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In this Explainer, find out...
What factors motivated the 2023 National Mental Health and Well-being Strategy?
What are the core components of the National Mental Health and Well-Being Strategy?
What key issues must the National Mental Health and Well-Being Strategy respond to?
Introduction
Around the world, there is growing recognition of mental health’s importance for one’s quality of life and productivity. This trend is mirrored in Singapore where mental health issues like anxiety and depression result in economic costs. A study done by Duke-NUS and the Institute of Mental Health (IMH) estimates that mental health conditions collectively cost Singapore’s economy S$15.7 billion each year, representing 2.9 per cent of its Gross Domestic Product for 2022. This data highlights the urgent need for comprehensive mental health strategies in Singapore. These policies not only improve individual well-being but also safeguard economic stability and societal resilience.
In response to increasing rates of mental illness, Singapore's 2023 National Mental Health and Well-being Strategy (also referred to as “the Strategy”) emphasises mental health as a national priority. This aligns with the global movement to address mental health for enhanced social and economic outcomes. On this note, this Policy Explainer will introduce and break down the key components of the Strategy.
Mental Health in Singapore
Defining Mental Health
Having good mental health is a positive state where a person feels good emotionally, mentally, and socially. It is marked by feelings of happiness and satisfaction, the strength to bounce back from challenges, and the ability to handle life’s ups and downs. Good mental health includes positive feelings, a sense of purpose, and the ability to build healthy relationships and enjoy activities.
Mental health disorders are conditions where a person experiences ongoing patterns of thoughts or behaviours that cause distress and make it hard to think, feel, or act normally. These conditions are not chosen and can make it tough for people to do things they usually enjoy or need to do.
Traditionally, mental health has been understood in a way that categorises people as either "mentally ill" or "normal," like an on-off switch. This view, called the categorical model, does not leave room for the idea that one’s mental health can change over time. In contrast, a newer way of thinking sees mental health as a continuum, or a spectrum, where people can experience different levels of mental well-being. In this model, mental health is not just two categories. Instead, everyone can move along this spectrum at different points in life.
This continuum model helps break down the stigma around mental health by showing that everyone, at some point, might need support. It helps people see that asking for help when stressed or anxious is normal and doesn’t mean they are “mentally ill” or weak. This approach encourages a healthier, more supportive view of mental health, where getting help is just part of taking care of ourselves.
Factors Motivating the National Mental Health and Well-being Strategy
1. Rising Rates of Mental Health Conditions
Mental health issues have been on the rise in Singapore, driven by the stress of city life and the challenges posed by developments like the COVID-19 pandemic. According to the 2022 National Population Health Survey, the number of people experiencing poor mental health went up from 13.4 per cent in 2020 to 17 per cent in 2022. Young adults aged 18 to 29 had the highest rates, with 25.3 percent reporting poor mental health. This increase highlights an urgent need for better mental health support and resources.
2. Increased Public Awareness and Openness
Mental health is no longer a hidden topic in Singapore. In recent years, people have become more open to talking about mental health issues and seeking support, partly because of efforts to raise awareness and break down stigma. This growing openness has helped more people understand that it is okay to ask for help, creating a supportive environment and more demand for accessible mental health services.
3. The Need for Integrated Care
Mental health care is not just about treating one part of a person’s well-being; it requires a mix of support for one’s physical, mental, and social health. This is called integrated care, and it combines different types of help—like counselling, medical treatment, and social support—to meet people’s mental health needs in a balanced way. With integrated care, people do not just get treatment for symptoms; they also receive support to improve their overall well-being and quality of life. The complexity of mental health issues today has shown that Singapore needs this holistic approach.
Singapore's National Mental Health and Well-Being Strategy
Goals of the Strategy
Singapore’s National Mental Health and Well-Being Strategy is designed with several key goals in mind:
Promoting early intervention and support for individuals with mental health needs;
Reducing the stigma associated with seeking help; and
Enhancing the quality and accessibility of mental health services.
To achieve these goals, the strategy is built around the Tiered Care Model, which organises mental health services into four levels of care, each addressing varying degrees of mental health needs (see Figure 1). The tiers range from Tier 1 which focuses on mental health promotion amongst people who have no or minimal symptoms of mental health conditions to Tier 4 which provides high-intensity services for people with high mental health needs and severe symptoms. In between, Tiers 2 and 3 provide appropriate support for people whose mental health conditions display mild to moderate symptoms.
Figure 1: The Tiered Care Model
Components of the Strategy
The National Mental Health and Well-being Strategy has four key components:
1. Expanding Capacity of Mental Health Services
This includes increasing inpatient psychiatric bed capacity at facilities like IMH and expanding community-based mental health services through new polyclinics and partnerships with general practitioners (GPs). The Strategy also espouses developing specialised programmes for high-risk groups, such as youth and marginalised populations, to ensure tailored support for those who may face unique mental health challenges.
2. Enhancing Capabilities of Service Providers for Early Identification and Intervention
The Government has developed a National Mental Health Competency Training Framework, ensuring that healthcare professionals have the necessary skills for effective mental health care. Over 100,000 frontline workers, including teachers, social workers, and emergency responders, will be trained to recognise and respond to mental health needs. This approach also promotes collaboration among healthcare providers, social workers, and community organisations, streamlining referrals and creating a more connected support system.
