In recent years, poor mental health has become a topic of concern in Singapore.
According to the Ministry of Health’s (MOH) National Population Health Survey 2022, released on 27 September 2023, the prevalence of poor mental health increased from 13.4% in 2020 to 17% in 2022.
Fortunately, things may be making a turn for the better.
In Parliament on 7 February 2024, Deputy Prime Minister Lawrence Wong announced that mental health will be a “key priority” in the national agenda.
The motion on advancing mental health care was passed unanimously in Parliament.
The debate was so long that it lasted two days, so here is a handy summary of Singapore’s push to make mental health a national priority.
Why Now: Mental Health “Always in the Shadows”
Mr Wong noted that mental health has grown in importance across the world, adding that the topic has become even more crucial following the COVID-19 pandemic.
He said, “It was always in the shadows. It’s not something we talked about publicly.”
As attitudes towards mental health have become more positive, with people being more informed and willing to talk about it openly, it seems like a good time for more measures to be put in place to improve the mental health scene.
Improving Healthcare System to Meet the Mental Health Needs of Singaporeans
During a parliamentary motion on advancing mental health, Mr Wong announced measures that Singaporeans can look forward to.
The government plans to implement these measures by 2030.
Besides increasing capacity at the Institute of Mental Health (IMH) and the redeveloped Alexandra Hospital, the government aims to introduce mental health services at all polyclinics and 900 more GP clinics.
Furthermore, the government aims to increase the number of public-sector psychiatrists by 30% and public-sector psychologists by 40%.
It also plans to train another 28,000 frontline personnel and volunteers.
Notably, a press release by MOH in 2022 reported that in 2020, the median waiting time for a new subsidised appointment to see a psychiatrist at a public hospital was 34 days.
Thus, these new measures would help with the growing demand for mental health services in Singapore.
Measures Will be Implemented Step-by-step
Of course, it isn’t possible to implement everything all at once.
The first measure to be implemented would be increasing the capacity at IMH and the redeveloped Alexandra Hospital for those who need specialist care.
As for long-term care facilities, capacity will also be increased to provide “step-down care” for those who need it.
Following the capacity increase, the government aims to increase the number of public sector psychiatrists and psychologists.
Then, mental health services will be introduced to all polyclinics.
Finally, 28,000 more frontline personnel and volunteers at various community and social service touchpoints will be trained.
This will enable them to “identify people struggling with mental health and offer early assistance”.
Mr Wong reasoned that the rationale behind this staggered implementation was that hiring more psychiatrists and increasing capacity at IMH is not the be-all and end-all solution.
He added, “We also need to strengthen capabilities across our entire spectrum of care, including at our polyclinics and GPs, and also across other settings like schools, workplaces, and in the community so that more timely support can be rendered to those in need.”
Another Crucial Reason for the Wide Range of Solutions
Last year, in October, the national mental health and well-being strategy was launched, bringing a new tiered care model to organise mental health services depending on the severity of an individual’s needs.
The tiers span across health, social and education settings.
The initiative also aims to focus on preventive care under a holistic strategy rather than simply focusing on treating mental disorders.
In Parliament, Mr Wong called for a need to understand a “full range of mental health issues”.
On the one hand, mental health conditions like bipolar disorder and schizophrenia can be debilitating.
On the other hand, issues like anxiety and stress may not be as debilitating and do not usually require medicalisation.
However, the latter two are still valid mental health conditions that should not be taken lightly.
Because mental health issues exist on a spectrum, the government aims to implement a broad range of solutions.
Redefining the “Singapore Dream”
When one thinks of the Singapore Dream, they probably envision the 5Cs – cash, car, credit card, condominium, and country club membership.
This dream has the underlying assumption of being mentally stable and content with life.
However, Mr Wong noted that mental health stigma remains despite a shift in attitudes.
He acknowledged that the stigma “reduces a complex and difficult problem into unhelpful labels and stereotypes”, adding that those struggling with mental health are often subject to discrimination.
He said, “It may cause them to be socially ostracised. It makes them feel ashamed and isolated and stops them from seeking treatment.”
Thus, on 7 February, Mr Wong acknowledged that improving mental health means changing mindsets about what constitutes success.
This was one of the key points from the Forward SG engagements, a nationwide feedback exercise conducted by the government and chaired by Mr Wong.
He defined the changed, more inclusive Singapore Dream as one “where we are not pressured to conform to narrow definitions of success; where we embrace excellence and talents across many areas, and find meaning and purpose in what we do”.
Noting that making mental health a national priority cannot happen through policy alone, he called for redefining Singapore’s ideals.
Dr Wan Rizal (PAP-Jalan Besar) reminded the House that stigma is “not just a societal issue”.
He added, “It’s profoundly personal, affecting individuals and families in every corner of our community.
“The stigma mutes voices that need to be heard. It isolates those who feel alone in their struggle and deepens the wounds of those silently suffering.”
