Barriers underlying care gaps in Singapore’s mental health landscape and suggestions for improvement from service providers’ perspectives: a qualitative approach

BackgroundDespite the high prevalence of mental health conditions globally, there are few studies investigating perspectives of providers on barriers underlying care gaps. Therefore, the primary aim of this project was to understand barriers underlying care gaps and suggestions for improvement from...

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Main Authors: Siang Joo Seah, Charlotte Chao Min Tan, Mary Su-Lynn Chew, Jin Jin Lim, Dhiya Mahirah, Yi-Ching Lynn Ho, Sing Ai Lee, Ee-Lian Lee, Sungwon Yoon, Vicknesan Marimuttu, Ngar Yee Poon, Julian Thumboo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1527521/full
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author Siang Joo Seah
Charlotte Chao Min Tan
Mary Su-Lynn Chew
Jin Jin Lim
Dhiya Mahirah
Yi-Ching Lynn Ho
Sing Ai Lee
Ee-Lian Lee
Sungwon Yoon
Sungwon Yoon
Vicknesan Marimuttu
Ngar Yee Poon
Julian Thumboo
Julian Thumboo
author_facet Siang Joo Seah
Charlotte Chao Min Tan
Mary Su-Lynn Chew
Jin Jin Lim
Dhiya Mahirah
Yi-Ching Lynn Ho
Sing Ai Lee
Ee-Lian Lee
Sungwon Yoon
Sungwon Yoon
Vicknesan Marimuttu
Ngar Yee Poon
Julian Thumboo
Julian Thumboo
author_sort Siang Joo Seah
collection DOAJ
description BackgroundDespite the high prevalence of mental health conditions globally, there are few studies investigating perspectives of providers on barriers underlying care gaps. Therefore, the primary aim of this project was to understand barriers underlying care gaps and suggestions for improvement from mental healthcare service providers in Singapore.MethodsSemi-structured interviews were conducted with 20 mental healthcare providers from public and private sectors, including administrators, practitioners, and an advocate. Participants were recruited via purposive sampling and snowballing. Interview transcripts were analyzed using thematic analysis.ResultsBarriers underlying service accessibility included insufficient integration across organizations and sectors for timely referrals and concerns about stigma of receiving services. Barriers to service effectiveness included limited public sector bandwidth and lack of supervision requirements for private sector allied health practitioners. General practitioners (GPs) faced financial and referral issues when serving as first touchpoint for mental healthcare. Fragmentation of information systems hindered coordinated care implementation, while lengthy referral forms and complex referral routes created additional obstacles. Public sector manpower issues and heterogeneity in frontline staff’s skills for right-siting patients hindered capacity maintenance.ConclusionThese findings highlight systemic challenges related to under-resourcing and a lack of coordination across sectors and organizations, ultimately hindering equitable access to mental healthcare. To address these challenges, recommendations include expanding insurance coverage, strengthening private sector regulation, and reforming reimbursement structures for integrated care. Streamlining referrals and improving data sharing will enhance coordination. Additionally, normalizing mental health conversations, empowering support networks, and increasing access to community-based services will reduce stigma and provide timely care, ultimately improving service delivery and access.
