She wanted to injure sickly son so he would be taken to a home, but killed him instead
She was diagnosed with schizophrenia in 2006, and had to stay at the Institute of Mental Health (IMH) three times between February 2011 and February last year.
In two of these occasions, Rebecca Loh Chui Lai, 32, was admitted into IMH after attacking her mother, Madam Kum Yuet Mei, 65.
And she was remanded in IMH once for carrying a chopper in a public place.
Despite her history of violence, Loh believed she was not mentally unwell and would not take her medication.
Her non-compliance with her treatment ended in tragedy.
She pushed her only child, nine-year-old Gabriel Loh Zhen Jie, out of the kitchen window to his death on June 1 last year.
The single mother was jailed the maximum 10 years yesterday, after pleading guilty to culpable homicide not amounting to murder.
Deputy Public Prosecutor (DPP) Eugene Lee said when Loh committed the offence, she was suffering from post-schizophrenic depression.
Gabriel was a sickly child and very small for his age, and DPP Lee said the boy suffered from a host of medical conditions including liver impairment that resulted in severe jaundice and malnutrition.
His father was Loh's acquaintance, and she lost contact with him before their son was born.
The mother-and-son pair had been living with Madam Kum in a fifth-storey flat at Block 704, West Coast Road.
The jobless Loh was financially dependent on her mother, a part-time assistant in a bakery, who earns $800 a month.
At around 6pm on the day of the incident, Loh was feeling very stressed about her finances and was worried about providing for Gabriel, the court was told.
She felt that if she could cause him to suffer injuries that were serious enough to attract the attention of the authorities, he would be taken away from her and placed in a home where he could receive better care.
She thought that she would then not be stuck at home with him, making it possible for her to look for a job.
Gabriel was playing with a handheld game on a sofa in the living room when she picked him up and carried him towards the kitchen window.
He struggled and managed to break free twice, until finally he told his mother that he had no more strength to resist and began to cry.
The boy tried his best to grip onto the bamboo pole holders when she placed him on a small ledge outside the window. But she pushed his hands away, causing him to fall to the ground.
Residents in the neighbourhood saw the horrifying incident and informed the police.
Officers who later arrived at the scene arrested Loh. Gabriel was taken to the National University Hospital, where he was pronounced dead at around 7pm.
DPP Lee urged Justice Tay Yong Kwang to sentence Loh to between eight and 10 years' jail, stressing that she would possibly need treatment for the rest of her life.
He said: "She will need to be secured in a structured environment so that she can receive proper treatment for her psychiatric condition.
"This will ensure that she does not pose a danger to the public and to her immediate family members."
In mitigation, Loh's lawyer, Mr Amarick Gill, suggested that the court order IMH consultant Dr Bharat Saluja, who had assessed her, to submit a report before she was sentenced.
The lawyer said: "The focus of this report will be the... doctor's medical opinion on whether Rebecca may be cured, will relapse or will always spiral downhill.
"Rebecca may indeed need treatment for the rest of her life, and it is possible such treatment need not come from a prison setting."
Rejecting Mr Gill's suggestion, Justice Tay said he would be "surprised if any doctors come with such a prognosis" as Loh's case involved her mind and not a body part.
For committing the offence, Loh could have been fined on top of receiving the maximum jail sentence.
"She will need to be secured in a structured environment so that she can receive proper treatment for her psychiatric condition. This will ensure that she does not pose a danger to the public and to her immediate family members."
- Deputy Public Prosecutor Eugene Lee
Caregivers can neglect themselves for sickly kids
Imagine carrying a heavy load on your back without a moment of rest.
That is how stressful long-term caregiving can be, said Mrs Sara Tan, the executive director of Hougang Sheng Hong Family Service Centre.
"It is very possible for the caregiver to sink into depression or develop other psychiatric condition if the caregiver has little respite from other sources of support, such as other family members or friends, community service providers or avenues to draw strength from," she said.
Without avenues to "recharge their energy", caregivers will burn out sooner or later, she added.
Sometimes, parents may be so focused on caring for their sickly children that they neglect their own health.
Some may even feel guilty for taking a breather, said Dr Lim Boon Leng, a psychiatrist at Dr BL Lim Centre For Psychological Wellness.
"They often develop conditions like depression or anxiety disorder. But as they think feeling that way is part and parcel of caregiving, the psychiatric conditions go undetected," he said.
Dr Thong Jiunn Yew, a psychiatrist at Nobel Psychological Wellness Clinic, agreed.
"Some of the parents who come to us do not mind looking after their sickly children, but worry about who is going to take care of their children after they die," he added.
If left to fester, these medical conditions may lead to impaired judgment.
Said Mrs Tan: "While I believe that no parents in their logical mind will want to harm their children, it is not uncommon for us to come across parents who do 'mistreat' their children...
"Some may lose hope in the child's future and may perceive their act (of killing the child) as ending the child's suffering."
The only way to cope is to seek help from counsellors and doctors, said all three experts.
Mrs Tan added that parents also need to be told that they deserve a break and must know where they can turn to for respite.
All three experts emphasised the importance of family members in detecting caregiver stress and making sure that they seek help.
But Dr Lim pointed out a loophole that lets certain patients fall through the cracks.
Under the law, the police can arrest anyone believed to be of unsound mind and who is potentially dangerous to himself or other people.
But this applies only when harm has been done. It does not take care of patients who have a case history and could suffer a relapse, Dr Lim said.
He suggested having a community treatment order, which gives doctors the authority to put patients on a mandatory treatment plan.
If the patient fails to comply, then he may be admitted to the hospital as a formal patient.
- FOO JIE YING