https://orcid.org/0000-0001-8215-5214
Figures
Abstract
Mental health disorders are on the rise globally, with policies promoting programmes that aim to enhance mental wellbeing across various population domains. This scoping review aims to examine the literature to identify and map the mental health programmes in Singapore, while identifying critical knowledge gaps and scope for future systematic reviews. A systematic search was conducted across multiple databases including Medline, PsycINFO, CINAHL, OpenGrey and ProQuest, complemented by hand and bibliography searches. Articles published from 2000 onwards in English language were included. Independent parallel reviews were conducted by multiple reviewer pairs. Data was extracted into standardised, pre-piloted templates that incorporated the Template for Intervention Description and Replication (TIDieR) checklist. One hundred and six studies were included in the review, demonstrating diverse programmes targeting different age groups, with particular focus on older adults in hospital and community settings. The programmes addressed mental health outcomes in individuals with mental disorders, physical conditions, neurodevelopmental and learning disabilities, and among healthy individuals. Implemented by trained care teams or multidisciplinary professionals, these programmes generally showed positive outcomes. However, significant gaps were identified in the literature regarding user experiences, with minimal focus on implementation barriers and enablers. Notably, there was limited evidence of successful community-level implementation beyond the experimental phase, raising questions about programme sustainability and real-world effectiveness. Critical gaps were also identified in youth-specific suicide prevention programmes, despite suicide being a leading cause of death among youths, and programmes targeting the impact of built environment on mental health outcomes and workplace wellbeing. These areas represent important opportunities for future research and intervention development in Singapore’s mental health landscape. Singapore has developed an active research network over the past decade to design and implement programmes aimed at improving mental health across different populations and settings. However, stronger collaborative approaches between academics and policymakers are needed to better utilise research findings and understand which programmes add value to the public health domain. Future research should focus on implementation science, long-term sustainability, and cost-effectiveness of these programmes in real-world settings.
Citation: AshaRani P, Ong XE, Karuvetil Z, Chen CS, Ther L, Cheng L, et al. (2026) Mapping programmes for mental health promotion in Singapore: A scoping review. PLoS One 21(4): e0347518. https://doi.org/10.1371/journal.pone.0347518
Editor: Vincenzo De Luca, University of Toronto, CANADA
Received: October 28, 2025; Accepted: April 5, 2026; Published: April 28, 2026
Copyright: © 2026 AshaRani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the manuscript and its Supporting Information files.
Funding: The author(s) received no specific funding for this work.
Competing interests: NO authors have competing interests.The authors have declared that no competing interests exist.
Introduction
Mental health extends beyond the absence of psychological disorders. It represents a state of wellbeing that enables individuals to cope with routine life stressors while maintaining productive functioning [1]. Optimal mental health facilitates better functioning, coping, and thriving [2], whereas individuals with mental health conditions experience varying states along a continuum – from optimal cognitive and emotional functioning to severe psychological distress and disabilities [2].
Global statistics reveal that approximately 970 million people lived with mental health disorders in 2019 [2–3], with 11.63% of individuals aged 5–24 years experiencing at least one mental health condition [4]. The burden of these disorders is substantial, accounting for 31.14 million years lost to disabilities (YLDs) within this age group. In 2019, mental health disorders constituted 15.6% of YLDs globally, with depressive and anxiety disorders ranking second and sixth, respectively, among the leading causes of YLDs worldwide [2]. A recent review spanning 29 countries and 156, 331 adults (aged 18 and above) revealed lifetime prevalence rates of mental health disorders at 28.6% for males and 29.8% for females [5]. The study further demonstrated elevated lifetime morbidity risk at age 75, reaching 46.4% in males and 53.1% in females. Among men, alcohol abuse, major depressive disorder, and substance use disorder were the primary contributors, while women were predominantly affected by major depressive disorder, post-traumatic stress disorder, and generalised anxiety disorders.
A systematic review of 439 articles from 48 countries demonstrated substantial economic implications, with societal costs ranging from USD 547 Purchasing Power Parity (PPP) to 16,783 PPP per capita [6]. The global burden of mental health disorders intensified significantly during the COVID-19 pandemic [2]. The prevalence of major depressive disorder increased from 193 million pre-pandemic cases to 246 million during the pandemic, while anxiety disorders escalated from 298 million to 374 million cases, representing increases of 27.5% and 25.5% respectively. These escalating prevalence rates and associated economic burden underscore the urgent need for evidence-based preventive strategies and management interventions to mitigate both individual suffering and societal costs.
In response to this growing crisis, population-level prevention and health promotion strategies have become essential for enhancing mental wellbeing and resilience. The World Health Organisation’s (WHO) global mental health action plan 2013–2030 emphasises multisectoral collaboration in delivering preventive activities through integrated healthcare systems, promoting mental health among at-risk populations, and ensuring accessible community-level interventions [2]. These efforts focus on enhancing protective factors (including social connections, employment, and physical activity) while reducing risk factors (such as substance use, chronic conditions, and stigma) [7]. However, implementation challenges have resulted in significant treatment gaps, with coverage varying dramatically between high-income nations (33%) and low-middle income countries (8%) [8–9]. The subsequent revision endorsed by the World Health Assembly included additional targets to address these challenges through improved caregiver support, awareness programmes, suicide prevention initiatives, and integration of mental health into primary care which was adopted by various countries worldwide as a framework for national mental health policy development [10]. In Singapore, these global imperatives take on particular significance given the nation’s commitment to building a comprehensive healthcare system that addresses both physical and mental wellbeing within its unique multicultural and urban context.
In Singapore, mental health disorders affect 13.9% of the population [11], imposing an annual incremental societal cost of S$1.7 billion [12]. The post-pandemic landscape has witnessed an escalation in both prevalence and costs, with annual expenditure reaching approximately S$15.7 billion [13]. To address these challenges, Singapore implemented the National Mental Health Blueprint (NMHB, 2010–2012) and subsequent National Mental Health Strategy, which established frameworks for community healthcare integration, enhanced mental health-primary care partnerships, and developed integrated care pathways addressing both mental and physical health needs [14]. The Community Mental Health (CMH) Masterplan further strengthened this initiative by prioritising early intervention and community-based support systems [15]. Recent developments, including workplace mental health initiatives, digital mental health services, and the Healthier SG programme, have reinforced this systematic approach to mental healthcare delivery [16]. Healthier SG shifts the care model from reactive care for those who are sick to prevention of health problems among the population. The plan includes promotion of health beyond clinical care by addressing and learning more about the social, environmental, and behavioural determinants of health. It involves increasing the number of family doctors who can provide preventive care, develop personalised health plans (diet, exercise, regular screening, etc.), and extend activities through community partners. This will facilitate onboarding of the population to the Healthier SG initiatives to ensure a holistic approach to care, and reinforce the enablers (e.g., IT systems, manpower, and regional health managers). To date, no reviews were conducted locally to map the literature landscape that is needed for understanding the reach and impact of these programmes.
Given the escalating prevalence and associated costs, understanding effective preventive and management strategies for mental health disorders is crucial. Despite Singapore’s strategic policy framework and substantial investment in mental health initiatives, no systematic mapping of implemented programmes and their outcomes has been conducted to date. While international reviews have examined mental health interventions in various contexts [17], none have specifically focused on Singapore’s unique healthcare system, multicultural population, and policy environment. This represents a critical knowledge gap, as the effectiveness of mental health programmes can vary significantly across different healthcare systems, cultural contexts, and implementation settings. Without a comprehensive understanding of what programmes have been implemented locally, their target populations, theoretical foundations, and outcomes, policymakers and practitioners lack essential evidence to guide resource allocation and programme development. There is a dearth of literature on the interventions or programmes that promote the mental health outcome of the population locally. This knowledge synthesis is vital for identifying globally applicable interventions to mitigate the progression of the mental health crisis. The scoping review design was chosen due to the broad nature of the research question, which aimed to map the available evidence on mental health programmes in Singapore across diverse populations, settings, and intervention types. This approach was particularly appropriate given the uncertainty about whether sufficient data existed for a systematic review, and the need to first understand the breadth rather than the depth of available evidence.
This scoping review aimed to identify and map mental health programmes and interventions (concept) implemented across Singapore’s healthcare and community settings (context) targeting all residents (population), following the Population, Context, Concept (PCC) framework. The specific research questions were:
a) what are the available mental health programmes in Singapore, b) what are the key characteristics of these programmes (e.g., target populations, setting, delivery approaches, outcomes and direction of evidence) c) what are the current knowledge gaps, and areas warranting systematic review or future research. By collating and summarising the available evidence, this review provides insights into mental health promotion strategies within Singapore’s urban Asian context, including how these initiatives operate within existing systems and sociocultural frameworks. The findings may be particularly relevant for other urban Asian settings with similar sociocultural characteristics and healthcare structures seeking to enhance their mental health promotion strategies.
