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Access to Treatment
62%
of migrant workers in Singapore facing injury claims and salary disputes have a serious mental illness.1
1 in 5
of migrant workers reported that they have never sought care due to cost.2
4 in 10
mothers in Singapore demonstrate depressive or anxiety related symptoms during pregnancy.3
Why should you care?
While Singapore’s health system is largely accessible, some groups fall through the cracks when it comes to accessing treatment due to structural or cultural barriers. These include vulnerable groups such as migrant workers, and even those who are not traditionally seen as vulnerable such as mothers with pre- and post-natal depression.
Why should you care?
The key structural barriers that impede access to mental health treatment and health services include financial barriers and one’s residency status. Those at the intersection of both factors, such as the migrant workers and foreign spouses, are doubly marginalized as many healthcare subsidies and schemes are dependent on citizenship status.4
Migrant workers are particularly prone to mental health conditions—which stands in sharp irony against their relatively low mental health literacy. The physically demanding nature of their work often result in psychosomatic symptoms, on top of the risk for illness and injury. Often unaware about their healthcare financing options, they experience even more psychological distress due to (both real and perceived) financial barriers to healthcare, which further reduces their health-seeking behaviour.2 Lastly, many incur massive debts to finance their migration to Singapore which gives rise to constant emotional burden.1
Migrant workers are particularly prone to mental health conditions—which stands in sharp irony against their relatively low mental health literacy. The physically demanding nature of their work often result in psychosomatic symptoms, on top of the risk for illness and injury. Often unaware about their healthcare financing options, they experience even more psychological distress due to (both real and perceived) financial barriers to healthcare, which further reduces their health-seeking behaviour.2 Lastly, many incur massive debts to finance their migration to Singapore which gives rise to constant emotional burden.1
Maternal Mental Health
A more insidious barrier to mental health is cultural in nature due to the invisible psychological barrier that stems from stigma and cultural expectations. This affects everyone regardless of financial means and is thus much harder to detect. Mothers undergoing pregnancy-related mental health issues is an example of an ‘invisible’ group.
While services are available, many mothers are not aware if their condition is “severe” enough to receive treatment and shy away from treatment due to stigma and fears of not being able to be a “good mother”. The lack of support from those around them is also a major impediment towards seeking timely intervention. This carries a ripple effect as studies have found a strong correlation between mothers who demonstrate depressive or anxiety related symptoms during pregnancy, and their children developing mood disorders later in life.3
While services are available, many mothers are not aware if their condition is “severe” enough to receive treatment and shy away from treatment due to stigma and fears of not being able to be a “good mother”. The lack of support from those around them is also a major impediment towards seeking timely intervention. This carries a ripple effect as studies have found a strong correlation between mothers who demonstrate depressive or anxiety related symptoms during pregnancy, and their children developing mood disorders later in life.3
What are the existing forms of support?
The COVID-19 situation and its severe impact on migrant workers’ mental health has led to a greater multi-stakeholder commitment towards providing better access to mental healthcare for migrant workers through more activities that ensure mental wellbeing and provision of help and counselling.6
A new division under the Ministry of Manpower, the Assurance, Care and Engagement (ACE) Group has been recently set up. Part of their mandate is to ensure a comprehensive medical support plan and provide more accessible health services for migrant workers.
A new division under the Ministry of Manpower, the Assurance, Care and Engagement (ACE) Group has been recently set up. Part of their mandate is to ensure a comprehensive medical support plan and provide more accessible health services for migrant workers.
What more could be done?
To lower the cultural barrier and stigma towards mental health, community groups continue to play a significant role to promote mental wellbeing and facilitate access to treatment. Migrant workers should be better aware of their rights including the rights to have mandatory medical insurance. Migrant workers are often unaware of their rights and end up distressed over the misperception that they have no recourse for help. With better information availability, this can be avoidable.7
How you could help?
Support migrant workers through existing migrant worker wellness programmes run by Healthserve and Humanitarian Organisation of Migrant Economics (HOME). Help fund their programmes through Giving.sg.
For new mothers or mothers-to-be, pay attention to those around you and recognise those who might be struggling with perinatal mood and anxiety disorders. Encourage them to seek timely treatment where necessary. You can refer them to appropriate maternal community mental health services. Clarity Singapore works with hospitals such as KK Women’s and Children’s Hospital to reach out to mothers struggling with perinatal mood and anxiety disorders. They also provide a hotline for mothers seeking counselling services.
For new mothers or mothers-to-be, pay attention to those around you and recognise those who might be struggling with perinatal mood and anxiety disorders. Encourage them to seek timely treatment where necessary. You can refer them to appropriate maternal community mental health services. Clarity Singapore works with hospitals such as KK Women’s and Children’s Hospital to reach out to mothers struggling with perinatal mood and anxiety disorders. They also provide a hotline for mothers seeking counselling services.
1 Harrigan, N. and CY Koh. (2015). Vital yet vulnerable: Mental and emotional health of South Asian migrant Workers in Singapore. Lien Centre for Social Innovation Social Insight Research Series, Singapore Management University.
