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Lost productivity due to depression and anxiety may cost Singapore nearly S$16b a year: IMH, Duke-NUS study

SINGAPORE — Anxiety and depression could be costing Singapore close to S$16 billion a year, or around 2.9 per cent of its gross domestic product (GDP), which suggests that more needs to be done to help sufferers cope.

Lost productivity due to depression and anxiety may cost Singapore nearly S$16b a year: IMH, Duke-NUS study
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  • Anxiety and depression may cost Singapore around S$16 billion yearly, a study by Duke-NUS Medical School and the Institute of Mental Health found
  • Their survey showed that 14 per cent of respondents had symptoms consistent with depression and 15 per cent had symptoms consistent with anxiety
  • Those affected reported missing an extra 17.7 days of work a year and were 40 per cent less productive while at work
  • This brought the total value of lost productivity attributable to anxiety and depression to S$15.7 billion
  • Duke-NUS said that this was consistent with global findings 

SINGAPORE — Anxiety and depression could be costing Singapore close to S$16 billion a year, or around 2.9 per cent of its gross domestic product (GDP), which suggests that more needs to be done to help sufferers cope.

This was based on a joint study by researchers from Duke-NUS Medical School and the Institute of Mental Health (IMH), which published their findings in the peer-reviewed medical journal BMC Psychiatry on Feb 14 this year.

In a press release on Wednesday (April 26), Duke-NUS said that the survey was done online between April and June last year, and it polled 5,725 adults.

To quantify the economic burden of depression and anxiety symptoms, the paper stated that a cross-sectional online survey was administered in English to Singaporean residents who are members of a national web panel curated by global consultancy company Kantar Profiles.

The panel has more than 500,000 people and is broadly representative of the socio-economic, gender and ethnicity distributions in Singapore.

The researchers said that the study is the first of its kind after the onset of the Covid-19 pandemic to estimate the prevalence and economic burden of depression and anxiety symptoms among Singaporean adults.

THE FINDINGS

The survey found that:

  • 14 per cent of the respondents had symptoms consistent with depression
  • 15 per cent, including those with depression, had symptoms consistent with anxiety

Among those who were identified as having these conditions:

  • 32 per cent reported seeking healthcare to treat their conditions
  • 24 per cent consulted a mental health provider

Duke-NUS said that 13 per cent of those suffering from the aforementioned mental health conditions made at least one visit to an emergency department, and 9 per cent were admitted into a hospital.

This increased healthcare costs by an average of S$1,050 a year for these individuals, it added.

Other results showed that the affected respondents:

  • Reported missing an extra 17.7 days of work a year, which translates to S$4,980 a worker
  • Were 40 per cent less productive while at work, which is equivalent to S$28,720 in economic losses yearly

As a result, this brought the total value of lost productivity attributable to anxiety and depression in Singapore to S$15.7 billion a year.

Of this, presenteeism accounted for 81.6 per cent (S$12.8 billion) and absenteeism accounted for 14.2 per cent (S$2.2 billion). Healthcare resource utilisation took up the remaining 4.2 per cent (S$0.7 billion).

Presenteeism refers to the lost productivity that occurs when employees are not fully functioning in the workplace because of an illness, injury or other condition.

Absenteeism simply refers to an employee who does not show up for work.  

Duke-NUS said that the S$15.7 billion figure is consistent with global findings.

For instance, studies in the United States before Covid-19 estimated the economic burden of diagnosed depression to be 1.6 per cent of its GDP.

The burden of diagnosed anxiety disorder is estimated to be between 0.25 per cent and 0.78 per cent of a country’s GDP.

The World Health Organization also estimated that Covid-19 has directly or indirectly contributed to an increased prevalence of depression (28 per cent) and anxiety (26 per cent).

Other estimates put the global economic burden of mental health conditions at US$1 trillion (S$1.3 trillion) a year, Duke-NUS added.

HELPING PEOPLE GET DIAGNOSED, TREATED

Commenting on the figures related to people suffering from mental health symptoms. Professor Eric Finkelstein, one of the study’s authors, said that the results are of concern because they suggest that these individuals are not benefitting from effective treatments.

“Successful efforts to improve mental health will have both health and productivity benefits”, he added, referring to the S$15.7 billion worth of productivity lost due to anxiety and depression.

Prof Finkelstein is also a health economist with Duke-NUS’ Health Services and Systems Research Programme.

Another co-author of the study, Associate Professor Daniel Fung, gave suggestions on how society can move forward from here.

Among them is to make greater efforts to encourage undiagnosed cases to seek treatment, as well as to expand access to peer support programmes.

Assoc Prof Fung, who is also chief executive officer of IMH, spoke about increasing efforts to improve mental health literacy and to reduce stigma surrounding mental health conditions, as well as to provide more training for general practitioners and allied health professionals to diagnose and treat mental health symptoms.

“(These suggestions) are all part of a successful recovery strategy for the whole population,” he added.

SURVEY’S LIMITATIONS

The researchers acknowledged in their publication that the primary limitation of their study is the reliance on an online panel to gather their data.

Even though it is broadly representative of Singapore’s demographics, the researchers said they “cannot guarantee” that their sub-sample of people with depression and anxiety symptoms is similarly representative.

This is because it depends on eligible participants’ willingness to take the survey.

Another limitation they highlighted was that for reasons of brevity, they had chosen to use a simpler version of a patient health questionnaire.

The tradeoff was that the chosen method may not have picked up all patients with depression or anxiety symptoms.

However, comparisons with a few other published studies available suggested that their results were “credible despite this concern”.

A third limitation was that they may have overestimated the economic burden attributed to absenteeism and presenteeism because they compared a person with depression or anxiety symptoms to someone who is perfectly productive.

“However, it is likely that people without a mental health condition have reduced productivity due to other health conditions,” they added.

Related topics

mental health depression anxiety Duke-NUS IMH

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