Improving Access to Mental Health Resources for Migrant Construction Workers in Singapore

By Nicole Quah (’21), Celine Lee (’24), and Luke Seow (’24)


Lack of mental health education and employer behaviour regulation has created a mental health crisis among migrant construction workers in Singapore. Therefore, we must raise awareness on the importance of mental health in Singapore and encourage collaboration between non-governmental organisations (NGOs) and the government.

Background and Analysis

With over 300,000 foreign migrant workers on work permits [1] as of June 2020, migrant workers’ importance to the Singaporean economy is indisputable. [2] Yet, despite being essential, migrant workers have often been the subject of social, spatial, and institutional exclusions, leading to an unequal incorporation of migrant bodies in the city-state on the basis of their ‘transient’ status. [3]

Migrant workers’ access to mental health is one aspect that has long been neglected. This is especially concerning as migrant workers are uniquely susceptible to mental illness as a result of their work conditions. A 2015 study conducted by the Singapore Management University (SMU) discovered that 62% of the sampled migrant workers met the screening criteria for a Serious Mental Illness, as poor living conditions, the threat of deportation, and separation from their families, along with other reasons, make migrant workers particularly susceptible to mental health issues. [4]

These issues have been exacerbated by the Covid-19 pandemic. Singapore’s successes in containing its community transmissions has been marred by its treatment of migrant workers, who are segregated in dormitories where heavy movement restrictions are imposed. The isolation of migrant workers in dormitories for long periods of time without guaranteed payment has led to financial insecurity and feelings of entrapment. [5] There have been numerous self-harm incidents and suicides amongst the community over the past few months [6], though there are no official statistics or publicly accessible investigations into their causes.

Yet the mental health system available to migrant workers appears to be woefully inadequate.

Migrant workers often lack awareness of the available healthcare resources in general, compromising their access to care. A 2013 survey of 433 non-domestic migrant workers [7] found that only 27.6% of the respondents received or were aware of company-bought medical insurance. Of those, 67.7% reported that the information was not communicated in their native language. This gap is compounded within the context of mental health treatment, which is inaccessible to many migrant workers due to the enduring unaffordability of most treatments and the scarcity of affordable, NGO-provided ones.

Mental health treatment is often prohibitively expensive for migrant workers as it is excluded from the minimum health insurance coverage that employers are mandated to provide for migrant workers covered under the Employment of Foreign Manpower Act. [8] While employers have the option to purchase additional riders that cover mental health, most do not. Since current legislation does not require employers to cover mental health costs, mental health issues are not considered as “emergency medical services”, and coverage is “highly dependent on employers’ goodwill”. [9] As a result, most forms of mental health treatment are prohibitively expensive for migrant workers.

Additionally, affordable forms of mental health support for migrant workers are limited. Currently, NGOs provide the bulk of affordable mental health services for migrant workers. NGOs such as the Migrant Workers’ Centre (MWC) has a 24-hour helpline manned by the organisation’s staff for workers who require any form of assistance, while medical NGO Healthserve provides a mental wellness hotline where workers can access medical information and submit requests for tele-counselling sessions conducted by trained volunteers.

Talking Points

  1. Migrant workers are more susceptible to mental illnesses due to the threat of deportation, financial burden, and poor working conditions, but their medical insurance currently does not cover mental health treatments.
  2. Further, the majority of migrant workers are unaware of their medical rights as their employers rarely disclose information on how to access medical resources, let alone mental health resources.
  3. To address these vulnerabilities, the Ministry of Manpower (MOM) should provide manpower and financial support to NGOs currently providing mental health resources to migrant workers and require employers to purchase insurance for mental health services for them. Additionally, the state could consider creating a channel that disseminates awareness of aforementioned mental health services and other mental health-related information.

The Policy Idea

We recommend that the MOM could alleviate the burdens faced by migrant construction workers by (1) providing manpower and financial support to NGOs currently providing mental health resources; (2) requiring employers to purchase insurance for mental health services for their employees and; (3) creating a channel that disseminates mental health-related information to migrant workers.

More details are provided in Annexes A and B.

Policy Analysis

Firstly, we recommend that the state considers upscaling existing mental health services provided by NGOs. Singapore’s NGOs have spent years catering to the mental health needs of the migrant worker population. As case workers from these NGOs work with migrant workers on a daily basis, they are more familiar with migrant workers and their needs [10] and are broadly considered to be more trustworthy and approachable than their state counterparts [11].

