Mental health help-seeking behaviour among migrant workers and migrant domestic workers in Singapore: a mixed-methods study

BACKGROUND: Migrant workers (MWs) and migrant domestic workers (MDWs) in Asia face elevated risks of mental health issues due to factors like long working hours, abuse, and family separation. In Singapore, despite established support systems, formal help-seeking remains low. This study aimed to investigate the mental health help-seeking behaviors, preferences, and perceived barriers and facilitators among MWs and MDWs in Singapore. METHODS: A mixed-methods study was conducted in two phases. Phase 1 involved a quantitative survey with 1,465 MWs and 1,462 MDWs from the six largest nationality groups in Singapore. Phase 2 consisted of 14 focus group discussions (FGDs) with 48 MWs and 52 MDWs to explore their experiences in further detail. RESULTS: The majority of MWs (79.2%) and MDWs (91.4%) reported seeking help for emotional problems, primarily from informal sources such as family and friends. Awareness of formal support services, such as the Ministry of Manpower (MOM), was moderate among MWs (58.4%) and MDWs (66.8%). For receiving mental health information, both groups preferred face-to-face workshops. However, their preferences for help-seeking differed; while 48.1% of MWs preferred a trained professional, 51.5% of MDWs preferred a trained fellow migrant worker. The qualitative findings identified significant barriers to formal help-seeking, including fear of job loss, financial constraints, lack of awareness of services, and stigma. Key facilitators included trustworthy relationships with family and friends, and positive, culturally sensitive interactions with healthcare professionals. CONCLUSIONS: While many MWs and MDWs experience emotional distress and seek support, they predominantly rely on informal networks due to multi-level barriers to formal care. These findings underscore the need for integrated support models that include peer-led initiatives, culturally and linguistically competent healthcare services, and clearer communication about available, affordable mental health resources to improve the well-being of this population.