ARE WE INVESTING ENOUGH IN MENTAL HEALTH AS A NATIONAL PRIORITY?
Across the world, governments spent an average of just over 2 per cent of their health budgets on mental health in 2020, according to the World Health Organization Mental Health Atlas. Additionally, 66 per cent of total government spending on mental health was directed towards an outdated approach: Psychiatric hospitals.
The World Bank deemed “all countries can be considered ‘developing’ countries in the context of mental health, as all are lagging in addressing the growing burden”.
We are certainly guilty of that too. In 2017, Singapore’s mental health spend at S$300 million was only 3 per cent of the Ministry of Health’s total expenditure, versus 11 per cent for diabetes and 6 per cent for aged care.
In 2022, the projected mental health spend increased to S$434.6 million but stayed at 3 per cent of total healthcare expenditure (not including COVID-19 expenditures). More interestingly, only 3 per cent of Singapore’s mental health spend in 2022 was for promotion and prevention, while 97 per cent was on treatment.
The National Mental Health and Well-being Strategy launched in October last year, however, is clearly premised on a new policy narrative that mental health is a continuum, not merely the absence of illnesses – a much-welcomed shift.
Under the new national strategy, a tiered care model will organise mental health services and support measures according to the severity of an individual’s needs, along with multiple touchpoints including a new national mental health hotline and text service.
Certain goals have also been set for implementation by 2030, including making mental health services available in all polyclinics and 1,350 HealthierSG GP clinics. The number of public sector psychiatrists is also set to grow by about 30 per cent to 260, and the number of psychologists by about 40 per cent to 300. In addition, the number of Community Outreach Teams (CREST) catering to youths will be nearly doubled to 15, from eight currently.
Indeed, there is no doubt that our mental health spend will and must certainly increase beyond 3 per cent of total health expenditure in the next six years.
If one in seven Singaporeans (14 per cent) has a mental health condition according to the 2016 Singapore Mental Health Study (and likely more by now), should we not invest more than 3 per cent of the total health budget on mental health?
I hope that we would also see a more even distribution between mental health promotion/prevention and care treatment as we take a population health approach.
Because where, and how much, we invest is where the change will be.