Materials and methods
This scoping review adopted Joanna Briggs Institute’s (JBI) guidance for scoping reviews [18]. The protocol for the scoping review has been published in Open Science Framework repository [19]. The protocol followed JBI best practice guidance and reporting items for scoping review protocol [20]. The PRISMA ScR fillable checklist was used to track the reported item [21].
Search strategy
A systematic search was conducted in Medline, PsycINFO, CINAHL, OpenGrey and ProQuest. Hand searches were conducted in the Singapore Medical Journal and the Annals of the Academy of Medical Science Singapore. Local grey literature was searched through additional hand searches at government and other stakeholder websites. Bibliographic searches were performed on the included articles to identify any missing articles. The search was restricted to articles published in English between 2000 to the search date. This timeframe was chosen as the majority of Singapore’s mental health policies were implemented after 2000. The focus on English language publications was appropriate as this is the primary language of academic and scientific publication in Singapore. Only studies involving human participants were included given the public health focus of the review. The search strategy and keywords were developed through discussion with the mental health team which included healthcare system administrators, clinicians, population health specialists, experts in evidence synthesis, as well as through literature searches. The preliminary keywords were developed with PCC components and included indexed/MESH terms, keywords, proximity operators, and phrases. Pilot searches were conducted in Medline, and the search terms were modified through discussion among team members. The sensitivity and specificity of the searches were assessed by screening the search outputs against pre-identified articles and by reviewing the initial 100 articles to refine the keywords. The final set of keywords were approved by all team members before the final search in all the included databases. The detailed list of keywords used is included in the supplementary file (S2 Appendix). The initial search was conducted on 24 August 2023 and a search update on 15 May 2025.
Inclusion and exclusion criteria
Studies were included if they involved programmes conducted in humans, looking at programmes targeting mental health outcomes, conducted in Singapore, in English and published from 2000 onwards. Articles were excluded if they were case reports or series or conference proceedings, reviews, studies looking at physical health outcomes, and those conducted outside Singapore or not presenting separate data for multicountry studies. Mental health programmes were defined as structured and planned sets of activities or interventions intended to improve the mental health outcomes of targeted populations, beyond routine clinical care.
Screening and study selection
References were imported, sorted, deduplicated and managed in EndNote. Screening included title and abstract and full text screening. All screening was conducted by reviewer pairs as independent parallel reviews. For title and abstract screening, a screening template was created in Excel with clear definition of the inclusion and exclusion criteria. Articles with uncertain eligibility during initial screening were retained for full-text review. The reviewers underwent training and conducted a pilot test using 20 articles to ensure consistency in the screening process across individuals and pairs. An agreement of 80% or above was used as a benchmark. Disagreements below this threshold were investigated and the definitions of inclusion and exclusion criteria were revised for clarity and the changes were communicated to the reviewers by the lead author. Upon reaching acceptable agreement level, the screening (independent and parallel) was continued for the rest of the articles. Any discrepancies were discussed and resolved, and advice was sought from a senior reviewer when needed. The screening templates captured the audit trails for all discussions, screening decisions and reasons for exclusion of articles. Where the information was insufficient to determine the inclusion of the articles, the corresponding author of the article was contacted for clarification. Three attempts were made before the article was excluded. A similar strategy was employed for full text reviews of the included articles.
Data extraction
A data extraction template was developed based on the aims, PCC components, TIDieR checklist, and other data fields recommended by JBI [18]. The fields captured were author, year, source of publication, population, sociodemographic characteristics of the population. Additional fields included sample size, study settings, sampling method, type and description of the programme, duration of the programme, study design, discipline, treatment and comparator arms (for interventional studies), institution, outcomes, tools used to measure outcomes, main findings, direction of evidence. The template was piloted using 5 articles and discrepancies were noted and resolved through discussion. A standardised definition guide was developed for each item in the data extraction template to ensure consistent interpretation and extraction across all reviewers. This guide provided explicit operational definitions and criteria for data extraction. Data extraction was conducted in pairs independently and checked by AR and XE. Since scoping reviews typically do not include risk of bias assessments (RoB) [20], the current review did not include RoB assessments.
Data analysis
The extracted data were analysed descriptively and synthesised narratively in accordance with the scoping review methodology. No meta-analysis or RoB assessments were conducted due to the scoping review methodology which does not include inferential statistics. Missing information was recorded and marked as “not reported” for transparency, and overlapping categories were reported separately. This information is reflected in the data summary and in the tables. Programme categories were derived through discussion within the team that followed an inductive thematic analysis. This included review of programmes, components and descriptions to generate initial codes, which were then refined and regrouped based on programme characteristics. AR and XE checked all entries from individual coders and conflicts were resolved through discussion or a third reviewer (MS) where needed. Quantitative analysis was performed using Microsoft Excel and Statistical Package for the Social Sciences (SPSS) version 23 (IBM SPSS Statistical Package). Results were summarised and presented through tables, Figures, and graphs to facilitate clear visualisation of patterns and trends in the data. The narrative synthesis followed a framework approach, organising findings by programme categories and characteristics to address the research objectives.
Results
Adherence to JBI guidance was documented using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR, S1 Table). Fig 1 shows the PRISMA flowchart that details the search results and screening.
Study characteristics and overview of programmes
A total of 106 articles were included for data extraction. Publication frequency showed a notable increase from 2013 (Fig 2a), with peak publication numbers occurring in 2015 (n = 12, 11.3%), 2020 (n = 11, 10.4%), and 2022 and 2024 (n = 11, 10.4% each). Fifteen studies included children (14.2%), five included adolescents (4.7%), 19 included young adults (17.9%), 50 included adults (47.2%), and 45 included older adults (42.5%, Fig 2b) with 27 studies (25.5%) having a combination of different age groups that were counted in the respective categories.
(a) Publication frequency, (b) Population, (c) Institutions that hosted the study, (d) Study settings, (e) Data sources, (f) Sample sizes for included studies, (g) Health conditions under study.
The institutional contributions (for publications) were distributed across three major healthcare clusters and other institutions. The National University Health System (NUHS) was the leading contributor with 34 publications (32.1%, Fig 2c). This included National University of Singapore (NUS) (n = 26, 24.5%), National University Health System/National University Hospital (NUHS/NUH) (n = 4, 3.8%), Jurong Health Campus (JHC) including Ng Teng Fong General Hospital (NTFGH) (n = 3, 2.8%) and NUHS polyclinic (n = 1, 0.9%). The National Healthcare Group (NHG health) contributed 26 publications (24.5%), with Institute of Mental Health (IMH) being the major contributor (n = 20, 18.9%), followed by Tan Tock Seng Hospital (TTSH) (n = 4, 3.8%), Khoo Teck Puat Hospital (KTPH) and National Skin Centre (NSC) contributing 1 each (0.9%).
The SingHealth cluster contributed 19 publications (17.9%), distributed across KK Women’s and Children’s Hospital (KKH) (n = 6, 5.7%), Singapore General Hospital (SGH) (n = 6, 5.7%), Changi General Hospital (CGH) (n = 4, 3.8%), National Cancer Centre Singapore (NCCS) (n = 2, 1.9%), and SingHealth Polyclinics (n = 1, 0.9%). The remaining 27 publications (25.2%) came from other institutions, with Duke-NUS Medical School being the main contributor (n = 7, 6.5%), followed by Nanyang Technological University (NTU; n = 7, 6.5%), Dyslexia Association of Singapore (DAS) and Ministry of Social and Family Development (MSF) (n = 2 each, 1.9%), and various other institutions contributing one publication each.
Study participants were primarily recruited from healthcare (n = 46, 43.4%), community settings (n = 37, 34.9%; Fig 2d) and educational institutions (n = 15, 14.2%). Eight studies (7.5%) recruited participants from other sources such as prison, nursing homes, children’s home, dyslexia association, hospices and online platforms. The studies utilised both primary data collection (n = 96, 90.6%) and existing databases (n = 10, 9.4%), including clinical databases (Fig 2e).
