Mental Illness in Singapore

The Singapore Mental Health Study - a three-year, $6.9 million nationwide study - showed that more than one in ten people in Singapore will be stricken by mental illness in their lifetime. Over 6,600 people, Singapore citizens and permanent residents aged 18 and above, were surveyed for the study, which was funded by the Singapore Millennium Foundation and the Ministry of Health (MOH). Depression is the commonest mental illness. Others include alcohol abuse or obsessive-compulsive disorder (OCD). One in ten does qualify as an epidemic. What the study did not attempt to do was to explain the causes.

I stumbled across a talk by Richard Wilkinson, Professor Emeritus of social epidemiology at the University of Nottingham, on TED. (www.ted.com/talks/richard_wilkinson.html). He is best known for his book with Kate Pickett, "The Spirit Level" (2009). Although the causal linkages are difficult to prove, he argues that the underlying data shows that societies with more equal distribution of incomes have better health, fewer social problems such as violence, drug abuse, teenage births, mental illness, obesity, and others, and are more cohesive than ones in which the gap between the rich and poor is greater.

While one can question the reliability of the data, the hypothesis makes intuitive sense. The more unequal a society is, the more there is a loss in communal spirit. People gradually lead distinct lifestyles and detach themselves from each other. Between rich and poor, there is less mutual support and communities become isolated. When social mobility is low - ie very difficult for you to move out of the bottom rungs - there is a heightened sense of injustice and unfairness. All this is detrimental to mental health, which manifests itself in destructive behaviour.

The Business Times headline on Christmas eve 2011 was "Singapore sits moodily atop wealth poll". Singapore is a rich nation, but it also has the second highest income gap between the rich and the poor according to the 2009 United Nations Development Report. Only Hong Kong has a higher income gap. I remember that a senior politician told me back in the 90s that this was inevitable. I wonder if the Scandanavian countries reached this same conclusion back then.

If the state of mental health is a symptom and not the cause, curing it may be more intractable than we think. If the choice is to create a more equal, mobile society, will this destroy the razor sharp competitiveness that the Singapore economy is built upon?