Mental Health (IMH) case manager on Dec 13, 2021, Ashley Poo broke down after lamenting the loss of two close friends through suicide and over missing her pastor’s wife, who had also died. “I know I’m getting better, I feel better, but I’m just tired. I can’t take this anymore,” she sobbed. It was the first time she had broken down in seven months, but she said she felt better after crying.

Ashley enjoying her birthday party with Timothy, Mrs Poo and her father Gregory Poo, then 57, on Nov 25, 2021, when she turned 21. She had missed out on her 19th and 20th birthday celebrations because she was an in-care patient at IMH during those periods.

Ashley using her phone while lying down on the sofa in the living room on Dec 2, 2021. She slept there for a few days after she had overdosed on pills. “My room triggers bad memories because I used to overdose in there,” she said. Although she took her medication, she watched YouTube videos and scrolled through Discord for almost an hour in the dark before she fell asleep. Throughout the night, Ashley talked in her sleep. She said it happens when she is stressed.

Ashley attending a class at Republic Polytechnic, where she is a student. Because of her condition, she often misses out on her school life. “I have better control of my depression and I’m more emotionally stable than last year (2020),” she said. “To be frank, I’m tired of being depressed.”

Ashley with pre-school educator Low Li Yi at the Christmas Wonderland at Gardens by the Bay on Dec 19, 2022. Li Yi, 22, and Ashley became fast friends in 2018, when they were freshmen at Republic Polytechnic. Li Yi accompanied Ashley to the school counsellor before she was diagnosed and had even received a suicidal text from Ashley. Throughout it all, Li Yi stood by Ashley and offered a listening ear. “It was very scary. She left me a message and I got really sad,” she recalled. “I really tried to be there for her whenever she needed, even though I didn’t know how to help. I just talked to her or asked her out for a meal.”

“Mirtazapine, Paroxetine, Lamotrigine, Pregabalin, Quetiapine,” Ashley rattles off a list of drugs quickly, as if reciting the alphabet. Her prescription has changed over the years to better manage her anxiety, mood, sleep and psychotic symptoms. Before bed, her father handed her a cup of water and seven pills. The drugs are hidden in her parents’ room as a precaution against her overdosing on purpose. That night, Ashley ate all but one pill. She revealed that she had been stashing drugs away. “I’m trying to collect 100 pills,” she whispered.

Ashley visiting an arcade at Suntec City to blow off steam on Dec 13, 2021. She had been under some stress because of her mid-semester exams. She bought a penknife that same day, and used it to harm herself when she thought she had done badly.

Ashley sitting in her favourite seat on the upper deck during a two-hour bus ride from Jurong East Bus Interchange to Toa Payoh Bus Interchange on service 143 on Dec 7, 2021. As exams drew near, she felt overwhelmed, so she skipped a day of school. “I just want to get away from school,” Ashley said. “The further, the better.” When she feels stressed, she often takes bus rides with no destination in mind. “When my dad was a Grab driver, he used to drive my brother and me around to explore,” she explained.

Ashley dabbing at her arm in a public toilet at Suntec City on Dec 13, 2021. Even though Ashley felt better after going to the arcade, she insisted on buying a penknife to replace the rusty one she had. Exiting the store, she made a beeline for the toilet and locked herself in a cubicle. She said: “I cut my arm to remind myself that I can feel something, even if it’s physical pain.”

A page in a journal Ashley kept during her stay at IMH in 2019. She wrote: “I know depression and anxiety are common and serious issues that can affect anyone. I just wished it didn’t affect me because I want to live a normal life.” Ashley said she has matured since then and is no longer resentful of her condition.

“I am not looking forward to the appointment,” Ashley said. “I love my art therapist but I feel like I’m not ready to receive therapy.” She was worried about discussing her recent drug overdose because it triggers negative thoughts and emotions in her, she added. That night, she went home and cut her forearm with a rusty penknife.

The inflamed skin on Ashley’s wrist on Feb 8, 2023. Ashley has scabs all over her arms and legs. She said that her skin will itch whenever she feels stressed, and at times, she will scratch so hard it bleeds. “I’m used to it but sometimes it hurts,” she said.

Ashley's father Gregory Poo, 58, works as an IT executive at Anglo-Chinese School (International) and volunteers at The Green Roof, a rooftop garden initiative by the staff. He says the garden gives him an outlet to “discharge negative energy”. “While taking care of the plants, there are situations that are not within your control. But you can always plant them again and watch them grow patiently,” he said. “When the plants bear fruit, I feel fulfilled.” Besides gardening, Mr Poo also attends portrait drawing, watercolour and acrylic painting courses. He hopes to encourage Ashley to try new things to feel a sense of pride and accomplishment when she picks up a new skill.

Ashley’s bedroom. For 74 days, from December 2021 to March 2022, Ashley’s bed at home went untouched. In that time, her parents received four updates about her condition, but IMH never gave any treatment plans or an estimate for when she might be discharged, Mrs Poo said. It was her eighth and longest stay at IMH as an in-care patient.

Her parents provide constant reassurance that she “will never be a burden”, but Ms Poo still feels guilty about sharing her problems with them. Mrs Poo’s biggest struggle is not knowing how her daughter is truly coping. “It’s like a living hell for me,” she said. “There’s this constant fear within about what will happen. Am I going to receive a call to say that it’s the end? It’s cutting my heart into so many pieces.” As a devout Christian, her religion is the “survival tactic” that helps her in tough times, she said. “It’s my constant prayer that Ashley will one day realise her potential and her worth.”

Ashley reuniting with her brother Timothy Poo, then 16, at home on March 2, 2022, after she had spent 74 days at IMH. Her family is a constant light in the dark. “I worry about her. I miss her a lot. When she’s around, she’d randomly walk into my room to just sit on my bed. And we’d go to the shopping mall to have hotpot for lunch or watch Marvel movies together,” Timothy said.

Mr Gregory Poo hopes that mental health issues will not be stigmatised so that people will not hesitate to seek help or feel pressured to keep quiet about their condition. “Because the most important thing is you and your well-being,” he said. Mrs Poo told Ashley: “You are a blessing wherever you are. See the potential that you have, see how many lives you are touching by being truthful about what you’re going through.”