Sample sizes varied considerably across the 106 articles, with the largest group of studies (n = 35, 33%) having sample sizes between 51–200 participants (Fig 2f). Eleven studies (10.4%) exclusively recruited female participants, and one (0.9%) recruited only male participants, while gender-specific data was not reported in 12 studies (11.3%). Study designs included Randomized Controlled Trials (RCT; n = 25, 23.6%), quasi-experimental studies (n = 18, 17.0%), other interventional studies (n = 34, 32.1%), cohort studies (n = 7, 6.6%), other observational studies (n = 8, 7.5%), mixed methods studies (n = 7, 6.6%) and qualitative studies (n = 7, 6.6%). Of these, 12 (11.3%) were pilot studies across different study designs.
The mental health programmes were categorised into four main types based on their focus area (Fig 2g): programmes for those with mental health and neurological conditions (n = 37, 34.9%), those addressing mental health in those with physical health conditions (n = 24, 22.6%), programmes for those with neurodevelopmental and learning conditions (n = 8, 7.5%), and programmes for healthy populations without any specific diseases (n = 37, 34.9%). The intervention approaches in these programmes included seven categories: therapeutic interventions (n = 15, 14.2%), educational and psychoeducational interventions (n = 30, 28.3%), management and treatment programmes (n = 27, 25.5%), prevention and early intervention initiatives (n = 25, 23.6%), psychosocial support services (n = 1, 0.9%), physical and activity-based programmes (n = 4, 3.8%), and other programmes (n = 4, 3.8%). The majority of programmes (96 out of 106, 90.6%) demonstrated positive outcomes across various mental health domains, with strong representation from Singapore’s three major healthcare clusters and academic institutions. Programmes addressed diverse age groups with a focus on older adults, had strong theoretical foundations, and were implemented across settings through diverse delivery modes. However, significant gaps were identified in youth-focused interventions, workplace mental health programmes, and community-based sustainability of research findings. The detailed profiles of the studies is indicated in S2 Table. The following sections examine these four categories in great detail.
Programmes for mental health and neurological conditions
Types of programmes.
Among the 37 articles under this category (Table 1), there were 35 peer-reviewed articles (94.6%), one practice forum and one thesis (2.7% each), with 8 articles (21.6%) using existing databases as data sources and the rest involving primary research (78.4%).
The programmes demonstrated considerable diversity in their approach and target populations. Management and Treatment interventions were the most prevalent (n = 16, 43.2%), followed by prevention and early interventions (n = 9, 24.3%), educational and psychoeducational interventions (n = 6, 16.2%), therapeutic interventions (n = 5, 13.5%), and psychosocial support (n = 1, 2.7%). These programmes included technology-enhanced programmes featuring mobile applications such as RegnaTales and Intellect alongside virtual reality-based stress management systems. Community-based early intervention programmes included the Community-Based Early Psychiatric Interventional Strategy (CEPIS) and Assertive Community Treatment (ACT). Specialised clinical programmes included memory clinics and primary care dementia clinics, while other programmes included mindfulness-based interventions, and creative arts-based therapies incorporating dance and music reminiscence therapy. Several ongoing hospital-based programmes were also evaluated, including the Early Psychosis Intervention Programme (EPIP). Programmes such as RegnaTales, an app-based intervention for managing aggression in children, showed promising results but were limited to a single pilot study. Further details are indicated in Table 1.
Characteristics of the programmes
Population and setting.
A substantial number of programmes (n = 12) focused solely on older adults’ mental health in either hospital (n = 2) or community settings (n = 10), aiming to improve depressive symptoms and to manage cognitive decline. An additional 6 studies included mixed population including adults and older adults. Twelve studies that focused on children, adolescents or young adults were conducted among patient populations (n = 7), students (n = 2), and community residents (n = 3) in various settings. The programmes for adults (n = 15) were mainly conducted in hospital (n = 8) and community (n = 7) settings.
Disease specific approaches.
Eleven of the articles (29.7%) were on mood disorders, with 2 of them also focusing on anxiety, 5 (13.5%) on cognitive impairment and dementia and the rest on various mental illnesses. Among the 11 programmes on mood disorders, five focused on post-natal depression; early detection through regular screening, prevention through case management and psychoeducation and management through close follow up at the community level. Six studies focused on depression and/or subsyndromal depression, and included life story reviews, art therapy and collaborative care models. Virtual reality (VR) guided stress management programme was the focus of another study.
Population specific approaches.
The programmes for older adults included dementia care programmes, psychosocial interventions (tai chi, art therapy, mindfulness awareness practice, music reminiscence therapy), creative interventions (person-centred dance, arts and dementia program), therapeutic approaches (life-story reviews, integrated personal therapy), community-based strategies (CEPIS), and functional programmes (ADL+). The programmes showed considerable variation across studies. Life story book reviews were evaluated in 2 studies, which were from the same research group. Cognitive stimulation and dementia-focused programmes were examined in 6 studies, with emphasis on preventing and managing dementia in community care models. The programmes targeting children and adolescents focused on behavioural and emotional regulation, including cognitive-behavioural therapy for disruptive behaviours, the Building Emotion and Affect Regulation (BEAR) programme for emotional dysregulation, and the mobile app RegnaTales for aggression management, with delivery primarily in school, hospital, and residential care settings. The programmes for young adults targeted early psychosis intervention, gaming disorder, and subclinical obsessive-compulsive disorder (OCD). The programmes for adults foused on maternal mental health through interventions such as postnatal psychoeducational programmes, the Sure-mums intervention, and technology-based peer-support programmes for postnatal depression and anxiety, alongside comprehensive care coordination models (General Practitioner Partnership Programme, Multilevel Bidirectional Care Coordination Model) and innovative stress management approaches including VR DE-STRESS and V-DESSERTS virtual reality-based programmes.
Theoretical foundation of the programmes.
Many of the programmes had theoretical underpinnings based on evidence drawn from overseas (n = 14), with Bandura’s self-efficacy theory (for depression), solution-focused brief therapy (for depression), relaxation theory (for stress), Cognitive Behavioural Therapy (CBT) for disruptive behaviours, emotional dysregulation, and obscessive compulsive disorders (OCD), CBT with Exposure and Response Prevention for OCD, the illness management and recovery model for those with various mental health disorders, life story review for depression being the common ones. Other theoretical foundations included the Theory of Psychosocial Development, gut-brain axis theory combined with mindfulness practices, collaborative care models for depression management, the Neuman System Model for VR-based stress interventions, and the Response, Early intervention and Assessment in Community mental Health (REACH) model’s five operating criteria for children and adolescent mental health services. Some programmes were developed in Singapore to suit the population, healthcare systems and cultural demands, for example, the GP and community centre partnerships to care for older adults in the community setting, whilst the others were adapted with minimal modifications.
Programme delivery and implementation.
The majority (n = 24) were conducted by clinicians (psychiatrists, psychologists, case managers, social workers, nurses or counsellors), whilst the rest were conducted by trained research staff, health coaches or volunteers. Seven programmes were conducted in participants’ homes, 10 in community settings, 2 in schools, 16 in hospitals (with 2 overlapping with participants’ homes), and the remainder in various settings including prisons, nursing homes, and social service agencies. Programme duration varied from single sessions to two years, while intensity of the session varied from daily practice to monthly sessions, with seven studies not reporting timing and dose. Most of the programmes demonstrated personalisation through various approaches (n = 26), including age-appropriate tailoring, language-specific allotments, disease severity adjustments, and participant choice and needs. Eleven programmes did not report any tailoring.
Twenty-eight programmes had no modifications from the original structure during implementation. Programme modifications included cultural adaptations through renaming to match the cultural context, pandemic-aligned recruitment strategies, additional module elements, and feedback-based improvements. Adherence reporting was inconsistent across studies. Where reported, it showed mixed responses ranging from moderate to high, with no clear correlation between dose and mode of delivery. Adult and adolescent-focused programmes primarily utilised technology-based or psychoeducational approaches. In healthcare settings, programmes mainly targeted adults and focused on continued care for those diagnosed with mental health conditions or at-risk populations (such as those at risk for postpartum depression). These primarily comprised educational interventions (psychoeducation or clinician-led education) delivered either face-to-face or through web platforms, mindfulness-based programmes, and management approaches. A detailed record of programme characteristics was captured using the TIDieR checklist and is presented in S3 Table.
Mental health outcomes and direction of evidence.
