SINGAPORE - A study has found that Singapore spends about US$2.3 billion (S$3.1 billion), or 18 per cent, of its total healthcare expenditure on stress-related illnesses annually.
This put the nation's proportion of expenditure on stress-related illnesses second-highest out of the nine regions studied in the report, coming just 0.8 per cent behind Australia's 18.8 per cent.
The other seven regions were Hong Kong, South Korea, Taiwan, Thailand, United Arab Emirates, the United Kingdom and the United States.
The report, which was produced by healthcare consultancy firm Asia Care Group on behalf of health insurance and services company Cigna, was published on Thursday (Nov 21).
Globally, 84 per cent of people surveyed in past studies admitted to feeling stressed, said Cigna's regional chief executive officer Julian Mengual, while 64 per cent reported that they operated in an "always on" environment.
This refers to people feeling the need to engage with work both during and outside office hours, a culture which Mr Mengual said contributes to stress levels worldwide.
The problem is more prevalent in Asia, where 91 per cent of respondents reported feeling stressed and 80 per cent saying they had an "always on" work culture.
These earlier research findings led the company to pursue further research in the area in order to raise awareness about stress as a healthcare problem, he said.
"Stress is a big issue... (but) sometimes this is a topic that people don't like to talk about, and we really need to address it to move things forward," said Mr Mengual, who also noted that stress is linked to diseases such as hypertension and diabetes.
Cigna's latest study analysed healthcare utilisation rates and related costs of stress-related conditions using public and private data on inpatient and outpatient admissions, and visits to general practitioners (GP) and the emergency department in each region.
Stress-related conditions can refer to physical and mental symptoms that are caused by stress. Some physical symptoms are headaches, muscle aches, joint pain, irritable bowel syndrome, heartburn and trouble breathing, while the mental symptoms include anxiety, depressive and panic disorders.
In Singapore's case, data from the Ministry of Health and private hospitals was used to make the calculations.
Among other things, it was found that over 160,000 people here are admitted to public hospitals as inpatients for stress-related illnesses every year, at an annual cost of around US$931 million.
More than 11 million appointments are made with GPs here annually as a result of such illnesses, costing about US$1.1 billion.
Over two million GP appointments each year were for chest pain driven by stress-related mental illness, and about 240,000 people were sent to the Accident and Emergency departments of hospitals for stress-related illnesses yearly.
Asia Care Group's managing partner Thalia Georgiou said: "In a country of just over five million people, that's a very sizeable number."
Aside from calculating the costs of stress-related illness, the report also presented recommendations for governments, employers, healthcare providers and public and private healthcare insurers to deal with the problem.
For example, care providers can train their staff to ensure they are equipped to detect, diagnose and manage stress-related illnesses.
"Identifying patients suffering from stress-related illness earlier in their journey and upskilling hospital staff to detect and manage patients with stress conditions are likely to be highly effective in reducing the burden on hospital beds and financing," said Ms Georgiou.
Employers also need to recognise that chronic stress and its related illness caused by a poor working environment can be as serious as a physically unsafe environment, said the study. Among the measures recommended was for companies to insist its employees do not work during their annual leave.
Recruitment consultancy Phaidon International's managing director of Asia Pacific Andrew McNeilis, who spoke at the report's launch, said: "Many people don't feel confident of saying to their boss that they're not coping, that they feel very stressed... I think that's something that has to be addressed from the leadership, top-down."
Aside from making legislative changes such as adjusting maximum working hours, the report stated, governments can undertake campaigns to help citizens self-detect signs and symptoms of stress-related illness and encourage a supply of psychiatrists and therapists to meet the rising need for care.
It also recommended that insurers consider enhancing cover for stress-related illnesses, including common mental health conditions, as this will likely improve clinical outcomes.
Ms Georgiou said: "Obviously there's no quick and easy fix for this... There has to be a concerted effort among employers, public and private insurers, governments, (healthcare) providers and ourselves as individuals as well.
"There has to be a whole system recognition that this is a problem, and then action taken."