Why expanding mental health services in Singapore is not as easy as getting more therapists to join the field

Across the system, the pressures look different but are just as challenging. Having worked in hospital, primary care, and community and prison settings, senior counsellor Roxanne Koh said demand for mental health care services has risen sharply in recent years.

Ms Koh is a senior counsellor at Filos Community Services, a community-based social service agency that provides subsidised mental health support outside the hospital system. She also runs her own private practice. 

In community care, clients often present with multiple, overlapping challenges, from mental health conditions to caregiving stress, financial difficulties and social isolation, requiring not just counselling, but coordination with families, social services and healthcare providers, said Ms Koh. 

“In hospital and community mental health settings where I have worked, counsellors rarely do just counselling,” she said. 

Counsellors often provide accessible support for emotional and relational issues, while psychologists draw on their more specialised clinical training to assess, diagnose and manage more complex conditions. 

Ms Koh said counsellors in these settings also take on case management, crisis response, outreach, and significant administrative work alongside direct clinical hours. 

She added that while no single part of the work is overwhelming on its own, the combined demands could leave little time for reflective practice, which she described as a structural issue rather than one specific to any single organisation.

Ms Koh and Ms Ooi’s experiences reflect how structural issues, high overheads and a shortage of mental health professionals are among the constraints that Singapore must overcome as it ramps up mental health services to meet rising demand from a population increasingly mindful of its mental well-being. 

Across the board, clinicians and experts said demand for mental health support has risen sharply in recent years, especially after COVID-19, driven by greater awareness and life stressors, with more people seeking help and presenting with increasingly complex needs.

The 2024 National Population Health Survey found that the prevalence of poor mental health was the highest among younger adults aged 18 to 29 years, at 25.5 per cent. 

However, Professor Tan Bhing Leet, director of the health and social science cluster at the Singapore Institute of Technology, said that increasing the number of mental health professionals is not an overnight process, given the time required for training and honing their skills in practice. 

She also said that expanding the mental health workforce is not simply about increasing numbers, but ensuring that practitioners have the clinical experience and supervision needed to deliver effective, evidence-based care.

If workforce expansion prioritises numbers over supervision and competency, it could dilute the quality of the services rendered, she added.

An imbalance may also occur, where lower-income service users with chronic mental health conditions face longer waiting times, compared to self-paying service users who can afford services in the private sector.