The outcomes captured across the 37 programmes included clinical symptoms (depression, anxiety, stress and other psychopathology), cognitive outcomes (such as decline in cognitive function, attention, memory and executive functions), functional capacity (Quality of life (QoL), activities of daily living), healthcare utilisation (referral, readmission, service utilisation, length of stay), and psychosocial outcomes (coping, social connection, caregiver burden, self-efficacy). Thirty-three (89.2%) studies employed validated questionnaires to capture the outcomes while three studies (8.1%) utilised hospital records and a single study (2.7%) included self-reported measures. Thirty-five studies (94.6%) reported positive outcomes observed as improved service utilisation, symptom severity, functional capacity and other wellbeing measures. The rest (n = 2) reported neutral/no effects. Overall, these programmes encompass a systematic, multi-faceted, tailored approach targeting the mental health of different populations across age groups and disease conditions, with the majority demonstrating positive outcomes through measurable improvements in clinical symptoms, service access and utilisation, and wellbeing indices.
Programmes to improve mental health outcomes in those with physical health conditions
Types of programmes.
All 24 research articles were peer-reviewed publications. Programmes on Management and Treatment approaches were predominant (n = 9, 37.5%), followed by therapeutic interventions (n = 6, 25.0%), educational and psychoeducational interventions (n = 5, 20.8%), prevention and early intervention programmes and physical and activity-based programmes, each represented a smaller proportion (n = 2, 8.3% each), highlighting a strong emphasis on management-focused approaches rather than preventive or supportive interventions. The programmes addressed multiple health conditions and demonstrated considerable diversity in their therapeutic approaches. These ranged from technology-driven self-management interventions (Combined Diabetes and Renal Control Trial (C-DIRECT) for complex comorbidities, Chronic Disease Self-Management Programme (CDSMP) for self-care education), to tele-health monitoring (OPTIMUM for telemedicine-based diabetes management). Other programmes focused on psychological support (Cognitive Behavioral Therapy with Mindfulness and Values-based activity (CBT-MV), the Renewing Intimacy and SExuality Intervention (RISE) for cancer survivors, and the “Caring for the Caregiver Programme” for family support) and other creative programmes (music therapy, therapeutic play interventions, and biography and life story book (BLSB) approaches). These diverse programmes show the breadth of innovative treatment modalities employed to improve mental health outcomes in those with physical health conditions. The characteristics are presented in Table 2.
Characteristics of the programmes
Population and setting.
The majority of studies focused on patients alone (n = 21, 87.5%), with 2 studies focusing on caregivers (8.3%) and one for nursing home residents (n = 1, 4.2%). Among the 24 programmes, 3 were solely for older adults (12.5%), 7 only for adults (29.2%), 11 for both adults and older adults (45.8%), 1 for adult and child (4.2%), 1 for children and 1 for unreported age groups (4.2%). Nineteen programmes were conducted in healthcare settings (79.2%), 3 in community settings (12.5%), 1 in a nursing home (4.2%), and 1 in combined hospice and clinic settings (4.2%). There was no age-specific variation in programme settings across different age groups.
Disease specific approaches.
The programmes addressed diverse health conditions with cancer being the common focus of the studies (n = 11, 45.8%), followed by chronic conditions, cardio/cerebrovascular conditions (n = 3 each, 12.5%), chronic pain (n = 2, 8.3%), and other physical conditions (gastrointestinal, surgical interventions, knee pathology, surgery, other physical ailment) (n = 1 each, 4.2% each).
The programmes were tailored to disease pathology, symptom burden, comorbidities and management needs of different conditions. For cancer (n = 11, 45.8%), the programmes addressed physical and mental health functioning, cognitive functions, quality of life, emotional concerns and other challenges in oncology care. The interventions included CBT-based therapies, mindfulness, psychosocial interventions and rehabilitation programmes. For cardiovascular diseases (n = 3, 12.5%), the programmes addressed long-term management challenges to empower patients in home-based condition management, to provide post-stroke couple support focusing on information, decision-making and practical skills, and to shift them towards integrated chronic care models. Programmes targeting chronic conditions (n = 3, 12.5%) focused on self-management and self-efficacy of the disease and comorbidities through motivational interviews, group therapies and psychoeducation. Programmes for other conditions addressed disease-specific challenges through Acceptance and Commitment Therapy (ACT), CBT, cognitive stimulation, life story books, relaxation interventions, and psychological support.
Population specific approach.
The programmes targeted different age groups with mixed populations (adults and older adults) being the most common (n = 11, 45.8%), followed by adults (n = 9, 37.5%), older adults (n = 3, 12.5%) and children (n = 1, 4.2%). The programmes demonstrated distinct approaches tailored to the developmental needs, health challenges, and care preferences of different population groups.
The programmes for older adults addressed complex comorbidities (chronic kidney disease, diabetes complications, etc.) and their impact on life. The content was aimed at maintaining independence while addressing age-related vulnerabilities through support systems. These programmes focused on improving coping, psychological wellbeing, and disease management whilst providing essential psychosocial support, including life story book reviews, cognitive stimulation, and self-management programmes.
The programmes for adults focused on active disease management, symptom control and psychological coping, caregiver support, psychoeducation and maintaining functional capacity across different diseases. These included tailored interventions such as internet-based therapies and telehealth for disease management which addressed both physical and psychological wellbeing of the population. Programmes for children were designed to create awareness of surgical and hospitalisation processes to reduce anxiety and promote wellbeing through play interventions.
Theoretical foundations of the programmes.
The theoretical underpinnings of the programmes (n = 15, 62.5%) included frameworks such as self-efficacy theory, based on Bandura’s work (n = 6, 25.0%), which was mainly adopted by programmes targeting chronic disease management, caregiver support, stoma care, pain management, and diabetes care. This theory’s emphasis on personal mastery, vicarious experiences, verbal persuasion, and physiologic feedback were translated to the self-management focus of many interventions. CBT formed the theoretical basis for several programmes (n = 4, 16.7%), particularly those addressing psychological outcomes in gastrointestinal disorders, chronic pain, and cancer. Other psychological frameworks adopted by the programmes included ACT and the psychological flexibility model for chronic pain management, social cognition theory combined with motivational interviewing for complex comorbidities, and the health belief model for diabetes self-management.
Several programmes incorporated locally adapted frameworks, such as the biography and life story book intervention developed using Agency for Integrated Care (AIC) Dementia Resource Kit, and the chronic care management model with integrated care approaches shifting from traditional clinician-centric hospital care. Some programmes (n = 9, 37.5%) did not explicitly state their theoretical foundations, though they demonstrated evidence-based approaches through structured interventions combining health education, stress management, behavioural training, and psychosocial support tailored to specific patient populations and clinical contexts.
Programme delivery and implementation.
Overall, the majority of the programmes (n = 15, 62.5%) were delivered face to face with 2 delivered through mobile apps, 1 through online, and the rest were through hybrid mode. The main content of the programme included psychoeducation, psychotherapy and included behavioural therapies such as ACT, CBT and mindfulness. These programmes were delivered mainly by trained clinicians (n = 21, 87.5%) and varied in duration and intensity from 3 days to 6 months. Programmes for chronic conditions were aimed at creating awareness of long-term complications and improving the self-management of the conditions, with education, and CBT being common elements. Tailoring was done for 10 (41.7%) programmes and included adaptations for local use, (e.g., languages, activities, population characteristics), flexible schedules, level of risk, and symptom severity. Modifications were implemented for 5 programmes only (20.8%) and included pandemic specific adaptations. Adherence to the programme showed mixed results. A detailed list of items as per the TIDieR checklist is given in S4 Table.
Mental Health outcomes and direction of evidence.
The studies measured multiple outcomes including anxiety, depressive symptoms, self-efficacy, cognition (cognitive symptom management, cognitive functions), coping, quality of life and life satisfaction, using validated measurement tools. Programmes also measured psychological and psychosocial domains such as emotional wellbeing, social functioning and interpersonal relationships, with marital and sexual satisfaction included among the measures. Outcomes aligned with the health contexts. For example, cancer-related programmes measured body image concerns, caregiver burden and awareness towards advance care. Patient experiences were also captured in some programmes, which shows the breadth of mental health outcomes and the recognition of the importance of psychological wellbeing in those with physical health conditions rather than merely symptom reduction and management of functional capacity. Three studies (12.5%) employed semi-structured interviews to capture the outcomes, while the rest employed validated questionnaires. Eighteen studies (75.0%) showed a positive outcome, and one showed a negative outcome (4.2%), and five (20.8%) reported no changes.
Programmes to improve mental health outcomes in those with neurodevelopmental and learning conditions
Types of programmes.