2 Ang, J.W., Chia C., Koh, C.J., Chua, B.W., Narayanaswamy, S., Wijaya, L. Chan, G., Goh, W.L., & Vasoo, S. (2017). Healthcare-seeking behaviour, barriers and mental health of non-domestic migrant workers in Singapore. BMJ Global Health, 2(2).
3 Tan, S.H. (2018, December 05). Key findings from 10-year study on maternal health. CNA.
4 Chiu, MY., Ghoh, C., Chung, G., & Choi, K.P. (2019). Multistressed families in Singapore: A focus on transnational families. Children and Youth Services Review, 101, 372-382.
5 Umboh, S.J., How, C.H., & Chen, H (2013). Postnatal depression: a family medicine perspective. Singapore Med J, 54(9), 477-481.
6 Goh, T. (2020, Aug 07). Steps to better support migrant workers’ mental, physical health. The Straits Times.
7 Ang, J.W., Koh, C.J., Chua, B.W., Narayanaswamy, S., Wijaya, L., Chan, L.G., Soh, L.L., Goh, W.L., & Vasoo, S. (2019). Are migrant workers in Singapore receiving adequate healthcare? A survey of doctors working in public tertiary healthcare institutions. Singapore medical journal, 10.
2 Ang, J.W., Chia C., Koh, C.J., Chua, B.W., Narayanaswamy, S., Wijaya, L. Chan, G., Goh, W.L., & Vasoo, S. (2017). Healthcare-seeking behaviour, barriers and mental health of non-domestic migrant workers in Singapore. BMJ Global Health, 2(2).
3 Tan, S.H. (2018, December 05). Key findings from 10-year study on maternal health. CNA.
4 Chiu, MY., Ghoh, C., Chung, G., & Choi, K.P. (2019). Multistressed families in Singapore: A focus on transnational families. Children and Youth Services Review, 101, 372-382.
5 Umboh, S.J., How, C.H., & Chen, H (2013). Postnatal depression: a family medicine perspective. Singapore Med J, 54(9), 477-481.
6 Goh, T. (2020, Aug 07). Steps to better support migrant workers’ mental, physical health. The Straits Times.
7 Ang, J.W., Koh, C.J., Chua, B.W., Narayanaswamy, S., Wijaya, L., Chan, L.G., Soh, L.L., Goh, W.L., & Vasoo, S. (2019). Are migrant workers in Singapore receiving adequate healthcare? A survey of doctors working in public tertiary healthcare institutions. Singapore medical journal, 10.
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Why should you care?
While Singapore’s health system is largely accessible, some groups fall through the cracks when it comes to accessing treatment due to structural or cultural barriers. These include vulnerable groups such as migrant workers, and even those who are not traditionally seen as vulnerable such as mothers with pre- and post-natal depression.
Why should you care?
The key structural barriers that impede access to mental health treatment and health services include financial barriers and one’s residency status. Those at the intersection of both factors, such as the migrant workers and foreign spouses, are doubly marginalized as many healthcare subsidies and schemes are dependent on citizenship status.4
Migrant workers are particularly prone to mental health conditions—which stands in sharp irony against their relatively low mental health literacy. The physically demanding nature of their work often result in psychosomatic symptoms, on top of the risk for illness and injury. Often unaware about their healthcare financing options, they experience even more psychological distress due to (both real and perceived) financial barriers to healthcare, which further reduces their health-seeking behaviour.2 Lastly, many incur massive debts to finance their migration to Singapore which gives rise to constant emotional burden.1
Migrant workers are particularly prone to mental health conditions—which stands in sharp irony against their relatively low mental health literacy. The physically demanding nature of their work often result in psychosomatic symptoms, on top of the risk for illness and injury. Often unaware about their healthcare financing options, they experience even more psychological distress due to (both real and perceived) financial barriers to healthcare, which further reduces their health-seeking behaviour.2 Lastly, many incur massive debts to finance their migration to Singapore which gives rise to constant emotional burden.1
Maternal Mental Health
A more insidious barrier to mental health is cultural in nature due to the invisible psychological barrier that stems from stigma and cultural expectations. This affects everyone regardless of financial means and is thus much harder to detect. Mothers undergoing pregnancy-related mental health issues is an example of an ‘invisible’ group.
While services are available, many mothers are not aware if their condition is “severe” enough to receive treatment and shy away from treatment due to stigma and fears of not being able to be a “good mother”. The lack of support from those around them is also a major impediment towards seeking timely intervention. This carries a ripple effect as studies have found a strong correlation between mothers who demonstrate depressive or anxiety related symptoms during pregnancy, and their children developing mood disorders later in life.3
While services are available, many mothers are not aware if their condition is “severe” enough to receive treatment and shy away from treatment due to stigma and fears of not being able to be a “good mother”. The lack of support from those around them is also a major impediment towards seeking timely intervention. This carries a ripple effect as studies have found a strong correlation between mothers who demonstrate depressive or anxiety related symptoms during pregnancy, and their children developing mood disorders later in life.3