He nodded to the importance of cultivating an environment where people are unafraid to seek help or talk openly, saying that this mission spans “every facet” of society.
Calls for Better Regulation of Professionals
On 6 February, the House heard speeches from MPs on a motion filed by the Government Parliamentary Committee (GPC) for Health, “That this House recognises the importance of mental health as a health, social and economic issue; affirms the importance of a robust national mental health ecosystem; and calls for a whole-of-Singapore effort to implement a national strategy to enhance mental health and well-being.”
The debate lasted for over six hours, with 15 MPs, seven Nominated MPs and a Non-Constituency MP speaking about various aspects of mental health.
Referencing the national mental health and well-being strategy, Dr Wan noted that the lowest tier of the four-tier model covers community-led mental health promotion, self-help and peer support.
Thus, he called for ensuring the quality of the programmes and certifying volunteers and professionals.
Ms He Ting Ru (WP-Sengkang) had similar thoughts, saying that the current lack of regulation requires more attention.
She proposed setting up a regulating body consisting of organisations like the Singapore Association for Counselling and the Singapore Psychological Society to “ensure a universal standard of care and quality of care in the provision of such services to support mental health”.
Ms He highlighted the importance of volunteers and professionals having “at least a baseline level of training, expertise and ethical practice”.
She also suggested establishing safeguards for the protection of “vulnerable minors”.
Calls for Better Mental Health Insurance Coverage
On 6 February, a few MPs raised concerns about mental insurance coverage.
For instance, Dr Tan Wu Meng (PAP-Jurong) noted “the sense of fear and anxiety” of being denied insurance when one gets diagnosed with a mental health condition.
Responding to these concerns on 7 February, Mr Wong pointed out that life insurers in Singapore have offered coverage to people with mental health conditions.
However, he acknowledged that “the underwriting of such persons can be a complex matter, as our own data is limited, and insurers here typically reference the underwriting guidelines of global life reinsurers”.
Nonetheless, he added that the government will review how coverage can be improved.
He said that the government will ensure that financial institutions deal with all their customers fairly, including those with mental health conditions.
Measures to Better Understand Employees’ Mental Well-being in the Workplace
Minister of State for Manpower Gan Siow Huang announced the introduction of iWorkHealth Lite, a “dipstick survey” that can be completed in five minutes.
The survey aims to allow companies to gauge their employees’ work stress and burnout levels.
The iWorkHealth Lite comes under the Ministry of Manpower’s (MOM) iWorkHealth assessment.
This free, online, company-administered tool allows employers to gain insight into their employees’ well-being and stressors.
The shortened survey was a response to feedback from companies.
They suggested using iWorkHealth as a “pulse survey” to make monitoring the mental well-being of their employees more accessible and frequent.
Responding to the sentiment among MPs about eradicating mental health stigma, Ms Gan said that employees should be “treated fairly and based on merit”, even if they disclose their mental health conditions.
She added that the upcoming Workplace Fairness Legislation “sends a strong signal that there is no place for discrimination against employees and jobseekers with mental health conditions”.
The Ministry of Education is On the Way to Achieve Target of Deploying More than 1,000 Teacher-counsellors Across Schools
In 2021, the Minister of Education, Mr Chan Chun Sing, introduced a series of measures to improve students’ mental health.
Firstly, the Ministry of Education (MOE) aimed to deploy more than 1,000 teacher-counsellors in the next few years.
Secondly, all teachers would receive enhanced professional development in mental health literacy to improve their abilities to identify and support students in need.
On 7 February, Mr Wong noted that Singapore is seeing a surge in mental health issues among youths, adding that the government is “redoubling efforts” to understand these issues better.
He said that Singapore is working with researchers worldwide to tackle the root cause of the rising cases of mental health issues among youths.
Notably, the issue is seen in other countries as well.
Researchers believe that one of the reasons behind this issue is due to heavy social media usage.
After all, it creates the pressure to present the best version of one’s self online and leaves people open to cyberbullying.
Besides that, as youths spend more time online, they are more likely to end up sleep-deprived, exercise less and have fewer real-life interactions.
Another reason for the increase in mental health issues is that children have less room to play and explore in the real world, causing them to be “less likely to grow up with a sense of independence and confidence to take charge of their own lives”.
On the same day, Mr Wong noted that MOE is on track to achieving its target of deploying more than 1,000 teacher-counsellors across schools.
He added that parents will be provided with resources to help them support their children’s mental health needs.
Furthermore, more peer support networks will be established in the community, such as in schools, institutes of higher learning (IHLs), workplaces and among national servicemen.
On 7 February, Mr Wong called Singaporeans passionate about mental health to join the national movement to make mental health and well-being a “key priority”.
He said that while the government has implemented some measures and goals, the issues are “complex”.
He added, “We want everyone on board so that we can learn together and continue to fine-tune our strategies based on your feedback, ideas, and shared experiences and insights.”