A Duke-NUS study finds 77% of Singapore adults with anxiety or depression symptoms skip professional care entirely, but most say they'd accept help from peers with lived experience.
Nearly four in five Singaporeans living with symptoms of anxiety or depression are carrying those symptoms without ever walking into a clinic or picking up the phone to a mental health professional. That figure, 77 per cent, comes from research by Duke-NUS Medical School and the Institute of Mental Health, based on an online survey of 350 adults conducted as part of a broader project on the economic impact of these conditions.
That number should bother you. Singapore has spent years trying to make mental health easier to talk about, and the need is not hidden. Yet most people in this study still stayed outside professional care. The system may be available on paper, but availability is not the same thing as access when people worry about stigma, records, employers, family judgment, and the quiet social cost of saying they are not coping.
The more useful finding is what came next: 62 per cent of those same people said they would be willing to accept support from peers with similar backgrounds or shared lived experience. Don't dismiss that as a soft alternative to care. It tells you something precise about where the resistance sits. Many people are not rejecting help itself. They are rejecting the formal route into help.
Singapore's "saving face" culture has always made this a harder problem than raw GDP statistics suggest. According to an earlier Duke-NUS and IMH study published in BMC Psychiatry, anxiety and depression symptoms were costing Singapore roughly S$15.7 billion a year in lost productivity, about 2.9 per cent of GDP, based on 2022 survey data. Affected workers reported missing an additional 17.7 days of work per year and operating at 40 per cent reduced productivity while present. The economic case for narrowing the treatment gap is plain enough. The harder question is how you reach people who don't want the label that comes with treatment.
Peer support is not a new idea, but this study gives it a useful foothold in Singapore's context. Younger adults showed more openness to peer-based care, which fits a generation that talks about anxiety and depression more directly than its parents did. The more revealing finding is among white-collar managerial respondents. Directors and managers were more open to informal peer support than clerical and sales workers, and the researchers suggested this may reflect higher health literacy, more work stress, and fewer natural peer networks at senior levels.
The higher you sit, the more isolated you can become.
Here's the thing about treatment gaps: you can build more clinics and train more psychiatrists, but the gap won't close if the cultural barriers stay intact. Singapore has invested in mental health infrastructure over recent years, yet a 77 per cent non-treatment rate among symptomatic adults means the formal system is still touching only a fraction of the people who need it. Peer support programs, whether run through workplaces, community groups, or digital platforms connecting people with similar experiences, give people another door to open before the problem becomes a crisis.
The research, published in the Singapore Medical Journal, does not pretend peer support is a complete answer. Good. It shouldn't. Running this kind of support at scale requires training, supervision, boundaries, and careful matching. A badly run peer program can turn a vulnerable conversation into one more place where people feel exposed or misunderstood. But the demand signal is hard to ignore. More than six in ten people with unmet mental health needs said they would accept this form of help.
Employers should pay attention to that, especially because the workplace is already part of the problem. Employee Assistance Programs exist across many large Singapore companies, but separate research into care barriers has found that workers often avoid them because they worry about confidentiality and career impact. If you think that fear is irrational, ask yourself how many employees would tell HR before telling a trusted colleague that they are depressed.
Peer networks work only if they feel genuinely separate from performance management. A company cannot brand a support channel as confidential while quietly letting it sit inside the same structure that decides promotions, transfers, and exits. Workers will see through that immediately. The companies that get this right will treat peer support as a real channel with trained participants, clear privacy rules, and routes into professional care when someone needs more than a conversation.
The cost of getting it wrong is already visible. S$15.7 billion in annual lost productivity is not an abstract mental health talking point. It is missed work, low energy, presenteeism, delayed decisions, and people quietly trying to function while symptoms eat into their days. If Singapore wants more people to seek help, it has to meet them where the fear is. For many, that first place may not be a clinic. It may be another person who has been there.
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