SINGAPORE, Aug 25 — A study to assess the psychological impact of Covid-19 in Singapore has found that nearly one in 10 respondents (9.3 per cent) met the criteria for mild to severe stress, caused by factors such as financial fears over the pandemic, and worries that loved ones could be infected.

Of 1,058 respondents, who are Singaporeans and permanent residents, 8.7 per cent met the criteria for clinical depression, while 9.4 per cent met the criteria for clinical anxiety and 4.8 per cent met the criteria for both conditions.

About one in 20 respondents also indicated they had had suicidal thoughts in the two weeks before being interviewed by the researchers.

The study, conducted by the Institute of Mental Health (IMH) in collaboration with the University of Hong Kong, concluded that Covid-19 had had a “significant impact on the mental well-being of Singaporeans”.

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Questionnaires used in the study measured depression, stress, insomnia and anxiety symptoms experienced by an individual in the two weeks before the respondents were interviewed.

The top three sources of stress were found to be:

― Risk of family members or friends getting infected by Covid-19 (50.5 per cent)

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― Financial loss (50.1 per cent), such as losing work opportunities or having to take unpaid leave

― Unemployment (46.7 per cent)

The study was funded by the Ministry of Health, Temasek Foundation and the National Centre for Infectious Diseases.

​​It also examined the risk and protective factors of mental and social well-being during this period.

Data collection for the study, which was done mainly via Zoom interviews, began in May 2020 during the circuit breaker period that halted movement of people and non-essential activities. It was completed in June this year.

Its findings were presented by Associate Professor Mythily Subramaniam, assistant chairman of the medical board for research at IMH, on the first day of the Singapore Mental Health Conference 2021 on Tuesday (Aug 24).

The two-day virtual conference features 70 speakers here and abroad who will discuss opportunities and challenges related to mental healthcare against the backdrop of the ongoing Covid-19 pandemic.

In a press release on the study, IMH said that based on published studies on global mental health — in particular on depression, anxiety and stress during the pandemic — Singapore fared better than the United States, the United Kingdom, Japan and Hong Kong.

Similar studies have been done before. One by a marketing communications agency looked at how the pandemic has impacted business owners and employees, while another by a human resource software company examined the pandemic’s impact on the mental health of Singaporeans.

In his speech at the conference on Tuesday, guest-of-honour Masagos Zulkifli, Minister for Social and Family Development and Second Minister for Health, said that more can be done to raise mental health literacy.

“What was also concerning during the pandemic was the loose ascribing of mental health conditions to persons who have knowingly flouted safe management measures.

“Their behaviour may or may not be mental-health-related. By correlating such acts with being mentally unwell, it does not only trivialise the matter, but also reveals a lack of awareness, threatening to deepen the stigma of mental health conditions further,” he said.

He added that the pandemic has also resulted in some experiencing a state of low mental well-being, and feelings of stagnation and emptiness.

The following were some of the key findings of the IMH study. 

1. Stress

― Age: Those aged 50 to 64 were less likely to be stressed than the 21-to-34 age group

― Body mass index (BMI): Obese respondents were more likely to have anxiety than those in the normal range

― Resilience: Higher resilience was found to be associated with lower likelihood of anxiety

― Social support: Higher perceived social support was associated with lower likelihood of depression

2. Depression

― Age: Those 65 and above were less likely to be depressed than respondents aged 21 to 34

― Marital status: Those never married and ​​those divorced, separated or widowed were more likely to be depressed than respondents who are married or cohabiting

― BMI: Overweight and obese and respondents were more likely to be depressed than those in the normal range

― Resilience: Higher resilience was associated with lower likelihood of depression

― Social support: Higher perceived social support was associated with lower likelihood of depression

3. Anxiety

― BMI: Obese respondents were more likely to have anxiety than those in the normal range

― Resilience: Higher resilience was found to be associated with lower likelihood of anxiety

Other findings

More than four in five, or 81.8 per cent, of respondents said that they would seek professional help if they were to develop any emotional or psychological problems related to Covid-19.

The top five sources of help were: General practitioners (GPs) or family doctors, followed by counsellors, polyclinic doctors, psychiatrists and religious or spiritual advisers.

However, 17.8 per cent said that they would not seek help, giving reasons such as being able to manage by themselves, going to family or friends for help first, being too busy or the help being too costly. Others had privacy concerns while some thought that the professional help would not be of use.

Assoc Prof Mythily said that the high proportion of people willing to seek professional help was “heartening” because “typically, people are not willing to seek help for their mental health problems”.

“I do feel that with the pandemic, some of the stigma that has been associated with mental health conditions has gone because people feel that, 'Okay now, I have a reason, it's not a reflection on me, it is something outside my control which is happening, which is causing stress, depression or anxiety'.

“I think it's also a collective feeling that everybody's struggling,” she said.

While it is a “good thing” that people are looking to seek help, it also means that Singapore will have to build up its “capacities or capabilities fairly rapidly”, Assoc Prof Mythily said.

“Especially as people have suggested, it is going to be the GPs and counsellors (from whom) they want to seek help, so that group has to be supported and that group has to be built up fairly fast for handling mental health conditions,” she said.

Half of the respondents said that they would not consider seeking help from mental health helplines, while just under a third said that they would consider this channel but were unaware of the helplines available.

One such channel, the National Care Hotline, launched in April last year to provide support to those facing mental health concerns, had handled more than 45,000 calls as of the end of May this year, with the top concerns pertaining to the need for emotional support, mental-health-related issues and family-related or social matters.

Where you may seek help

― Samaritans of Singapore: 1800 221 4444 (24 hours), or 1767 (24 hours)

― Singapore Association of Mental Health: 1800 283 7019 (Monday to Friday, 9am-6pm)

― Emergency Helpline (Institute of Mental Health): 6389 2222 (24 hours)

― Care Corner Counselling Centre (Mandarin): 1800 353 5800 (10am-10pm)

Tinkle Friend: 1800 274 4788 (Monday to Friday, 9.30am-5pm) ― TODAY