Formal mental health help-seeking remains low in SG despite established support systems, as most MWs and MDWs gravitate towards informal sources of help.A mixed-methods, two-phase study sheds light on help-seeking behaviours and perceived barriers and facilitators to mental health support among migrant workers (MWs) and migrant domestic workers (MDWs) in Singapore.
Phase I was a quantitative survey comprising 1,465 MWs and 1,462 MDWs (40 percent aged 30–39 years). Phase II comprised 14 focus group discussions (48 MWs and 52 MDWs) to examine barriers and facilitators to help-seeking and how participants sought help for emotional and mental health issues. MWs belonged to the CMP* sectors and stayed in dormitories during their participation; MDWs had to be working in SG at the time of recruitment. [Arch Public Health 2026;84:45]
Phase I
Fifty-eight percent of MWs expressed awareness about help-seeking organizations in SG. Of these, 76.1 percent mentioned MOM**, 10.9 percent cited the police, and 5.2 percent cited their embassy as help-seeking facilities. However, only 16.8 percent turned to MOM and <4 percent sought emotional support from the police or embassy. Instead, most preferred family/friends outside SG (60.9 percent), friends/family/neighbours in SG (58.6 percent), and their employer (33.6 percent).
Among MDWs, 66.8 percent were aware of help-seeking organizations in SG, with 75.4 percent citing MOM, 46.8 percent the CDE***, and 12.5 percent their employment agency as sources. However, a majority (91.4 percent) of MDWs still sought emotional support from friends/family/neighbours in SG (45.1 percent), employers (37.5 percent), and friends in their home country or outside SG (37 percent).
Looking at help-seeking preferences for emotional issues, 48.1 percent of MWs preferred an expert (psychologist, psychiatrist), whereas 39.7 percent opted for a fellow MW with proper training. Conversely, more MDWs preferred a fellow MDW with proper training over a trained professional (51.5 percent vs 33.4 percent).
The predilection for informal sources of help may have been driven by trust, cultural familiarity, and accessibility. [Am Behav Sci 2020;64:784-801; J Immigr Minor Health 2020;22:571-579] These sources are usually more emotionally attuned and personal, which may resonate well with an individual’s unique circumstances. [J Health Soc Behav 2011;52:145-161]
“[I]nformal support plays a crucial role in offering emotional comfort and a sense of belonging, [but] it may not always provide the appropriate structured interventions necessary for managing severe mental health conditions,” the researchers noted.
Formal support systems are usually task-oriented and leverage professional expertise to deliver quality care. However, it may fall short in terms of flexibility and raise perceptions of impersonal and transactional care. [Ann Fam Med 2021;19:171-177]
Phase II: Help-seeking barriers
The survey identified three individual-level barriers to help-seeking: Lack of awareness of available services, communication difficulties, and self-reliance. Communication may be confounded by the discomfort of sharing personal issues, compelling some individuals to resolve their issues independently, the researchers said. “The explicit refusal to share suggests that self-reliance serves as a protective mechanism, potentially preventing them from seeking professional help.”
Fear of gossip and social judgment was considered a key interpersonal barrier. “Many [participants] felt that help-seeking efforts could isolate them from their only established social networks within their country of work … Consequently, the risk of losing this standing through gossip outweighed the potential benefits of seeking professional help,” they said.
Other barriers identified were stigma, fear of job loss or termination, and financial and healthcare-related issues.
Seeking help for mental issues may lead to mislabelling and social ostracization. “[Moreover,] the label of mental illness carries the weight of incompetence,” the investigators noted.
“Fear of termination or non-renewal if mental health issues were disclosed emerged as a dominant concern … The precariousness of migrant work contracts, often tied to employer sponsorship, and the pressure workers feel to maintain current and future employment to support their families amplifies these fears and discourages timely intervention,” they added.
These factors may drive individuals to choose silence over help-seeking to preserve their social and career standing.
The cost of mental health care may also be a deterrent to help-seeking, especially with insufficient employer subsidies. “Consequently, participants often viewed healthcare expenditure as a trade-off against financial survival, deliberately prioritizing savings over seeking treatment,” the researchers said.
Phase II: Help-seeking facilitators
Two key help-seeking enablers were identified: Trusted family/friends and positive encounters with healthcare professionals (HCPs).
According to the investigators, most participants expressed willingness to seek help from friends or family with whom they had established close, trusted relationships. “This reliance on ‘kith and kin’ underscores that trust is a prerequisite for disclosure.”
Regular discussions with familiar HCPs provide a sense of comfort and safety when sharing sensitive mental health concerns, they added. HCPs who proactively incorporate mental health issues into conversations provide assurance that patients’ mental health concerns are valid, thus encouraging patients to seek help.
Phase II: Help-seeking sources
The participants identified multiple informal and formal sources supporting their efforts to seek help for mental health issues. These included family and friends; religious and spiritual support groups; MW support and advocacy networks (eg, MWC#, ACE## Group); and employers (mostly for MDWs).
“MDWs’ workplace is also their home, making the employer the most immediate and sometimes only source of tangible support during a crisis, recognizing that the employer acts as the primary safety net in the host country,” the researchers said.
Informal sources preferred
As of December 2025, Singapore is home to 482,600 MWs in the CMP sectors and 316,900 MDWs. [https://www.mom.gov.sg/foreign-workforce-numbers, accessed 4 August 2026] “To safeguard their welfare, SG has established various regulatory frameworks and protective measures. These include mandatory orientation programmes for employers of MDWs and settling-in programmes for newly arrived non-Malaysian MWs. Additionally, SG has made notable strides in enhancing workplace health and health regulations,” the researchers said.
However, formal mental health help-seeking remains low in Singapore despite established support systems, as most MWs and MDWs gravitate towards informal sources of help.
The results highlight the need for integrated support models that factor in peer-led initiatives, culturally and linguistically competent healthcare services, and clearer messages about accessible and affordable resources to improve the mental well-being of the migrant workforce, the researchers said.
“[Their support and care] require a whole-of-society effort. Partnerships with nongovernment organizations, HCPs, and employers are essential to ensure that programmes and services are coordinated and sustainable,” they concluded.