Singapore is grappling with a growing mental health crisis, emerging as the leading cause of disability and death among adolescents aged 10 to 14, while its overall impact on population health ranks highest in the ASEAN region. According to a groundbreaking study published in Lancet Public Health on May 28, 2025, mental disorders affected an estimated 12.8 percent of males and 11.7 percent of females in Singapore in 2021, with a total of 653,000 diagnoses recorded that year. As the city-state navigates post-pandemic recovery, rapid societal shifts, and an aging population, experts warn that the burden of mental health conditions demands urgent attention alongside other pressing public health issues like self-harm and cardiovascular diseases.
A Deepening Mental Health Burden
The Lancet study, part of the 2021 Global Burden of Disease (GBD) initiative, marks the first collaborative research between the National University of Singapore’s Yong Loo Lin School of Medicine (NUS Medicine) and the University of Washington’s Institute for Health Metrics and Evaluation (IHME). It reveals that anxiety and depression, exacerbated by the COVID-19 pandemic, were the most prevalent mental disorders in Singapore, affecting approximately 185,000 and 144,000 individuals respectively in 2021. The numbers are particularly stark among the elderly, with cases among those over 70 tripling, driven by the interplay of declining physical health and social isolation.
Lead author Marie Ng, an associate professor at NUS Medicine, highlighted the societal factors fueling this crisis. “The rise of social media and intense academic pressure have been linked to increased mental health issues among young people” she said. She also pointed to broader shifts in Singapore’s social fabric, including family breakdowns and growing isolation, trends often observed in developed, Westernized societies. For older adults, the rapid aging of the population—coupled with longer lifespans—has led to a surge in depression as physical health deteriorates. 
The pandemic compounded these challenges, triggering widespread uncertainty and anxiety across all age groups. Yet, there is a silver lining: Professor Ng noted that improved public awareness and reduced stigma have encouraged more individuals to recognize symptoms and seek help. This shift, while positive, underscores the scale of unmet need, as many cases remain undiagnosed or untreated due to lingering cultural barriers.
Adolescents and Self-Harm: A Critical Concern
Among Singapore’s youth, the mental health crisis manifests in particularly alarming ways. Mental disorders are now the leading cause of disability and death for children aged 10 to 14, a statistic that sets Singapore apart within ASEAN. Professor Alina Rodriguez from NUS Medicine’s psychological medicine department emphasized the long-term consequences of unaddressed issues. “Mental health challenges often emerge early in life, and if left unchecked, can lead to years of lost potential” she said. Schools are increasingly becoming frontline spaces where these struggles are observed, yet systemic support remains insufficient.
Self-harm, closely tied to mental health struggles, is another pressing issue. In 2021, it accounted for 47 percent of all injury-related deaths in Singapore, with the highest incidence among young adults aged 20 to 24. Notably, more females than males engaged in self-harm, though Singapore’s rates remain lower than those of neighboring high-income countries like Japan and South Korea. Falls ranked as the second leading cause of injury deaths, contributing to 22 percent of such fatalities, often among the elderly.
Across ASEAN, self-harm also features prominently among the top causes of injury-related mortality in countries like Malaysia, Thailand, Brunei, and Vietnam. Regionally, road injuries lead as the primary cause of injury deaths, followed by falls, self-harm, drowning, and interpersonal violence. The data paints a sobering picture of a region wrestling with interconnected public health challenges, where mental health often underpins broader patterns of injury and mortality.
Regional Context and Hidden Needs
Zooming out to the ASEAN region, the Lancet series of papers—four in total, covering mental disorders, cardiovascular disease, smoking, and injuries—estimates that 80.4 million people across the bloc were affected by mental disorders in 2021. This represents a staggering 70 percent increase since 1990, with anxiety disorders emerging as the most common condition. Yet, as Professor Rodriguez cautioned, these figures likely understate the true scale of the crisis. “Many cases are borderline, and stigma still prevents countless individuals from seeking care” she said.
Singapore’s position as the ASEAN country with the highest per capita impact of mental health issues on overall population health reflects both its advanced healthcare data collection and the unique pressures of its urban, high-achieving society. While the city-state has made strides in public awareness, the gap between diagnosis and treatment remains a critical barrier, particularly for marginalized or less visible groups.
Cardiovascular Diseases and Risk Factors
Beyond mental health, the Lancet study also sheds light on cardiovascular diseases (CVD), which remain a significant public health concern in Singapore despite the country boasting the lowest prevalence and mortality rates in ASEAN. CVD is the second leading cause of death locally, with over 385,000 individuals affected in 2021—a nearly 200 percent increase over the past three decades. An aging population and rising risk factors, including high blood pressure, poor dietary habits, high LDL cholesterol, elevated fasting plasma glucose, and tobacco use, drive this trend. Obesity, in particular, is identified as the fastest-growing risk factor.
However, Singapore’s performance in reducing CVD mortality outpaces both global trends and those of other high-income countries, reflecting effective public health interventions and access to advanced medical care. This success story offers a counterpoint to the mental health crisis, illustrating the potential for targeted policies to yield measurable outcomes over time.
Smoking Trends: Progress with Caveats
On tobacco use, Singapore demonstrates notable progress among males, with a smoking prevalence of 20.2 percent among those aged 15 and above—well below the ASEAN average of 48.4 percent. Among females, however, the rate of 6.56 percent exceeds the regional average of 4.47 percent, ranking fourth highest in ASEAN. This gender disparity suggests that while anti-smoking campaigns have gained traction, targeted efforts to address female smoking rates may be needed to sustain momentum.
Professor Ng summarized the broader implications of the findings. “The data presents a nuanced picture of Singapore’s health progress. While we’ve made remarkable strides in areas like cardiovascular care and tobacco control, the growing burden of mental health conditions and injuries, particularly self-harm and falls, calls for urgent and sustained attention” she said.
Toward a Holistic Public Health Strategy
The interconnected nature of these health challenges—mental disorders, self-harm, cardiovascular issues, and smoking—underscores the need for a comprehensive public health strategy in Singapore. Mental health, in particular, cannot be addressed in isolation; its links to physical health, societal pressures, and injury patterns demand integrated solutions that span education, healthcare, and community support systems.
For adolescents, early intervention programs in schools could prove transformative, equipping young people with coping mechanisms before issues escalate. Among the elderly, initiatives to combat social isolation and improve access to mental health services alongside physical care are equally critical. Meanwhile, public campaigns to further destigmatize mental health struggles could build on recent progress, encouraging more individuals to seek help without fear of judgment.
At the regional level, Singapore’s data offers valuable lessons for ASEAN neighbors grappling with similar challenges on a larger scale. Collaborative efforts, such as the joint research between NUS Medicine and IHME, could pave the way for shared strategies to address mental health and injury prevention across diverse cultural and economic contexts.
As Singapore charts its path forward, the question remains: can the city-state balance its pursuit of economic and societal advancement with the urgent need to safeguard the well-being of its people? The rising tide of mental health challenges suggests that this will be a defining test for policymakers and communities alike in the years ahead.