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spelling doaj-art-367a565cb06145c085e2a71c738f707c2025-08-20T03:07:54ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-05-011310.3389/fpubh.2025.15275211527521Barriers underlying care gaps in Singapore’s mental health landscape and suggestions for improvement from service providers’ perspectives: a qualitative approachSiang Joo Seah0Charlotte Chao Min Tan1Mary Su-Lynn Chew2Jin Jin Lim3Dhiya Mahirah4Yi-Ching Lynn Ho5Sing Ai Lee6Ee-Lian Lee7Sungwon Yoon8Sungwon Yoon9Vicknesan Marimuttu10Ngar Yee Poon11Julian Thumboo12Julian Thumboo13Centre for Population Health Research and Implementation, Regional Health System, Singapore Health Services Pte Ltd., Singapore, SingaporeCentre for Population Health Research and Implementation, Regional Health System, Singapore Health Services Pte Ltd., Singapore, SingaporeCentre for Population Health Research and Implementation, Regional Health System, Singapore Health Services Pte Ltd., Singapore, SingaporeCentre for Population Health Research and Implementation, Regional Health System, Singapore Health Services Pte Ltd., Singapore, SingaporeCentre for Population Health Research and Implementation, Regional Health System, Singapore Health Services Pte Ltd., Singapore, SingaporeCentre for Population Health Research and Implementation, Regional Health System, Singapore Health Services Pte Ltd., Singapore, SingaporeBridgepoint Health, Singapore, SingaporePsyMed Consultants, Singapore, SingaporeCentre for Population Health Research and Implementation, Regional Health System, Singapore Health Services Pte Ltd., Singapore, SingaporeDuke-NUS Medical School, Singapore, SingaporeDepartment of Psychological Medicine, KK Women’s and Children’s Hospital, Singapore, SingaporeDepartment of Psychological Medicine, KK Women’s and Children’s Hospital, Singapore, SingaporeCentre for Population Health Research and Implementation, Regional Health System, Singapore Health Services Pte Ltd., Singapore, SingaporeHealth Services Research Unit, Singapore General Hospital, Singapore, SingaporeBackgroundDespite the high prevalence of mental health conditions globally, there are few studies investigating perspectives of providers on barriers underlying care gaps. Therefore, the primary aim of this project was to understand barriers underlying care gaps and suggestions for improvement from mental healthcare service providers in Singapore.MethodsSemi-structured interviews were conducted with 20 mental healthcare providers from public and private sectors, including administrators, practitioners, and an advocate. Participants were recruited via purposive sampling and snowballing. Interview transcripts were analyzed using thematic analysis.ResultsBarriers underlying service accessibility included insufficient integration across organizations and sectors for timely referrals and concerns about stigma of receiving services. Barriers to service effectiveness included limited public sector bandwidth and lack of supervision requirements for private sector allied health practitioners. General practitioners (GPs) faced financial and referral issues when serving as first touchpoint for mental healthcare. Fragmentation of information systems hindered coordinated care implementation, while lengthy referral forms and complex referral routes created additional obstacles. Public sector manpower issues and heterogeneity in frontline staff’s skills for right-siting patients hindered capacity maintenance.ConclusionThese findings highlight systemic challenges related to under-resourcing and a lack of coordination across sectors and organizations, ultimately hindering equitable access to mental healthcare. To address these challenges, recommendations include expanding insurance coverage, strengthening private sector regulation, and reforming reimbursement structures for integrated care. Streamlining referrals and improving data sharing will enhance coordination. Additionally, normalizing mental health conversations, empowering support networks, and increasing access to community-based services will reduce stigma and provide timely care, ultimately improving service delivery and access.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1527521/fullmental healthcare gapsservice providers’ perspectivessuggestions for improvementqualitative
spellingShingle Siang Joo Seah
Charlotte Chao Min Tan
Mary Su-Lynn Chew
Jin Jin Lim
Dhiya Mahirah
Yi-Ching Lynn Ho
Sing Ai Lee
Ee-Lian Lee
Sungwon Yoon
Sungwon Yoon
Vicknesan Marimuttu
Ngar Yee Poon
Julian Thumboo
Julian Thumboo
Barriers underlying care gaps in Singapore’s mental health landscape and suggestions for improvement from service providers’ perspectives: a qualitative approach
Frontiers in Public Health
mental health
care gaps
service providers’ perspectives
suggestions for improvement
qualitative
title Barriers underlying care gaps in Singapore’s mental health landscape and suggestions for improvement from service providers’ perspectives: a qualitative approach
title_full Barriers underlying care gaps in Singapore’s mental health landscape and suggestions for improvement from service providers’ perspectives: a qualitative approach
title_fullStr Barriers underlying care gaps in Singapore’s mental health landscape and suggestions for improvement from service providers’ perspectives: a qualitative approach
title_full_unstemmed Barriers underlying care gaps in Singapore’s mental health landscape and suggestions for improvement from service providers’ perspectives: a qualitative approach
title_short Barriers underlying care gaps in Singapore’s mental health landscape and suggestions for improvement from service providers’ perspectives: a qualitative approach
title_sort barriers underlying care gaps in singapore s mental health landscape and suggestions for improvement from service providers perspectives a qualitative approach
topic mental health
care gaps
service providers’ perspectives
suggestions for improvement
qualitative
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1527521/full
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