Anxiety and depression may cost Singapore nearly S$16 billion a year, or 2.9 per cent of the nation’s gross domestic product. That’s the headline figure Professor Eric Finkelstein and his collaborators from the Institute of Mental Health calculated from a survey of adults in Singapore, in which they found that two in ten adults reported experiencing symptoms of either depression or anxiety, or both. This was the first study to estimate the prevalence and economic burden of depression and anxiety in Singapore after the peak of the COVID-19 pandemic.
“There was much anecdotal evidence suggesting this was the likely outcome, we were just the first to put a number to it,” says Finkelstein, from Duke-NUS’ Health Services and Systems Research Programme who led the study. “So, I wasn’t surprised by the findings.”
And it was not just anecdotal evidence. When Finkelstein took the pulse of the nation’s mental state and their perceived risks of COVID-19 back in 2020, he found that out of 897 participants, 23 per cent reported moderate and severe anxiety, levels that were significantly higher than previous mental health studies suggested.
To quantify the full economic impact of these conditions, Finkelstein and his collaborators surveyed 2,348 adults, who completed a depression and anxiety screening questionnaire on behalf of the 5,725 adults living in their households between April and June 2022. Published in BMC Psychiatry today, the team reported that 14 per cent of adults experienced symptoms indicative of depression and 15 per cent had symptoms consistent with anxiety.
Those whose screening indicated that they may suffer from either condition were asked to complete a more detailed questionnaire, which the researchers used to quantify the total economic loss.
And the vast majority of this loss — more than 81 per cent — came from reduced productivity as affected individuals tended to continue working but at a level far lower than their potential, with absenteeism and use of healthcare resources accounting for the remainder.
The researchers further discovered that of those who screened positive for depression or anxiety, only half had been formally diagnosed, while only a third reported seeking help for their conditions and even fewer sought the support of a mental health provider.
“Most concerning is the high rate of symptoms among those who do not appear to be actively being treated and the large reduction in productivity that results,” says Finkelstein. “This is a major hit on both health and economic output.”
Globally, the World Health Organisation estimates that COVID-19 added 53.2 million cases of depression and 76.2 million cases of anxiety since the start of the pandemic.
“Greater efforts to encourage undiagnosed cases to seek treatment, expanded access to peer support programmes, increased efforts to improve mental health literacy and reduce stigma, and greater training among community resources such as general practitioners and allied health professionals to diagnose and treat mental health symptoms are all part of a successful recovery strategy for the whole population,” said Associate Professor Daniel Fung, who is the chief executive officer of the Institute of Mental Health, and a co-author of the study, in a media statement that would go out publicise the findings.