However, given that there are approximately 300,000 migrant construction workers, NGOs do not have sufficient employees to meet all their needs. Demand is substantial; within two months of launching the hotline, Healthserve had received more than 4,000 enquiries and 300 workers signing up for tele-counselling sessions. [12] As such, an expansion of mental health services for them is necessary.

It would be ideal for the state to help migrant workers via NGOs by providing financial support to train a larger pool of volunteers and employing professional manpower (e.g. counselors) for migrant workers.

Secondly, the MOM should mandate that employers purchase insurance for mental health services for their employees covered under the Employment of Foreign Manpower Act and bear the full cost of this insurance. Though the state might face resistance from employers unwilling to bear extra health insurance costs for migrant workers, ignoring this mental health crisis will create widespread negative consequences. For example, leaving the crisis unaddressed could lead to indirect costs of illness and loss of productivity among migrant workers. Furthermore, the lack of health rights given to migrant workers could also “undermine Singapore’s reputation as a regional and global economic hub” and leave wider repercussions in the long-term. [13]

Finally, the MOM should work with employers and dormitory operators to create a distribution channel that disseminates information, both online and via pamphlets and posters, about mental health, such as how to identify mental illness and where and how to seek help when ill. [14] Information should be circulated online (via WhatsApp, WeChat, and other relevant social media platforms) and via pamphlets and posters, which should be put around dormitories to ensure that migrant workers receive information about mental health resources. These should be emphasised in the standard orientation briefing when the workers first arrive in Singapore, and dormitory operators should be required to publicise the information. To increase transparency and ensure that employers do not disregard the mental health needs of migrant workers after the orientation briefing session, the MOM should legally require that employers and dormitory owners print and display mental health posters in multiple languages.

The provision of mental health awareness has been proven to be beneficial to the migrant worker population. In recent years, a social platform, “Pangyao”, has been successfully used in Hong Kong and Macau to disseminate mental health information. A similar channel could be implemented in Singapore, resolving information asymmetry between employers and employees.

There is a lack of emphasis on mental health issues among the general Singaporean population. The lack of mental health resources and mental health literacy among Singaporeans reflect a wider social issue. [15] If the state elects to emphasise the mental health issues of a very vulnerable and marginalised population, we can subsequently ignite a national conversation on mental health awareness in general.

Key Facts

  1. Currently, employers are required to purchase a minimum health insurance coverage of SGD 15,000 per worker per year. [16] However, this insurance should increase to include mental health services. Employers should not be allowed to pass this additional financial burden on to migrant workers.
  2. Posters that detail mental health resources available to migrant workers should be distributed on each floor of every block in migrant worker dormitories. Information on mental health resources should also be printed in a booklet disseminated to migrant workers during their orientation conducted by the MOM when they first arrive, to ensure that they are aware of the resources available.
  3. Currently, there are approximately 8 psychologists and 4 psychiatrists per 100,000 people in Singapore. [17] Given that there are approximately 300,000 migrant workers on work permits [18], at least 24 psychologists and 12 psychiatrists should be allocated to the community to provide counselling sessions and treat mental health illnesses. These could either be professional manpower or university students majoring in clinical psychology.

Annex A: Expansion of Migrant Worker Mental Health Provisions

If NGOs confirm that there needs to be an expansion of mental health resources provided to migrant workers, we suggest that possible expansion efforts include hiring additional mental health professionals for migrant workers. These professionals must speak different languages to cater to the needs of migrant workers.

In addition to hiring professionals, another possibility would be for the MOM to establish a traineeship program with NGOs to increase the volunteer pool. Students from universities (such as the National University of Singapore and Nanyang Technological University) training to become counsellors can have part-time or full-time traineeships at NGOs, where they help listen to the problems of migrant workers and assist them in getting the help they need. The MOM and the Ministry of Health should support this effort through the form of a grant or subsidy provided to NGOs. Also, the MOM should fund the traineeships. This will increase the number of psychologists and psychiatrists for migrant workers, so that they can access counselling and mental health treatment options.

