SINGAPORE — Young adults are most at risk of suffering from mental disorders in Singapore, the latest Singapore Mental Health Study found. 

Those aged between 18 and 34 are more likely to have experienced bipolar disorder, major depressive disorder, alcohol abuse, and obsessive compulsive disorder, it said in a report on the findings, which were released on Tuesday (Dec 11). 

Other socio-demographic factors such as age, gender, marital status, education and income status are also associated with the prevalence of mental disorders. For example, alcohol abuse is more prevalent among the lower-educated, compared with those who have received tertiary education.

Dr Mythily Subramaniam, the co-principal investigator of the study, said that this is congruent with universal findings, because those with lower education may have “poor coping mechanisms” and may not understand the dangers of alcohol addiction.

The study, which began in 2016, interviewed more than 6,000 Singaporeans and permanent residents.

WHAT’S MAKING YOUNG PEOPLE ILL?

Professor Chong Siow Ann, vice-chairman of the medical board (research) at the Institute of Mental Health (IMH), said that while there is an urgency to “address the youth who are ill”, there is also a need to “understand what is making them ill” so that preventive measures can be taken.

While the study did not delve into specific reasons why young adults are more at risk, some experts pointed out that this could be because they are going through multiple transitions in life, both emotionally and socially.

“In that period of one’s life (between 18 to 34) there are many changes going on,” said Professor Kwok Kian Woon, a sociologist with the School of Social Sciences at Nanyang Technological University (NTU).

“Those who have just left school have to think about finding a job, those who go into tertiary education have to think about getting a diploma or degree. It is a time for new challenges, some of which can be rather stressful. Different individuals may have different levels of coping.”

Prof Chong from IMH said that an increased use of social media could also be a reason why young people are more at risk of experiencing mental disorders.

A study published in the American Journal Of Preventive Medicine in July last year found that the more time young people spent on social media sites such as Twitter, Google+, YouTube, LinkedIn, Instagram, Snapchat, Facebook and Reddit, the more socially isolated they perceived themselves to be.

Prof Kwok, who is also Associate Provost (Student Life) at NTU, said that tertiary students could be a “target population for certain kinds of intervention”. These interventions could include building a more supportive culture in tertiary institutions and workplaces, he added. For example, peers could look out for friends who are grappling with "extraordinary pressures", and encourage them to seek help from counsellors.

While social media has been identified as the cause of social isolation for some of the youth, Prof Kwok said that it can also be used as a tool to reach out to those with mental health disorders.

MORE YOUNGER PEOPLE HAVE OCD

Obsessive-compulsive disorder (OCD) is found to be more prevalent among young adults as well, compared with those aged 50 and above. The disorder is less likely in those with a monthly household income of between S$2,000 and S$3,999, compared with those who earn less than S$2,000.

OCD is also an increasingly prevalent mental illness in Singapore, with the most number of people experiencing it in the last year, compared with other mental illnesses.

Symptoms of OCD include a persistent fear of being contaminated and a desire for order and symmetry, resulting in excessive washing and impairing one’s ability to function or work.

The disorder is not only becoming more common, but those who experience OCD are also taking longer to seek help. This is because society tends to “normalise” and “trivialise” the condition, as it is often seen as a good thing when one wishes to be clean, Dr Subramaniam said.

The director of research at IMH added: “But it gets worse over time. We don’t pick it up early enough to see that it is interfering with someone’s life, and more vigilance is needed.”

The study also found that the prevalence of people experiencing OCD at least once in their lifetime is higher in Singapore than in South Korea, Australia and New Zealand.

FAILED RELATIONSHIPS A TRIGGER

One finding from the study was that those who are divorced and separated tend to experience depression and bipolar disorder, compared with those who are married.

Consultant psychiatrist Thomas Lee, medical director of The Resilienz Clinic at Novena Medical Centre, said that a failed relationship can be one of the biggest stressors for mental illness.

Dr Lee said: “Relationship problems are often tougher to deal with as they are intertwined with other parts of life. (It often involves) children, finances… it is much more complicated to deal with compared with a job, which one can just leave.”

One way to provide better help for this at-risk group is to train frontline workers who counsel couples with marital issues to look out for signs of mental disorders, he added. If counsellors are able to identify symptoms of mental illnesses early, they may be able to refer the couple to seek professional help.

Another group of people who have a higher risk of suffering from mental illness are those who are unemployed, the study showed.

Dr Subramaniam said that there is a “bi-directional” relationship between unemployment and the prevalence of mental illnesses.

“It is possible that a person may be unable to cope with the job, and resign due to a mental illness," she said. 

“On the other hand, being unemployed is a stressful event and can make one vulnerable to developing a mental illness.”

With the release of the findings on Tuesday, researchers called for more acceptance of people with mental health issues in workplaces, citing a recent survey by the National Council of Social Service (NCSS) which found that many are still unwilling to live or work with a person with a mental health condition.

SERVICES AT IMH:

• OCD clinic

The clinic, which was set up recently in 2015, accepts referrals from treating psychiatrists across Singapore. It helps those suffering from severe OCD. The clinic offers an assessment and individually tailored treatments to adults with severe OCD and related disorders.

• Community Health Assessment Team (Chat)

Young people may seek advice and help for emotional and mental health issues from youth support workers. The support workers provide confidential and personalised mental-health checks for those between 16 and 30 years old. The young people may connect with the support workers at “chat hubs” set up in polytechnics and post-secondary institutions.

• Mood Disorders Clinic

The clinic is run by a multi-disciplinary team consisting of psychiatrists, psychologists, pharmacists and case managers. The team manages complex cases of affective disorders, such as major depressive disorder (depression) and bipolar disorder.

• Mental Health Helpline

The 24-hour phone line (6389 2222) is manned by trained counsellors from the IMH, who provide risk assessment and link cases to relevant social services for help. They work with community partners like family service centres, government hospitals and town councils.