Mental health in Singapore is now on the national agenda

Mental health in Singapore is now on the national agenda- Let’s cut to the chase

Last Updated on January 24, 2025 by Prath

Reviewed by April Justice, LICSW

This article was originally published as an opinion piece in The Straits Times, a local Singaporean newspaper.

Almost five years back, Covid-19 put mental health on everyone’s radar as isolation, anxiety, grief and burnout spared no one. Youth mental health, in particular, came into focus.

The Singapore Government responded quickly with a Covid-19 Mental Wellness Taskforce which became the Interagency Taskforce on Mental Health and Well-being.

In 2024, the Government announced the creation of a more permanent body – the National Mental Health Office.

It also started implementing the National Mental Health and Well-being Strategy which, among other things, will introduce mental health services to all polyclinics, increase the number of public sector psychiatrists and psychologists, and deploy more teacher-counsellors in schools.

So where to from here?

I offer three suggestions that will keep us on track as we make progress in improving the mental health and well-being of our society.

This Article Contains:

1. Regulate talk therapy

As we ramp up the number of mental health professionals who provide talk therapy or counselling (counsellors, clinical psychologists, counselling psychologists, etc) to meet the growing demand for support, it is crucial that the quality of care provided is not compromised. This is especially important given that people seeking support are often emotionally vulnerable, lonely, or in distress.

Talk therapy invariably requires clients to open up about their struggles and in the process share deeply personal information with their therapist. As a result, they are required to quickly trust their therapist without any prior knowledge about them or an opportunity to assess them.

Currently, counsellors and psychologists are not required to register with a regulatory body in Singapore. This is unlike doctors, nurses and other allied health professionals, such as physiotherapists, who must register with the Singapore Medical Council (SMC), Singapore Nursing Board (SNB), and the Allied Health Professional Council (AHPC), respectively.

These bodies, among other things, regulate the professional conduct, standards, and ethics of their members. The SMC even has a formal and transparent process to receive complaints against doctors from any individual.

While there are industry peak bodies such as the Singapore Psychological Society (SPS) and the Singapore Association for Counselling (SAC), registration with them is voluntary and not required to work in either the public or private sector. Furthermore, these institutions lack any regulatory teeth when it comes to enforcing their ethical standards or investigating complaints made against their members.

This allows mental health professionals with poor ethics, conduct or competencies to continue working with unsuspecting clients even if they were let go from their previous place of work because of a serious breach. They may also choose to work as self-employed individuals without any oversight.

Many of us working in the private sector believe in more, not less, regulation even if it further limits the supply of professionals in the short term. In the long run, regulation will improve the quality of services being provided and build public trust in the effectiveness of non-medical interventions like talk therapy.

The Council for Estate Agencies (CEA) and the Early Childhood Development Agency (ECDA), established in the last decade or so to regulate real estate agents and childcare teachers respectively, are good examples to follow.

The CEA, formed in 2010, and ECDA, established in 2013, helped to lift the standards of relatively niche but growing industries. This, as use of childcare services became more mainstream and a booming property market increased the need for real estate agents.

The public, however, soon became frustrated and wary of unqualified fly-by-night agents and teachers who were not only short-changing their individual clients but also tarnishing the reputation of their entire industry.

Introducing a similar licensing regime or compulsory registration with the authorities will help standardise even basic qualification requirements. For instance, while many service providers require a therapist to have a minimum Master’s Degree in Counselling or Counselling/Clinical Psychology, not all have this requirement.

2. Avoid over-medicalising mental health

Mental health is a spectrum with illnesses and disorders being only one end of it. We must treat all mental health concerns as legitimate issues that require the appropriate level of support.

The Government’s new tiered approach is pragmatic and matches end users with the right type of support, depending on the severity of their struggles.

While more developed countries like the US and the UK have higher levels of awareness and lower stigma associated with mental health, institutions there have also over-medicalised it.

Psychiatrist Bessel van der Kolk describes in his best-selling book about trauma, The Body Keeps The Score, how “mainstream medicine is firmly committed to better life through chemistry and the fact that we can change our own physiology and inner equilibrium by means other than drugs is rarely considered”.

Did you know more than half of Singaporeans found talk therapy effective?

The American healthcare system, he believes, is too focused on diagnoses and drugs rather than tailored interventions and real healing.

For instance, more than 13 per cent of Americans reported taking antidepressant medication during the 2015-18 period, even before Covid-19 hit.

Dr van der Kolk notes how studies of non-drug treatment are rarely funded unless they involve so-called manualised protocols where patients and therapists must go through narrow, prescribed sequences that allow little fine-tuning to individual needs.

Furthermore, instead of tackling underlying social issues contributing to mental distress, the authorities there have also turned to medication. Dr van der Kolk shared how Medicaid, the US government’s programme for the poor, spent more on anti-psychotics than any other class of drugs.

A similar story has played out in the UK which saw the greatest increase across Europe in the use of antidepressants over the past decade.

In 2024, The Economist reported how in surveys, “Britons increasingly describe grief and stress as mental illnesses, redefining how sickness is understood”. 

This has strained the National Health Service, their universal healthcare system, where at least 1.8 million people are waiting for mental health treatment.

3. Improve access to help

If awareness is the first step, and overcoming stigma the second, then getting timely access to the help you need becomes the crucial third step for someone struggling with poor mental health.

Here, not just the government but insurance providers and employers also have a part to play.

In 2024, the World Health Organisation theme for World Mental Health Day was “Mental Health at Work”. They recognised that mental health and work are closely linked with a direct impact on performance, absenteeism, and turnover.

In Singapore, a study by the Institute of Mental Health (IMH) and Duke-NUS Medical School estimated that there is an estimated $16 billion loss in productivity every year due to employee anxiety and depression.

It is therefore heartening to see companies and insurance providers stepping up and putting money where their mouth is by subsidising both medical as well as non-medical interventions, similar to dental check-up or gym membership benefits currently available.

The Workplace Safety and Health Council has also announced that it will launch in 2025 guidelines for employers on how to support staff with mental health challenges.

In 2024, then Deputy Prime Minister Lawrence Wong said in Parliament: “So let there be no doubt: The Government is making mental health and well-being a key priority in our national agenda.”

It was a big and bold first step.

Eventually, though, the spotlight will move on to other pressing issues facing our country. I hope then that the important work of improving our nation’s mental health and well-being will continue in earnest.