Duke-NUS, IMH: Parents are concerned about more frequent signs of depression and anxiety in their kids

Researchers have found the outcomes of depression and anxiety symptoms in Singapore’s youth to be troubling.

SINGAPORE, 18 May 2023 – Depression and anxiety symptoms among Singaporean youths have resulted in them missing on average 190 hours—or 24 days—of school, according to a survey of parents in Singapore by Duke-NUS Medical School and the Institute of Mental Health (IMH). The survey also found that these youths’ school performance dropped by an estimated 63 per cent.

While youths missed an average of 24 days because of their symptoms, 13 per cent of them missed three months or more. The parents reported a similar reduction in their child’s ability to engage in other daily activities, revealing that these conditions permeate all facets of the child’s life.

“The real effects of untreated mental health conditions among youth will extend well into adulthood when they are less able to obtain rewarding and high-paying jobs due to poor school performance and other challenges resulting from their illness,” said Professor Eric Finkelstein, a health economist from Duke-NUS’ Health Services & Systems Research (HSSR) and senior author of the study. This study follows on from a similar survey among Singaporean adults published recently, which showed that depression and anxiety among adults are responsible for as much as a 2.9 per cent reduction in GDP due to roughly 1 in 5 adults having such symptoms.

This latest survey, conducted between April and June 2022, asked 991 parents about their children, totalling 1,515 youths, in order to gauge the state of youth mental health. The initial screening survey identified 104 parents whose children, aged 4 to 21, had depression or anxiety symptoms. These parents then filled out a more comprehensive survey with questions on school absences, school performance and healthcare utilisation.

The parents’ responses indicated that nearly 12 per cent of the youths had symptoms consistent with depression while approximately 13 per cent had symptoms consistent with anxiety; in total, 16.2 per cent of the youths were reported to have symptoms consistent with at least one of these conditions. Despite this, only 15 per cent had a formal diagnosis from a health professional, suggesting that many remain untreated.

This may explain why nearly two-thirds of the affected youths had an unplanned visit to an emergency department and just over half required inpatient hospitalisation over the past year. The parents reported spending an average of S$10,250 on medical care as a result of their children’s mental health condition. At the population level, direct healthcare costs for these conditions among youths are estimated to be S$1.2 billion.

Assistant Professor Irene Teo from Duke-NUS’ HSSR programme and co-author of the study added, “The results from our study show that greater outreach efforts are needed to encourage both children and adults to take advantage of the many avenues to obtain mental health treatments in Singapore.”

“These findings point to the importance of early intervention to help reduce the risk of long-term complications and improve outcomes. For this to happen, mental health awareness and literacy is necessary. For instance, if the parent recognises the symptoms (awareness) and knows what to do (literacy), they could encourage the child to talk about it or suggest getting some help,” said Associate Professor Daniel Fung, Chief Executive Officer, Institute of Mental Health, and a co-author of the study.

Prof Finkelstein added, “Along with greater access to evidence-based treatments, we should be implementing screening programmes for both children and adults to identify mental health conditions early, make better use of peer support programmes and increase efforts to destigmatise mental health. With the high prevalence and costs of mental illness among both children and adults, a successful mental health strategy should take on the same level of urgency as Singapore’s War on Diabetes.”

Published: 18 May 2023

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Chodavadia, P., Teo, I., Poremski, D. et al. Healthcare utilization and costs of singaporean youth with symptoms of depression and anxiety: results from a 2022 web panel. Child Adolesc Psychiatry Ment Health 17, 60 (2023). https://doi.org/10.1186/s13034-023-00604-z