6 A nationwide study of the local population in 2009 titled the Singapore Mental Health Study 7 highlighted the significant treatment gap for mental illnesses in Singapore.

The population comprises three main ethnic groups: Chinese (74.3%), Malay (13.4%) and Indian (9.1%), while 3.2% belong to other ethnic groups. Singapore is a multiethnic island city-state in Southeast Asia with a population of 5.61 million in 2016.

Negative attitudes towards mental illness are influenced by culture and affect people’s behaviour differently depending on their cultural background. 4 Thus, stigma is one of the greatest barriers to seeking treatment for those with mental illness. 3 Accordingly, they are reluctant to be identified as having a mental illness, resulting in high rates of treatment avoidance. 2 Individuals with mental illness often feel a sense of low self-esteem/well-being as they are rejected and discriminated against by others due to stigma.

Negative attitudes also give rise to the desire for social distance, a form of behavioural discrimination which involves reluctance to interact with persons with mental illness. Stigma against mental illnesses is one of the significant obstacles faced by mental health service users and providers and can be described as prejudice and discrimination against individuals with mental illness due to lack of knowledge, ignorance or misinformation. Link and Phelan 1 defined stigma as existing ‘when elements of labelling, stereotyping, separating, status loss and discrimination co-occur in a power situation that allows these processes to unfold’.

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