Let’s Talk with … Students who have just completed their research project on barriers to seeking support for mental health concerns in Singapore
As part of the School’s undergraduate module on Prevention and Control of Non-Communicable Diseases, students have an opportunity to undertake a group research project.
Andrea Chua Wei Ming, Claire Yan-Ling Karmakar, Jaden Rafael Yan, Lai Yixin, and Nurhusna Alifia Bte Suhaimi talk to us about their research project exploring the barriers young adults face in seeking mental health support in Singapore during the COVID-19 pandemic.
Mentorship was provided by their lecturers, Dr Cecilia Teng and Associate Professor Mythily Subramaniam. A/P Subramaniam is also the Assistant Chairman Medical Board (Research) at the Institute of Mental Health.
What led the team to research the barriers to accessing mental health support?
All of us felt that it was important to highlight the impact of the pandemic on mental health, as it is an urgent public health issue. Mental health can often be overlooked but has a serious impact on individuals, families, and communities.
Our literature review found that the pandemic has clearly impacted people’s mental health not only through the fear of catching the illness themselves and spreading it to their loved ones, but also through the impact of enforced restrictions and control measures. As a result, stress, anxiety, depressive symptoms and insomnia have all increased across the population level.
In the local context, we identified a gap in understanding barriers to seeking mental health support during the pandemic. Singapore has taken a cautious and controlled approach to the pandemic, which has meant restrictions and changes to everyday life.
It is expected that this approach will continue in the foreseeable future, so we wanted to explore the barriers to seeking help for mental health concerns and if these have changed over the course of the pandemic.
How did the team conduct the study?
We conducted a cross-sectional study among university students aged 18 to 25 years. The anonymous online survey consisted of questions relating to mental health literacy, social support, and accessibility to services. We focused on this group as our literature review found that people in this age group are more susceptible to developing mental health issues.
The COVID-19 restrictions meant an online survey was the easiest way to gather many views. Moreover, the target age group are high Internet users and so this platform was easily accessible to them. We also hoped that with the use of an anonymous survey, people would be more honest and open about their thoughts and opinions on mental health.
We managed to gather 74 responses for our online survey, with the respondents coming from different years of study and faculties.
What were the survey results?
The survey found that the main barriers to seeking support were:
- not being able to afford mental health support,
- not recognising early on that support is needed (linked to stigma and a lack of mental health literacy),
- long waiting times for support, and
- support not being anonymous.
Most respondents felt social distancing measures had negatively impacted their social relationships and made it more difficult to reach out to their peers for informal support.
There was a general awareness of mental health issues and common misconceptions, but there were gaps in mental health literacy. Only a few respondents could name specific organisations offering support services and explain how someone could access services.
Some respondents were dismissive of mental health concerns and did not view symptoms as important enough to address. Overall, there was the view that seeking help was almost a “last resort”. People tend to seek help when their mental health had deteriorated to the extent that it could no longer be ignored, such as suffering from extended periods of insomnia.
What did respondents think of the services available?
Most respondents felt that the shift of on-site services to online platforms during the pandemic made services more accessible.
The survey found a lack of diversity in the mental health support programmes offered at the University, with free counselling being the main offering. The barriers to accessing counselling included long waiting times and concerns over a perceived lack of anonymity.
Financial difficulties were a persistent barrier to seeking professional help among respondents. Before the pandemic, nearly a third of respondents felt that finances prevented respondents from accessing support, even though they recognised that they needed help.
The pandemic has exacerbated the financial stress among respondents, and a considerable number reported that although they had intended to seek help, they did not do so because of financial concerns. Respondents prioritised financial concerns regarding food, housing, transportation, education, and healthcare over seeking support for mental health. Given the above, we felt this issue is likely to disproportionately affect students from lower-income backgrounds.
What were some of the limitations to the study?
We would have liked to have explored in more depth the issues raised, which was not possible with an online survey. We would also have liked to have compared the issues raised across different age groups.
What would you like to see in terms of changes to mental health support?
Normalising conversations about mental wellbeing would help to reduce stigma, with a focus on promoting early identification.
Online anonymous wellbeing surveys may help individuals to identify when to seek support and direct them to the appropriate resources. In addition, aggregate, anonymous data may provide insights into the general mental wellbeing of students – particularly during extreme situations, like the pandemic.
Ensuring anonymity for those seeking support is essential, as is ensuring that financial barriers are removed (particularly for those from low-income backgrounds).
Did the team enjoy the module and research? What were your main learning points?
Despite the fact that the module was conducted 100% online, we enjoyed taking the module as it provided interesting insights into the different non-communicable diseases that are prevalent in Singapore.
The module taught us to be more aware of the different non-communicable diseases and when to screen for them appropriately. Through our background research it also highlighted to us the pressing issue of mental health in Singapore.
Students leading the research:
Andrea is an undergraduate pursuing a Bachelor of Science degree with a major in Life Sciences and minor in Public Health and is currently in her final semester. Other than her passion for immunology, she also enjoys being in touch with the humanities and arts via visits to museums and exhibitions. Moving forward, she is hoping to conduct immunology research that would be able to aid in infectious disease management.
Yixin has recently graduated with a Bachelor of Science degree with a major in Life Sciences and minor in Public Health. She also enjoys Chinese orchestra concerts and reading. She is now pursuing a career in biological research.
Jaden is a Year 3 Undergraduate at NUS Business School. Majoring in Finance, he spends most of his time looking at really expensive .jpegs on the internet. He is currently building his second start-up, focused on the blockchain space, and social finance.
Claire is currently a Year 2 undergraduate pursuing a Bachelor of Science degree with a major in Life Sciences and a minor in Public Health. She enjoys ballet and reading in her free time. She hopes to work in the healthcare industry after graduation.
Husna is currently a Year 3 undergraduate pursuing a Bachelor of Science degree with a major in Life Sciences and minor in Public Health. During her free time, she enjoys cycling and watching sunsets with her friends. She hopes to work in the healthcare industry and conduct clinical research after graduation.