Some people just want to vent without worrying about consequences
Across Singapore, three in four adults living with anxiety or depression quietly endure their suffering rather than seek professional help — held back not by ignorance, but by stigma, privacy fears, and the quiet cultural weight that frames emotional pain as something to be borne alone. A Duke-NUS study published in the Singapore Medical Journal offers both a sobering measure of this silence and an unexpected opening: the majority of those who resist clinical care say they would welcome a conversation with someone who has walked the same difficult road. It is a reminder that healing does not always begin in a clinic — sometimes it begins with recognition.
- Seventy-seven percent of Singaporeans with anxiety or depression go untreated, not because help is unavailable, but because the social cost of asking feels too high.
- Fear of workplace judgment and the cultural expectation to manage pain privately create a wall that professional services alone cannot scale.
- A quiet counterforce emerges: 62 percent of respondents say they would accept support from a peer — someone who has lived the same struggle — preferring one-on-one, often virtual conversations where distance offers safety.
- Younger adults and senior white-collar workers show the greatest openness to peer support, hinting that stress, health literacy, and generational shifts in attitude are reshaping who reaches out and how.
- At institutions like NUS, trained peer supporters operate in confidence, meeting colleagues where they are — not to replace therapists, but to hold the door open until someone is ready to walk through it.
Three out of four adults in Singapore who live with anxiety or depression have never sought professional help. According to a Duke-NUS Medical School study of 350 surveyed adults, 77 percent manage alone — held back by privacy concerns, stigma, and the fear that disclosure at work could cost them professionally. There is also something cultural at play: in many Asian contexts, emotional pain is treated as a private matter, and to speak of it openly can feel like weakness. As co-author Daniel Fung of the Institute of Mental Health observed, many people simply normalize their symptoms, convincing themselves that what they feel is just how life is.
Yet the same study revealed an unexpected opening. While most respondents rejected professional care, 62 percent said they would welcome support from a peer — someone with lived experience of the same struggle. Half preferred one-on-one conversations, and 43 percent favored virtual settings, where distance might feel safer. Younger adults showed the greatest willingness, reflecting a generational shift toward more open conversations about mental health. Managers and directors were also more receptive than clerical workers — possibly due to higher stress, better health literacy, or the isolation that can come with seniority.
At the National University of Singapore, this model already operates quietly. Sven Petersen, a principal research scientist who joined the peer support program after his own experience with depression and anorexia, described how these conversations often begin by accident — a colleague who looks troubled, a lunch that opens a door. Confidentiality is absolute, and that, he said, is the point: some people simply need to speak without fear of consequence.
Eric Finkelstein of Duke-NUS was clear that peer support cannot replace professional care — a peer cannot diagnose or prescribe. But a peer can stabilize, offer hope, and encourage someone to finally reach out to a clinician. When peer support functions as a bridge rather than a substitute, it can make formal treatment more reachable. The study's broader message is that no single solution fits everyone, and that the first step toward healing may need to look less like a clinic and more like a conversation.
Three out of four adults in Singapore who live with anxiety or depression have never walked into a psychiatrist's office. They have not called a psychologist. They have not sat down with a social worker. According to a study by Duke-NUS Medical School published last month in the Singapore Medical Journal, 77 percent of the 350 surveyed adults experiencing these conditions have chosen to stay silent, to manage alone, to wait it out.
The reasons are familiar enough: privacy worries, the sting of stigma, the fear that a boss or colleague will find out and judge them for it. In workplaces especially, the calculation feels clear—reveal your struggle, risk your job. There is also something deeper, something cultural. In many Asian contexts, emotional pain is treated as a private matter, not something to be aired in conversation. To speak of it openly feels like weakness. Daniel Fung, a senior consultant at the Institute of Mental Health and co-author of the study, put it plainly: people often normalize their symptoms, convincing themselves that what they are experiencing is just how life is.
Yet the same study uncovered something unexpected. While most respondents refused professional help, 62 percent said they would welcome support from someone who had walked the same path—a peer, someone with lived experience of the same struggle. The preference was clear: 51 percent wanted one-on-one conversations rather than group settings, and 43 percent preferred to talk virtually, where the distance might feel safer. The data suggested that informal, community-based support could fill a gap that professional services were not reaching.
Who was most open to this kind of help? Younger adults, unsurprisingly, showed greater willingness to accept peer support—a reflection of shifting attitudes toward mental health among the generation that grew up talking about it more openly. Those who had already sought professional care were also more likely to embrace peer support, suggesting the two approaches could work together rather than compete. Interestingly, managers and directors—people in white-collar roles—were more receptive to informal support than clerical or sales workers. Researchers speculated this might reflect higher stress, better health literacy, or the simple fact that senior roles often come with fewer natural peer networks to lean on.
At the National University of Singapore, the peer support system operates quietly, without fanfare. Sven Petersen, a principal research scientist who joined the program after his own battle with depression and anorexia during his academic years, described how these conversations often begin by accident—a colleague who looks troubled, a lunch conversation that opens a door. Peer supporters receive training to know how to approach someone in distress, how to listen without judgment. The confidentiality is absolute. "When someone talks to me, I would never share it with anyone else," Petersen said. "This is the important part, that some people just want to vent and talk about their problems without being worried about any consequences."
Eric Finkelstein, executive director of the Lien Centre for Palliative Care at Duke-NUS, was clear about the limits of this approach. Peer support cannot replace professional care. A peer cannot diagnose. A peer cannot prescribe. But a peer can stabilize someone in crisis, can offer hope, can encourage that person to finally reach out to a professional. When peer support works as a bridge rather than a substitute, it can actually make formal treatment more effective. The study's findings suggest that mental health support in Singapore cannot be one solution for everyone. Programs must be designed with intention, with an understanding that some people will only take the first step if that step is toward someone like themselves.
Citações Notáveis
There is still stigma and fear of judgment regarding mental illness, because it's perceived as weakness. People worry their jobs might be affected.— Daniel Fung, senior consultant at Institute of Mental Health
Peer support cannot replace professional care, but when peers encourage access to professionals and complement formal treatment, it can actually make formal care more effective.— Eric Finkelstein, executive director of the Lien Centre for Palliative Care at Duke-NUS
A Conversa do Hearth Outra perspectiva sobre a história
Why do you think so many people with anxiety and depression in Singapore refuse to see a professional, even when they're struggling?
It's not one thing. There's the obvious fear—that your boss will find out, that you'll be seen as weak or unstable. But there's also something quieter. In a lot of Asian cultures, you keep emotional pain private. You don't burden others with it. You certainly don't make it public.
But the study shows 62 percent would talk to a peer. What's different about that?
A peer has been there. They're not an authority figure with a clipboard. There's no power imbalance, no sense that they're judging you or writing things down that could follow you. You can just... vent. Say the thing you've been holding in.
So peer support is just venting? That seems limited.
It's not nothing. In a crisis, sometimes you need someone to help you feel less alone, to remind you that you'll survive this. A peer can do that. But the researchers were careful to say it's not a replacement for real treatment. It's a bridge. It gets you comfortable enough to eventually talk to a professional.
Who's most likely to accept peer support?
Younger people, mostly. And interestingly, managers and directors—people with high stress and fewer natural support networks. But also people who've already seen a professional. Once you've taken that leap once, the second one feels easier.
What does a peer supporter actually do?
They listen. They keep what you say completely confidential. They might help you think through what's happening, but they're not trying to fix you or diagnose you. They're just present. Sometimes that's enough to help someone take the next step.