Annex B: Distribution Channels

We recommend that the MOM work with NGOs to create a distribution channel that circulates information about mental health conditions, resources, and treatments. This information should be distributed through brochures, posters, social media pages, and other online platforms that migrant workers use. These sources should also be made available in different languages to ensure that the information is fully comprehensible to all migrant workers. The first step to establishing this distribution channel would be to incorporate it into the standard orientation briefing conducted by the MOM when the foreign migrants first arrive in Singapore. In addition to workshops on First Aid practices and workplace safety measures, all migrant workers would be required to attend a 30-minute Mental Health Awareness session, in which a resource pack would be handed to each worker (in their native language).

The resource pack would contain the following information:

  • a clear explanation on what mental health is;
  • a list of common mental illnesses and their symptoms;
  • a comprehensive action guide on what to do and who to seek help from when symptoms are identified;
  • the addresses, phone numbers, and other information on at least three easily accessible mental health clinics, and;
  • details on the workers’ healthcare coverage and insurance policies.


  1. Excluding Foreign Domestic Workers
  2. Ministry of Manpower. “Foreign Workforce Numbers.” Government. Ministry of Manpower Singapore. Accessed October 11, 2020.
  3. Neo, Jaclyn L. “Riots and Rights: Law and Exclusion in Singapore’s Migrant Worker Regime.” Asian Journal of Law and Society 2, no. 1 (May 2015): 137–68.
  4. Harrigan, Nicholas M, and Koh Chiu Yee. “Vital Yet Vulnerable: Mental and Emotional Health of South Asian Migrant Workers in Singapore.” Lien Center for Social Innovation, 2015.
  5. Yea, Sallie. “This Is Why Singapore’s Coronavirus Cases Are Growing: A Look inside the Dismal Living Conditions of Migrant Workers.” The Conversation, April 30, 2020.
  6. Aravindan, John Geddie, Aradhana. “Spate of Suicides among Migrant Workers in Singapore Raises Concern.” Reuters, August 6, 2020.
  7. Ang, Jia Wei, Colin Chia, Calvin J Koh, Brandon W B Chua, Shyamala Narayanaswamy, Limin Wijaya, Lai Gwen Chan, Wei Leong Goh, and Shawn Vasoo. “Healthcare-Seeking Behaviour, Barriers and Mental Health of Non-Domestic Migrant Workers in Singapore.” BMJ Global Health 2, no. 2 (March 2017): e000213.
  8. Ministry of Manpower. “Medical Insurance Requirements for Foreign Worker.” Ministry of Manpower Singapore. Accessed October 11, 2020.
  9. Rajaraman, Natarajan, Teem-Wing Yip, Benjamin Yi Hern Kuan, and Jeremy Fung Yen Lim. “Exclusion of Migrant Workers from National UHC Systems—Perspectives from HealthServe, a Non-Profit Organisation in Singapore.” Asian Bioethics Review, August 3, 2020: 370.
  10. The Global Development Research Center. “NGOs: Advantages and Disadvantages.” Accessed December 30, 2020.
  11. Poh, Yong Han. “Singapore’s Migrant Worker Debate: Advocacy Amid a Pandemic.” The Diplomat, April 12, 2020.
  12. Health Serve. “Health Serve Annual Report 2019.” Health Serve, 2019.
  13. Harrigan, Nicholas M, and Koh Chiu Yee. “Vital Yet Vulnerable: Mental and Emotional Health of South Asian Migrant Workers in Singapore.” Lien Center for Social Innovation, 2015.
  14. Tam, Wai Jia, Wei Leong Goh, Jeffrey Chua, and Helena Legido-Quigley. “健康是本钱 – Health Is My Capital: A Qualitative Study of Access to Healthcare by Chinese Migrants in Singapore.” International Journal for Equity in Health 16, no. 1 (June 15, 2017): 102.
  15. Tonsing, Kareen N. “A Review of Mental Health Literacy in Singapore.” Social Work in Health Care 57, no. 1 (January 2, 2018): 27–47.
  16. Ministry of Manpower. “Medical Insurance Requirements for Foreign Worker.” Ministry of Manpower Singapore. Accessed October 11, 2020.
  17. Ministry of Manpower. “Manpower for Patients Receiving Psychiatric Treatment and Mental Health Support.” Government, January 6, 2020.
  18. Excluding Foreign Domestic Workers

Image Credit: Nikkei Asia

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