SINGAPORE — A significant proportion of youth in Singapore has experienced severe or very severe symptoms of depression, anxiety or stress, the first nationwide survey on youth mental health by the Institute of Mental Health (IMH) found.
Nearly a third of young people aged 15 to 35 reported symptoms that included feeling empty, tense or upset most of the time, according to the National Youth Mental Health Study.
"Navigating the complexities of youth is challenging enough, but young people today are grappling with unique issues that previous generations did not," said Associate Professor Swapna Verma, who chairs IMH's medical board and was co-principal investigator of the study.
"For instance, social media exposes them to constant comparisons, intensifying concerns about body image.
"The anonymity of the online world has also given rise to cyber bullying, which adds a new dimension of harassment that can be relentless and far-reaching."
Young people were more likely to report having symptoms if they had experienced cyber bullying, had moderate to severe concerns about their body shape or spent more than three hours daily on social media, said IMH, which released the results on Sept 19.
The nationwide epidemiological study established the prevalence of severe symptoms of depression, anxiety and stress, along with their associated factors including cyber bullying, body shape concerns and excessive social media use, as well as the treatment gap and sources of support among young people here.
The one-third figure is similar to the findings of other research studies that are based on self-reporting, said the Health, Education, and Social and Family Development ministries in a joint release on Sept 19.
In particular, a higher prevalence of depression, anxiety and stress symptoms was found among those aged 15 to 24, and in the Malay ethnic group.
Between October 2022 and June 2023, a total of 2,600 Singaporeans and permanent residents completed a set of questionnaires on their own, using tablets provided by an interviewer. They received an inconvenience fee of $50 for completing the questionnaires.
They also went through several scales, including the Depression, Anxiety and Stress Scales, a set of three self-reporting scales designed to measure emotional states of depression, anxiety and stress experienced by an individual in the preceding week.
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The youth study found that anxiety was the most common mental health problem experienced by young people in Singapore. About one in four reported having severe or extremely severe symptoms of anxiety in the week prior to the survey. This included feeling worried, tense and restless most of the time.
About 15 per cent of Singapore youth had symptoms of depression to a similar degree, while nearly 13 per cent were highly stressed, unable to relax, or feeling upset or irritable most of the time in the week prior to the survey.
The silver lining was that about two in three of those who reported having severe or extremely severe mental health symptoms sought help, mainly by going to family and friends.
One in three youth did not seek help, despite having severe or extremely severe symptoms. Prof Swapna said this gives IMH the opportunity to find ways of intervening early, including looking at beefing up the mental health curriculum in schools.
Those who chose not to seek help said it was because they did not think specialists would be able to help them, or they were worried about what other people might think of them. Another worry was about privacy, confidentiality and having a permanent record of their condition.
The study found that young people who were less likely to experience severe or extremely severe symptoms of depression, anxiety and/or stress had higher levels of resilience, perceived social support and greater self-esteem.
Although not all individuals with severe or extremely severe symptoms of depression or anxiety have a clinical condition, being in such states for a prolonged period of time can be detrimental to their well-being, said Prof Swapna.
By identifying the groups who are at greater risk of developing mental health disorders, the study findings will enable policymakers and service providers to develop more targeted approaches in addressing their needs and preventing them from developing mental illnesses, she added.
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IMH's study, like many others, showed that excessive social media use is a public health concern and has tremendous impact on youth mental health, said Associate Professor Mythily Subramaniam, assistant chairman of medical board (research) at IMH and co-principal investigator of the study.
Research around the world has found that adolescents who spend more than three hours each day on social media may be at heightened risk for mental health problems, particularly mood and anxiety disorders, she said.
The identification of significant associated factors, such as excessive social media use, body shape concerns and cyber bullying, also underscores the importance of integrating preventive measures into schools and youth services, she added.
"Furthermore, all three factors may be potentially linked to each other. The time young people spend on social media could also be related to cyber bullying and the two may either independently or together cause body shape concerns," she said.
The IMH study was done in collaboration with the Ministry of Health, Chat (Centre of Excellence for Youth Mental Health) and NUS Saw Swee Hock School of Public Health.
In the multi-ministry release, the Government said that findings from the study affirm the whole-of-government and whole-of-society approach to tackling youth mental health issues in the National Mental Health and Well-Being Strategy that was launched by the Government in October 2023.
Many of the measures under the strategy are already in place, while others will be progressively rolled out over the next few years.
In schools, for instance, students are getting through their school curricula the knowledge and skills of managing their own mental well-being.
Parents can get help on matters such as managing screen use from a toolbox of strategies called Parenting for Wellness. The first phase of resources was launched on Sept 18, said the joint release.
Furthermore, in the first half of 2025, a guide on the healthy use of technology and social media, and to provide recommendations on how to mitigate negative impacts will be ready, it said.
This article was first published in The Straits Times. Permission required for reproduction.
