The Mental Health Divide

Unlike the common ground statements presented in the previous section, these statements were more divisive (typically consensus on agreement/disagreement was <60%), and thematically-related to one’s own mental health and perceptions of mental health systems in Singapore. Based on our poll sample, a majority of participants leaned toward negative views of the quality, access and cost of mental health services.

• I find it difficult to access information to seek help for my mental health in Singapore (n=549; 46.3% Agree; 30.1% disagree; 23.7% undecided)
• I trust that the mental health hotlines available will be helpful in addressing my issues(n=556; 37.4% Agree; 30.0% disagree; 32.6% undecided)I trust that my mental health diagnoses at public healthcare institutions will remain confidential to prospective employers (n=558; 52.2% Agree; 28.0% disagree; 19.9% undecided)
• The increase in public awareness of mental health has increased my willingness to reach out for mental health support when I need to (n=554; 63.0% Agree; 20.0% disagree; 17.0% undecided)
• I know how to seek out subsidised mental health services in Singapore (n=553; 29.7% Agree; 55.5% disagree; 14.8% undecided)
• I think that the standard of private mental healthcare in Singapore is satisfactory (n=542; 25.7% Agree; 26.0% disagree; 48.3% undecided)
• My understanding of mental health conditions have largely been influenced by mainstream media (n=557; 50.1% Agree; 37.0% disagree; 12.9% undecided)

Demographic differences for divisive mental health statements

We conducted multivariable analyses on the statements above to determine the factors associated with agreement on the respective statements. We present the findings only for statements where statistically-significant demographic attributes were found. 

Statement: I find it difficult to access information to seek help for my mental health in Singapore

In multivariable analysis, we found that (i) educational attainment and (ii) past mental health experiences were associated with agreement to this statement. 

With regard to educational attainment, in general those who had higher levels of education were less likely to agree with this statement. Specifically, those who had university level education were 0.71 times as likely as those with secondary and below educational attainment to agree with the statement. With regard to past mental health experience, in general, those who identified as ever facing mental health challenges were more likely to agree to the statement. Those who ever sought help were 1.85 times, while those who never sought help were 1.61 times more than those who don’t identify as having mental health challenges to agree with the statement.

“Finding information when seeking help for the first time was difficult for me 6 years ago. Things have improved since then and also since I sought help I had access to information as a patient/person with lived experiences.”

“There are resources available, and there has been quite a bit of publicity on, for example, where to seek help. But with the huge increase in attention to mental health, information is everywhere, but in bits and pieces. It can be quite overwhelming trying to navigate and filter information.”

Statement: I trust that the mental health hotlines available will be helpful in addressing my issues. 

In multivariable analysis, we found that (i) residence status, (ii) occupation, (iii) income, and (iv) past mental health experiences were associated with agreement to this statement. 

With regard to residence status, non-Singapore residents are 1.8 times as likely as Singapore citizens to agree with the statement. With regard to occupation, professionals (0.62 times) and unclassified workers (0.46 times) were less likely to agree with the statement, relative to those unemployed. With regard to income, in general, those earning an income were more likely to agree with the statement; however, those of lower income brackets were most likely to agree. With regard to past mental health experience, in general, those who identified as ever facing mental health challenges were less likely to agree to the statement. Those who ever sought help were 0.64 times as likely, while those who never sought help were 0.59 times as likely as those who don’t identify as having mental health challenges to agree with the statement.

“The hotlines were very unhelpful to me as I needed immediate help. Hotlines are hard to use as the person on the other line might not fully understand the situation.”

“I have experiences with both horrendous and excellent hotline services. There needs to be a way to leave feedback! but don't give up calling just bcos of a few bad experiences!”

Statement: I know how to seek out subsidised mental health services in Singapore. 

In multivariable analysis, we found that past mental health experiences were associated with agreement to this statement. Specifically, those who never sought help were 0.58 times as likely as those who don’t identify as having mental health challenges to agree with the statement, whereas the same trend was not observed for those who ever sought help.

“Smartlocal and Moneydigest provide good summaries of the affordable services/providers available, but I am still unclear of what is required/who would fall under subsidised services, and how to navigate through claims through insurance companies.”

“The path is long and arduous. You have to go to a polyclinic for a GP referral, and many hospitals are overbooked, and getting an appointment takes time. When you're feeling gloomy, that feels like absolute shit.”

Statement: My understanding of mental health conditions have largely been influenced by mainstream media. 

In multivariable analysis, we found that (i) age, (ii) educational attainment, (iii) religion, and (iv) past mental health experiences were associated with agreement to this statement. 

With regard to age, in general, those who were older were less likely to agree with this statement. With regard to educational attainment, in general, those with higher educational attainment were less likely to agree with the statement. Specifically, the effect was only statistically significant for the association between those who had a postgraduate education (0.69 times as likely as those with secondary education and below to agree). With regard to religion, those who had a religion were more likely (1.31 times as likely) than those without to agree with this statement. With regard to past mental health experience. Those who ever sought help were 0.69 times as likely as those who don’t identify as having mental health challenges to agree with the statement. But the same trend was not observed for those who never sought help.

At the beginning, yes, I thought hospitals looked like prisons out of horror movies and patients are scary and dangerous based on what I saw in Hollywood shows. After volunteering at imh i learnt it was not the case. Now as an advocate I do not base my understanding on the media.”

“Trustworthy resources on mental health are sorely lacking in mainstream media, especially in Singapore.”