All studies (n = 8) were peer-reviewed publications. The programmes were focused on educational and psychoeducational approaches (n = 5, 62.5%), management and treatment (n = 2, 25.0%) and prevention and early intervention initiatives (n = 1, 12.5%). Educational interventions included technology driven programmes such as the Immersive Interactive Mixed Reality (IMR) educational intervention for enhanced learning experiences, literacy-focused programmes such as the English Main Literacy Programme and Lexicaid, which provide language support for those with learning difficulties. Management approaches included behavioural interventions such as the Signposts for Building Better Behaviour programme and innovative attention training through The brain-computer interface (BCI) based Attention Training Game System. Therapeutic interventions encompassed cognitive-behavioural therapy and combined traditional behavioural approaches with natural play interventions.
Characteristics of the programmes
Population and setting.
Regarding study settings, educational or special educational institutions (n = 4, 50.0%) and hospitals (n = 3, 37.5%) were most common, with community settings (n = 1, 12.5%). The study populations mainly comprised children (n = 6, 75.0%), both children and adolescents (n = 1, 12.5%) and adults (n = 1, 12.5%).
Disease specific approaches.
Three studies (37.5%) included programmes targeting dyslexia, 2 (25.0%) for autism spectrum disorder (ASD), and 1 each (12.5%) for intellectual disability, developmental disability, and attention deficit hyperactivity disorder (ADHD). The programmes followed approaches specific to each condition. Dyslexia-focused programmes utilised the English Main Literacy Programme for targeted literacy development, alongside Lexicaid for specialised language support. ASD-related programmes incorporated the Signposts for Building Better Behaviour programme for behavioural management and traditional behavioural approaches combined with natural play interventions to address social communication and behavioural challenges. The ADHD-targeted programme employed The BCI-based Attention Training Game System, utilising brain-computer interface technology specifically designed for attention enhancement. Programmes addressing intellectual and developmental disabilities implemented CBT based approaches adapted for cognitive and developmental needs, while the IMR educational intervention provided technology-enhanced learning experiences suitable for various neurodevelopmental conditions.
Population specific approach.
All programmes targeted paediatric populations. Age-specific adaptations were made to accomodate cognitive capacity and developmental stages, with the majority of the programmes employing behavioural and play-based interventions and educational technologies (BCI attention training) that leverage children’s interest in interactive platforms while addressing the learning and attention challenges.
Theoretical foundations of the programmes.
The programmes demonstrated strong theoretical underpinnings, with the majority (n = 6, 75.0%) grounding their interventions in established evidence-based frameworks. Educational interventions for dyslexia were predominantly based on the Orton-Gillingham (OG) principles and incorporated evidence from the National Reading Panel (US), Professional Practice Guidelines (Singapore), and the Rose Report (UK). The PPP (Presentation, Practice, Production) stages approach provided structured learning progressions for literacy interventions. Therapeutic interventions employed manualised CBT protocols adapted for high-functioning children with autism spectrum disorder, emphasising anxiety reduction and stress management. Behavioural interventions employed applied behaviour analysis principles, comparing traditional behavioural approaches with natural play interventions for ASD. Technology-related interventions integrated neurofeedback theory through brain-computer interface attention training, whilst immersive interactive mixed reality interventions combined educational technology theory with cognitive disability support frameworks.
Programme delivery and implementation.
Programmes were delivered in educational settings (n = 3, 37.5%), hospitals (n = 3, 37.5%), community settings (n = 1, 12.5%) and in special needs schools (n = 1, 12.5%), focusing on children and adolescents with an aim to improve learning and self-management domains. These were delivered by educators or therapists through face-to-face sessions. The duration varied from weeks to several months. These were tailored to students’ needs and characteristics, though only one of the programmes reported modifications to match the pandemic regulations. High adherence was reported across all studies with no withdrawals. A detailed TIDieR checklist is included in S5 Table.
Mental health outcomes and direction of evidence.
The studies looked at various outcomes such as anxiety, stress, wellbeing, symptom severity, social and academic skills. Seven studies (87.5%) employed validated questionnaires and a single study used curriculum-based assessments (12.5%). All studies reported positive outcomes in all measured domains (100%; Table 3).
Programmes to improve mental health of healthy population (no specific disease)
Types of programmes.
All (n = 37) studies were peer-reviewed publications. The study characteristics are indicated in Table 4. Among the programmes, educational and psychoeducational approaches were most common (n = 14, 37.8%), followed by prevention and early intervention (n = 13, 35.1%), therapeutic interventions (n = 4, 10.8%), other programmes (wellbeing, performance improvement programmes, n = 4, 10.8%), and physical and activity-based interventions (n = 2, 5.4%). These programmes were intended to improve health behaviours (n = 6, 16.2%; includes health literacy, help-seeking), mental health stigma (n = 3, 8.1%), wellbeing (n = 14, 37.8%; overall, postnatal), and cognitive functions (n = 3, 8.1%). Other target areas included psychological distress and parenting skills (n = 2 each, 5.4% each), anxiety, suicidality, and attitudes towards those with intellectual disability, obesity management, peer support for domestic workers, stress, burnout, and work performance (n = 1 each, 2.7% each). Technology-driven programmes were common, including mobile health applications such as the Headspace mindfulness app, Home-but-not-Alone application, and Supportive Parenting App, alongside web-based platforms like the Live Chat online counselling (Ask iZ Master) and Online HOPE interventions. Advanced technology approaches included Brain-Computer Interface Based Cognitive Training Systems and computerised cognitive training through the NeeuroFIT programme. Evidence-based approaches such as Functional Family Therapy, CBT, and mindfulness-based wellness programmes were also included. Educational and psychoeducational programmes featured anti-stigma and disability awareness, neonatal care and postnatal care programmes. Activity-based interventions such as horticulture, exergames and pet therapy were also employed. Specialised programmes such as driver retirement programmes and better behaviour programmes were intended for those with special support needs.
Characteristics of the programmes
Population and setting.
Nearly half of the studies (n = 16, 43.2%) were conducted in community settings, 9 each in hospitals and educational institutions (24.3% each), and 3 were hosted online (8.1%). The programmes targeted diverse age groups with young adults being the most commonly targeted population (n = 11, 29.7%), followed by older adults (n = 10, 27.0%) and adults (n = 9, 24.3%). Adolescents (n = 1, 2.7%) and children (n = 2, 5.4%) were less frequently targeted. Three programmes (8.1%) targeted multiple age groups, including young adults with adults and older adults, and adults with older adults. One programme (2.7%) did not report the target population.
Disease specific approaches.
The population had no specific disease. Hence, no specific adaptations were made for the programmes.
Population-specific approaches.
The programmes for older adults addressed age-related mental health concerns including cognitive decline, social isolation, and late-life transitions. The content was aimed at maintaining cognitive function and psychological wellbeing while addressing vulnerabilities through community-based support systems. These programmes focused on improving mental wellbeing, cognitive stimulation, and social engagement through interventions such as horticultural therapy, exergames, brain-computer interface training, and wellness programmes that provided essential psychosocial support and cognitive enhancement.
The programmes for adults focused on work-related stress management, parenting support, psychological coping, and mental health promotion across various life domains. These included tailored interventions such as mobile health applications, online counselling platforms, and mindfulness-based training which addressed both psychological wellbeing and functional capacity in workplace and family contexts. Programmes for young adults were designed to address transitional life challenges, university-related stress, stigma reduction, and help-seeking behaviours through technology-enhanced interventions and peer support systems. Programmes for children focused on reducing anxiety, promoting emotional wellbeing, and developing coping skills through school-based interventions and online counselling platforms designed for their developmental stage.
Theoretical foundations.
The programmes demonstrated strong theoretical foundations, with the majority (n = 28, 75.7%) explicitly basing their interventions in evidence-based frameworks. Bandura’s Self-Efficacy Theory was the most frequently employed theoretical foundation (n = 6, 16.2%), particularly in parenting programmes and health behaviour interventions, followed by CBT principles (n = 4, 10.8%) addressing psychological distress and anxiety management. Other prominent frameworks included Social Cognitive Theory for health behaviour change, mindfulness-based approaches drawing upon Mindfulness-Based Stress Reduction programmes, positive psychology interventions utilising the PERMA model, and specialised theories such as the Theory of Planned Behaviour for help-seeking interventions, Attachment Theory for parent-child programmes, and Social Identity Theory for stigma reduction. Technology-enhanced interventions incorporated frameworks such as the mHealth user engagement pyramid, whilst family-based programmes drew upon Systems Therapy and parent-child interaction theories, reflecting the evidence-based approaches required to address the multifaceted nature of mental health promotion across cognitive, behavioural, social, and family system domains.
Programme delivery and implementation.