3. Promoting Mental Health and Well-Being
The Strategy also advocates for the promotion of mental well-being across society through public education campaigns like “It’s OKAY to Reach Out,” and by including mental health education in school curricula to equip students with coping strategies early in life. Resources are also being developed for parents to help them support their children’s mental well-being.
4. Improving Workplace Mental Health and Well-Being
Last but not least, the Strategy calls for efforts to encourage employers to adopt progressive policies that promote employee well-being, such as flexible work arrangements. It also sets out plans to build a community of Workplace Mental Well-Being Champions to lead well-being initiatives within organisations. Finally, the Strategy also supports measures to prevent discrimination against employees with mental health conditions. Recent Developments
In a February 2024 speech, Prime Minister Lawrence Wong (PM Wong) highlighted mental health as a national priority. He outlined plans to increase IMH’s capacity, redevelop Alexandra Hospital, and raise the number of public sector psychiatrists and psychologists by 30 per cent and 40 per cent respectively. The Government also aims to train 28,000 frontline personnel and expand mental health services to all polyclinics and 900 GP clinics by 2030.
Additionally, PM Wong stressed the need to shift cultural attitudes around success, addressing pressures related to education and career that contribute to mental health challenges. This shift aligns with the goal of creating a more inclusive "Singapore Dream" and is supported by broader initiatives, including reviews of Singapore’s education system and the strengthening of social safety nets.
To ensure accessible mental health care, Senior Minister of State for Health Dr Janil Puthucheary has also called for a “no wrong door” policy, where individuals can access mental health services regardless of the care provider they approach. This would help individuals seek help through multiple channels, complementing the Tiered Care Model. The Ministry of Health (MOH) is also developing the National Mental Health Office for better coordination of mental health referrals.
Key Issues Concerning Singapore's National Mental Health and Well-Being Strategy
Rethinking and Destigmatising Mental Health Disorders
Mental health has historically been treated as operating along a binary—one either has an illness or does not. Mental health professionals have increasingly adopted a continuum model as explained previously, with most individuals falling somewhere along a spectrum.
Singapore’s National Mental Health and Well-Being Strategy, as former Nominated Member of Parliament (NMP) Anthea Ong recognised, seems to be based on a continuum model of mental health. The Tiered Care Model deploys mental health services based on the severity of an individual's needs, across four tiers spanning health, social and education settings. This shift in government policy shows a move to expand our understanding of mental health as a condition that, in some way or another, can affect us all.
Re-conceptualising mental health is a broader move to address the stigmatisation which treats mental health issues as “abnormal”. Discrimination and stigma against people with mental health issues might lead to a reluctance to seek treatment. Member of Parliament (MP) Mariam Jaafar recognised: “No amount of government interventions and new structures, new care models, new resources, new legislations will work if we [do not] as a society transform.” A national response to mental health requires not just policies, but also a societal shift in attitudes regarding how we conceptualise mental health as a condition that is normal and which occurs more commonly than we think. Integrating Mental Health Treatment into Singapore’s Systems
As Singapore moves to normalise mental health treatments and integrate them into the healthcare system, mental health treatments must be subject to the same standards of quality assurance. MPs He Ting Ru and Dr Wan Rizal have stressed the need to ensure the quality of such programmes, with the latter suggesting that certifying volunteers and professionals within various tiers in the national mental health care model could ensure that proper care and treatment are delivered.
To normalise mental health treatment, MPs have stressed the need for Singapore’s healthcare system to treat mental and physical healthcare with equal importance. On this front, MP Dr Wan Rizal also mooted the possibility of mental health screenings to offer insights into a person’s mental well-being.
Policy efforts beyond the healthcare sector are also needed to address obstacles people with mental health issues might face in areas beyond healthcare treatments. Pointing out “the sense of fear and anxiety” of being denied insurance after being diagnosed with a mental health condition, MP Dr Tan Wu Meng called upon the Monetary Authority of Singapore (MAS) to reform the insurance sector.
On developing an increasing regard for mental health issues in the workplace, the Tripartite Alliance for Fair and Progressive Employment Practices (TAFEP) has released a joint advisory between organisations representing the interests of the government, workers and employers which place more focus on well-being in the workplace.
Conclusion
Amidst trends which indicate increasing incidences of mental health issues in Singapore, particularly amongst its youth, the Government has adopted a national strategy to develop a more comprehensive response to addressing mental health issues.
This Strategy for combating mental health illnesses has four core areas of focus: expanding the capacity of mental health services; enhancing the capabilities of service providers for early identification and intervention; promoting mental health and well-being; and improving workplace mental health and well-being. It is also based on a Tiered Care Model, which organises mental health services into four levels of care, each addressing varying degrees of mental health to provide individualised support.
Overall, the National Mental Health and Well-being Strategy is a profound shift in policy through greater governmental recognition and promotion of mental health. However, a sustained and concerted effort by all sectors of government and society will be required to ensure that everyone facing mental health conditions in Singapore is adequately cared for.
This Policy Explainer was written by members of MAJU. MAJU is an independent, youth-led organisation that focuses on engaging Singaporean youths in a long-term research process to guide them in jointly formulating policy ideas of their own.
By sharing our unique youth perspectives, MAJU hopes to contribute to the policymaking discourse and future of Singapore.
The citations to our Policy Explainers can be found in the PDF appended to this webpage.
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