The programmes were delivered by clinicians (n = 17, 45.9%) and the rest (n = 20, 54.1%) by educators, coaches, researchers or other trained personnel, with 4 programmes (10.8%) delivered through mobile apps and 8 (21.6%) through online mode whilst the rest (n = 25, 67.6%) were conducted through face-to-face sessions. Programme duration ranged from a single day to a year, with the majority lasting for extended periods with multiple sessions. Only 13 studies (35.1%) tailored their programmes to population characteristics, setting requirements, intended outcomes, and cultural contexts. Whilst 26 programmes (70.3%) reported no modifications, others (n = 11, 29.7%) adapted during the course of the study to address recruitment challenges and pandemic-related constraints. Moderate to high adherence was noted for most programmes (TIDieR Checklist is indicated in S6 Table).
Mental health outcomes and direction of evidence.
The programmes measured a comprehensive range of mental health outcomes across four main domains: psychological and mental wellbeing (most frequently assessed), emotional states (depression, anxiety, stress), cognitive functioning (attention, memory, neuropsychological performance), and behavioural indicators. Additional outcome categories included parenting-related measures (parental self-efficacy, confidence, postnatal depression, parent-child bonding), mental health literacy (depression literacy, help-seeking attitudes, stigma reduction), and specialised outcomes (mindfulness, self-compassion, burnout, compassion satisfaction, quality of life, social connectedness, sleep quality, test anxiety). Seven studies (18.9%) employed qualitative measures and the rest employed validated questionnaires to capture the outcome. Thirty-five (94.6%) of these programmes showed positive results.
Comparison of characteristics of different programmes.
A comparison of characteristics between the 4 groups showed that the programmes were mainly targeting those with mental health and neurological conditions and healthy populations (n = 37 each, 34.9%), while physical health conditions received moderate attention (n = 24, 22.6%) and neurodevelopmental and learning conditions were relatively underrepresented (n = 8, 7.5%). Key differences emerged in interventional approaches. Programmes for mental health and neurological conditions emphasised management and treatment interventions (n = 16, 43.2%), those for physical health conditions similarly focused on management approaches (n = 9, 37.5%) with limited prevention components, whereas neurodevelopmental programmes emphasised educational initiatives (n = 5, 62.5%). Programmes for healthy populations demonstrated the most diverse combination emphasising education and psychoeducational interventions (n = 14, 37.8%) and prevention and early intervention (n = 13, 35.1%). Populations varied markedly across categories, with neurodevelopmental programmes serving younger populations (75% children, 12.5% children/adolescents) in educational settings, physical health programmes predominantly included adults (n = 19, 79.2% including diverse age groups) in healthcare settings (n = 20, 83.3%), mental health and neurological programmes showed mixed age distribution with particular emphasis on adults and older adults (n = 30, 81.1% including overlapping age groups), and healthy population programmes demonstrated the broadest age representation across young adults alone (n = 11, 29.7%), older adults alone (n = 10, 27.0%) and adults alone (n = 9, 24.3%), with greatest community-based delivery (n = 16, 43.2%) and technology integration. Theoretical foundations were strongest in neurodevelopmental, and healthy population programmes, while outcomes varied from universal success in neurodevelopmental programmes to more modest results in physical health programmes (75.0%). These differences highlight distinct approaches and reveal critical population gaps, particularly the absence of school-aged student programmes for mental health promotion and limited workplace mental health interventions across all categories, despite these being crucial demographic groups in Singapore’s context. Additionally, mental wellbeing programmes for paediatric populations with physical health conditions were underrepresented, as were programmes targeting parents or caregivers of children with physical health conditions, highlighting significant gaps in addressing the mental health needs of these vulnerable populations.
Depth of evidence and knowledge gaps.
The evidence base predominantly consisted of primary data, whilst government reports largely described programmes from a policy perspective without detailed implementation insights. Reports lacking evidence or reviews were systematically excluded. Although quantitative outcomes were well-documented across studies, there was a critical lack of qualitative data capturing user experiences and programme satisfaction. Even when primary articles demonstrated implementation feasibility, they failed to adequately capture user perspectives. This created a significant gap in understanding the barriers and enablers of programme implementation in Singapore’s unique context. This limitation hampers the assessment of programme acceptability at both population and healthcare system levels.
Additionally, a major methodological weakness is evident in the research design, with only 25 RCTs among all studies, undermining the robustness of evidence. Programmes emphasised improving mental health through multiple approaches: reducing depressive symptoms, anxiety, improving cognition and managing mental health conditions in healthcare and community settings, prevention and health promotion and education and psychoeducational approaches to mental health. This focus revealed a balanced approach targeting multiple domains of health promotion. Nonetheless, the programmes under each domain lacked diversity. The same programmes were implemented in different populations by many studies. Given the rising prevalence of mental health conditions, new programmes that meet the changing needs of the population need to be designed and evaluated.
A significant oversight is the absence of programmes targeting school-aged students to promote help-seeking behaviours and improve mental wellbeing. This gap is particularly concerning given the crucial developmental stage and the increasing mental health challenges faced by youth in educational settings. Similarly, workplace mental wellbeing, despite being a critical aspect of adult mental health and productivity, was not addressed in any of the reviewed articles, representing another substantial gap in the literature.
Some programmes addressed mental health outcomes in individuals with physical disorders, focusing on coping, symptom management of depression and anxiety, and overall wellbeing. However, significant gaps remain in enhancing help-seeking behaviours among the general public. This is particularly crucial considering Singapore’s multi-ethnic population and unique cultural contexts. A substantial limitation emerges in the translation of research to practice: despite positive outcomes in experimental settings, there is insufficient evidence of successful implementation or sustainability in real-world community settings. The uncertainty about programme continuation beyond the research phase creates a concerning disconnect between research findings and practical community implementation. Additionally, digital mental health and artificial intelligence are important topics with immense public health potential. These elements were underrepresented in programmes, especially the youth-focused ones.
Several critical areas remain notably under-addressed. Suicidality and self-harm, despite their significance, were not targeted by any programmes. Whilst considerable attention was given to older adults in response to the ageing population, youth mental health programmes programmes are limited, need resourcing, and require substantial attention. Furthermore, although most studies employed psychometrically sound measures, there is a pressing need for culturally validated assessment tools specific to Singapore’s population. The substantial body of research focusing on older adults, while aligned with Singapore’s demographic challenges, warrants a systematic review to analyse the evidence on programmes improving mental health outcomes in older adults. Accumulating evidence demonstrates that environmental factors, including climate change, natural disasters, pandemics and urban design, significantly affect population mental health [128–130]. This highlights the paramount importance of developing interventions to build community resilience. However, these programmes were notably absent from the current research landscape. Lastly, the feasibility of population-level implementation requires economic evaluation to understand the cost-effectiveness of different approaches and how to make the economic case for investing in population mental health interventions, which is a significant limitation in current articles on programmes targeting mental health outcomes in Singapore.
Discussion
The scoping review aimed to capture programmes promoting mental health outcomes in Singapore’s population to understand the literature extent on various programmes targeting different age groups, and knowledge gaps to guide future research. One hundred and six articles were included, encompassing programmes targeting mental health outcomes in those with mental disorders, physical conditions, neurodevelopmental and learning disabilities, and healthy individuals. Whilst many programmes targeted older adults, others focused on adults and adolescents. There was a dearth of articles targeting key areas such as youth-specific suicide prevention, participants’ experiences, feasibility of expansion beyond the experimental stage, resilience and policy implications.
The publication timeline showed an increasing trend from 2013 onwards, coinciding with the NMHB plan and Community Mental Health Masterplan launched in 2012 [15]. These policies aimed to improve mental health through early detection and treatment, with more focus on community mental health. The policy paved the way for active community outreach efforts through various partners to understand the problem and design strategies to combat the emerging crisis. The focus areas identified (e.g., depression, anxiety, dementia) coincide with the mental health outcomes targeted by the programmes included in the current review. The policy also led to multiple research projects examining the nation’s mental health status to understand areas for intervention.
For example, the Wellbeing of the Singapore Elderly study (WiSE) launched in 2013 examined the prevalence of dementia and depression in Singapore and noted that 1 in 10 residents had dementia [131]. Following the study, dementia-friendly communities were implemented for early detection and management of dementia at the community level. Depression and anxiety have been recognised as major population health threats, with the Singapore Mental Health Study (SMHS) showing a lifetime prevalence of 13.9% for at least one mood, anxiety, or alcohol use disorder at the population level, higher than the 12% observed in SMHS2012. Depression alone had a prevalence of 6.3%, with significant differences noted for generalised anxiety disorder between SMHS2010 and 2016 [11].
Notably, a large proportion of programmes focused on depressive symptoms in hospital and community settings, emphasising management, treatment, and continued care. This focus aligns with the high prevalence of depression in Singapore, reported at 6.3% in the Singapore Mental Health Study [114]. Whilst many programmes demonstrated positive outcomes in controlled settings, their translation to broader community implementation remained limited. This gap between efficacy in research settings and real-world implementation is a recognised challenge in mental health interventions [132]. The limited community-level implementation could be attributed to several factors, primarily the lack of information on users’ perceptions and experiences. Understanding user perspectives is crucial for programme sustainability, as highlighted by implementation science frameworks [133]. User acceptance and engagement are key determinants of programme success, particularly in mental health interventions where stigma and cultural beliefs can significantly influence help-seeking behaviours and treatment adherence [134]. Additionally, sustainable implementation requires consideration of local context, resources, and capacity building [135], aspects that were often underexplored in the existing programmes. Given the changing mental health landscape globally, programmes that target areas beyond the current focus of the Community Mental Health (CMH) are needed.
The programmes included those developed and implemented by healthcare organisations for specific patient populations (such as EPIP, guidance clinics for children, and GP partnership programmes), to innovative mobile app-based games used in clinical settings. Additionally, programmes incorporated dance, music, other arts, mindfulness, memory clinics, care coordination programmes, and psychoeducation to improve mental health outcomes across various disease domains by promoting recovery and teaching essential coping skills. These programmes also aimed to foster self-efficacy in the target population. Enns et al., [17] summarised evidence on interventions targeting population mental health outcomes and observed that programmes mainly focused on depression, anxiety, stress, quality of life, and overall wellbeing, similar to our findings. The content shared similarities with overlapping components of psychoeducation, psychosocial elements, and overall wellbeing. What was lacking in the Singapore setting was a focus on academic development for students, parenting skills, and workplace mental health programmes. Enns et al. noted that none of the programmes in their study focused on environmental impacts on residents’ mental health, similar to the current review. Das and colleagues [136], in their umbrella review, summarised evidence on youth-targeted programmes and noted a focus on school-based, community-level, digital, and individual-based interventions mainly targeting depression and anxiety. Whilst these programmes shared elements with those in our review, they also addressed eating behaviours, suicide prevention, and knowledge – areas lacking in Singapore. Singapore has a suicide rate of 6.17 per 100,000 residents [137], which persists as a leading cause of death among youth. Given the importance of this topic, literature on programmes targeting suicide prevention and related knowledge is currently lacking. Studies have identified the importance of workplace interventions in mental and physical health promotion with many workplaces adopting various policies and programmes in this regard [138–139]. Given the significant proportion of time spent at work and its impact on mental wellbeing, there is a pressing need for evidence-based workplace mental health programmes in Singapore.
We have noted only limited evidence on early detection and prevention in youth. Recent studies among youth in Singapore have evidenced that 14.9% and 27% of youth experience severe depressive and anxiety symptoms respectively [140]. The lifetime prevalence of non-suicidal self-injury among youth was noted to be 25% [141]. These findings emphasise the need for more intensive youth-specific preventive programmes at the community level. Similarly, chronic diseases have a significant impact on the mental health of the population, with evidence showing that depressive symptoms are common among those with chronic conditions [7]. The research landscape in Singapore has begun to focus on this relatively underexplored area for intervention, which is a positive step in the right direction.
The strength of the scoping review includes the use of established JBI methodology, and the breadth of search strategy used. Despite the systematic search, it is possible that some articles might have been missed. Whilst the review focused on articles published in Singapore, which could be seen as limiting the generalisability of the findings, it offers valuable insights for other Asian countries. The findings are particularly relevant as they showcase evidence-based programmes and interventions in a multiethnic Asian population, providing potential models that could be adapted and implemented in similar Asian contexts. The study population’s ethnic diversity (predominantly Chinese, Malay, and Indian) mirrors the demographic composition found across many Asian countries, making the interventions and outcomes potentially more culturally relevant and adaptable compared to Western studies. This allows other Asian countries to learn from Singapore’s experiences and potentially adapt successful programmes to their local contexts whilst considering their specific cultural and healthcare system characteristics.
This scoping review identified critical gaps in Singapore’s mental health programme landscape. These include underrepresentation of youth-focused interventions despite rising mental health challenges in this population, limited workplace mental health programmes and suicide prevention initiatives, lack of school-based mental health promotion, and limited research on environmental impacts on psychological wellbeing in Singapore’s urban context. These gaps highlight priority areas requiring immediate policy attention and resource allocation to ensure comprehensive mental health coverage across all population groups and settings. Future research should prioritise developing and evaluating programmes to address these gaps, while incorporating user experiences and perspectives for sustainable and impactful programmes.
The substantial success rate (90.6%) of mental health programmes regardless of setting provides a compelling case for clinicians and policymakers to implement them for those who will benefit from these interventions. These programmes demonstrate significant value for healthcare systems by reducing symptom burden, improving functional capacity, decreasing healthcare utilisation through better self-management, and enhancing quality of life across diverse populations, ultimately contributing to more efficient resource allocation and improved patient outcomes.
However, critical policy action is urgently required to address significant gaps including the absence of school-based mental health programmes, workplace interventions, and programmes targeting suicidality, with immediate investment needed in youth mental health initiatives. Policymakers must prioritise sustainable funding mechanisms for scaling successful interventions beyond research settings, mandate economic evaluations to establish cost-effectiveness and return on investment, and strengthen research methodologies given the limited number of clinical trials. Policy frameworks should facilitate the translation of research findings into routine practice.
Conclusion
Mental health is a fundamental component of overall wellbeing, serving as a critical balance point that influences physical, social, and emotional functioning. Our review revealed a substantial increase in locally published research since the implementation of the NMHB and CMH Masterplan, with active research participation across all healthcare clusters in Singapore.
This scoping review identified 106 mental health programmes implemented across Singapore, with 90.6% showing positive outcomes across four main categories. The evidence revealed strong institutional engagement across Singapore’s three major healthcare clusters, with programmes successfully implemented across healthcare, community, and educational settings using diverse delivery modalities. Whilst there was robust evidence for programmes targeting older adults and adults, there was notably less emphasis on preventive strategies and health promotion initiatives among youth, adolescents and children. This imbalance is particularly concerning given the rising mental health challenges among youth and working young adults. The limited research on crucial areas such as suicide prevention programmes, workplace mental health initiatives, and the impact of built environments on mental health represents a significant gap, especially considering Singapore’s urbanised setting, workplace stress levels, and youth suicide rates.
Future research should prioritise addressing knowledge gaps identified in the review. Key priorities include incorporating user experiences and perspectives, developing and evaluating preventive interventions particularly for youth mental health, and investigating environmental influences on psychological wellbeing. Additional priorities for future research include creating sustainable workplace mental health programmes, establishing evidence-based suicide prevention strategies, evaluating the long-term effectiveness of community-based interventions, and assessing the cultural appropriateness and adaptability of existing programmes. These priorities will help ensure that mental health interventions in Singapore are not only effective in controlled settings but also sustainable and impactful in real-world applications across diverse population groups.
Supporting information
S1 Table. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist.
The table shows the list of PRISMA items and corresponding page numbers.
https://doi.org/10.1371/journal.pone.0347518.s001
(DOCX)
S3 Table. Study characteristics: Characteristics of all included studies.
https://doi.org/10.1371/journal.pone.0347518.s003
(DOCX)
S4 Table. Study characteristics based on TIDieR checklist list: Programmes targeting mental health outcomes in those with mental health and neurological conditions.
https://doi.org/10.1371/journal.pone.0347518.s004
(DOCX)
S5 Table. Study characteristics based on TIDieR checklist list: Programmes targeting mental health outcomes in those with physical health conditions.
https://doi.org/10.1371/journal.pone.0347518.s005
(DOCX)
S6 Table. Study characteristics based on TIDieR checklist list: Programmes targeting mental health outcomes in those with neurodevelopmental and learning conditions.
https://doi.org/10.1371/journal.pone.0347518.s006
(DOCX)
S7 Table. Study characteristics based on TIDieR checklist list: Programmes targeting mental health outcomes in healthy population.
https://doi.org/10.1371/journal.pone.0347518.s007
(DOCX)
Acknowledgments
The authors thank Dr. Maria Abraham for her contributions to the initial part of the scoping review.
References
- 1. Fusar-Poli P, Salazar de Pablo G, De Micheli A, Nieman DH, Correll CU, Kessing LV, et al. What is good mental health? A scoping review. Eur Neuropsychopharmacol. 2020;31:33–46. pmid:31901337
- 2.
World mental health report: transforming mental health for all. Geneva: World Health Organization. 2022. https://www.who.int/publications/i/item/9789240049338
- 3.
WHO. Mental disorders. 2022. https://www.who.int/news-room/fact-sheets/detail/mental-disorders
- 4. Kieling C, Buchweitz C, Caye A, Silvani J, Ameis SH, Brunoni AR, et al. Worldwide prevalence and disability from mental disorders across childhood and adolescence: evidence from the global burden of disease study. JAMA Psychiatry. 2024;81(4):347–56.
- 5. McGrath JJ, Al-Hamzawi A, Alonso J, Altwaijri Y, Andrade LH, Bromet EJ, et al. Age of onset and cumulative risk of mental disorders: a cross-national analysis of population surveys from 29 countries. Lancet Psychiatry. 2023;10(9):668–81. pmid:37531964
- 6. Christensen MK, Lim CCW, Saha S, Plana-Ripoll O, Cannon D, Presley F, et al. The cost of mental disorders: a systematic review. Epidemiol Psychiatr Sci. 2020;29:e161. pmid:32807256
- 7. Arango C, Dragioti E, Solmi M, Cortese S, Domschke K, Murray RM, et al. Risk and protective factors for mental disorders beyond genetics: an evidence-based atlas. World Psychiatry. 2021;20(3):417–36. pmid:34505386
- 8. Campion J, Javed A, Lund C, Sartorius N, Saxena S, Marmot M, et al. Public mental health: required actions to address implementation failure in the context of COVID-19. Lancet Psychiatry. 2022;9(2):169–82. pmid:35065723
- 9. Moitra M, Santomauro D, Collins PY, Vos T, Whiteford H, Saxena S, et al. The global gap in treatment coverage for major depressive disorder in 84 countries from 2000-2019: A systematic review and Bayesian meta-regression analysis. PLoS Med. 2022;19(2):e1003901. pmid:35167593
- 10. Eckardt JP. Barriers to WHO Mental Health Action Plan updates to expand family and caregiver involvement in mental healthcare. Gen Psychiatr. 2022;35(2):e100784. pmid:35372788
- 11. Subramaniam M, Abdin E, Vaingankar JA, Shafie S, Chua BY, Sambasivam R, et al. Tracking the mental health of a nation: prevalence and correlates of mental disorders in the second Singapore mental health study. Epidemiol Psychiatr Sci. 2019;29:e29. pmid:30947763
- 12. Abdin E, Chong SA, Ragu V, Vaingankar JA, Shafie S, Verma S, et al. The economic burden of mental disorders among adults in Singapore: evidence from the 2016 Singapore Mental Health Study. J Ment Health. 2023;32(1):190–7. pmid:34338569
- 13. Khanna V. The shocking economic toll of mental illness. 2023. https://www.duke-nus.edu.sg/newshub/media-coverage/shocking-economic-toll-of-mental-illness
- 14.
Ministry of Health. National mental health blueprint 2007-2012. Singapore: Ministry of Health. 2010. https://www.nlb.gov.sg/main/article-detail?cmsuuid=768c27a5-a785-413b-98a0-2fad1d8479e0
- 15.
Ministry of Health. Community Mental Health Masterplan and National Mental Health Blueprint. 2020. https://www.moh.gov.sg/newsroom/community-mental-health-masterplan-and-national-mental-health-blueprint
- 16.
Ministry of Health. White Paper on Healthier SG. 2022. https://www.moh.gov.sg/newsroom/white-paper-on-healthier-sg
- 17. Enns J, Holmqvist M, Wener P, Halas G, Rothney J, Schultz A, et al. Mapping interventions that promote mental health in the general population: A scoping review of reviews. Prev Med. 2016;87:70–80. pmid:26896634
- 18. Pollock D, Peters MDJ, Khalil H, McInerney P, Alexander L, Tricco AC, et al. Recommendations for the extraction, analysis, and presentation of results in scoping reviews. JBI Evid Synth. 2023;21(3):520–32. pmid:36081365
- 19. Nair APV, Tan C, Abraham M, Cheng L, Karuvetil Z, Subramaniam M. Mapping programs that promote mental wellbeing in Singapore: A scoping review protocol. 2023.
- 20. Peters MDJ, Godfrey C, McInerney P, Khalil H, Larsen P, Marnie C, et al. Best practice guidance and reporting items for the development of scoping review protocols. JBI Evid Synth. 2022;20(4):953–68. pmid:35102103
- 21. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73. pmid:30178033
- 22. Aloweni F, Doshi K, Agus N, Fook-Chong S, Wu SY, Kong LP, et al. Evaluating the feasibility and effectiveness of a mindfulness-based intervention on stress and anxiety of family caregivers managing peritoneal dialysis. Proceedings of Singapore Healthcare. 2021;31.
- 23. Chan MF, Ng SE, Tien A, Man Ho RC, Thayala J. A randomised controlled study to explore the effect of life story review on depression in older Chinese in Singapore. Health Soc Care Community. 2013;21(5):545–53. pmid:23639030
- 24. Chan MF, Leong KSP, Heng BL, Mathew BK, Khan SBAL, Lourdusamy SS, et al. Reducing depression among community-dwelling older adults using life-story review: a pilot study. Geriatr Nurs. 2014;35(2):105–10. pmid:24246689
- 25. Chew J, Zeng Z, Tan THB, Chew P, Ali N, Wang H, et al. ADL+: A Digital Toolkit for Multidomain Cognitive, Physical, and Nutritional Interventions to Prevent Cognitive Decline in Community-Dwelling Older Adults. Int J Environ Res Public Health. 2024;22(1):42. pmid:39857495
- 26. Huang H, Poremski D, Goh YL, Hendriks M, Fung D. Increasing the Continuity of Care between Primary Care Provider and a Psychiatric Hospital in Singapore. East Asian Arch Psychiatry. 2017;27(4):156–61. pmid:29259146
- 27. Jiao N, Zhu L, Chong YS, Chan W-CS, Luo N, Wang W, et al. Web-based versus home-based postnatal psychoeducational interventions for first-time mothers: A randomised controlled trial. Int J Nurs Stud. 2019;99:103385. pmid:31442783
- 28. Kasmani SS, Goh ECL, Lee K. A multilevel bidirectional linkage model in enhancing continuity of psychiatric care. Health Soc Work. 2018;43(2):126–30.
- 29. Khine WWT, Voong ML, Ng TKS, Feng L, Rane GA, Kumar AP, et al. Mental awareness improved mild cognitive impairment and modulated gut microbiome. Aging (Albany NY). 2020;12(23):24371–93. pmid:33318317
- 30. Klainin-Yobas P, Ignacio J, He H-G, Lau Y, Ngooi BX, Koh SQD. Effects of a Stress-Management Program for Inpatients With Mental Disorders: A Feasibility Study. Biol Res Nurs. 2016;18(2):213–20. pmid:26183182
- 31. Koh WLE, Low F, Kam JW, Rahim S, Ng WF, Ng LL. Person-centred creative dance intervention for persons with dementia living in the community in Singapore. Dementia (London). 2020;19(7):2430–43. pmid:30634864
- 32. Lai SH, Tsoi T, Tang CT, Hui RJY, Tan KK, Yeo YWS, et al. An integrated, collaborative healthcare model for the early diagnosis and management of dementia: Preliminary audit results from the first transdisciplinary service integrating family medicine and geriatric psychiatry services to the heart of patients’ homes. BMC Psychiatry. 2019;19(1):61. pmid:30736756
- 33. Lee TM, Bautista D, Chen HY. Understanding How Postnatal Depression Screening and Early Intervention Work in the Real World - A Singaporean Perspective. Ann Acad Med Singap. 2016;45(10):466–70. pmid:27832221
- 34. Lee NBC, Fung DSS, Teo J, Chan YH, Cai YM. Five-year review of adolescent mental health usage in Singapore. Ann Acad Med Singap. 2003;32(1):7–11. pmid:12625091
- 35. Lee Yoon Li M, Lee Si Min S, Sündermann O. Efficacy of the mHealth App Intellect in Improving Subclinical Obsessive-Compulsive Disorder in University Students: Randomized Controlled Trial With a 4-Week Follow-Up. JMIR Mhealth Uhealth. 2024;12:e63316. pmid:39680884
- 36. Loh AHY, Ong LL, Yong FSH, Chen HY. Improving mother-infant bonding in postnatal depression - The SURE MUMS study. Asian J Psychiatr. 2023;81:103457. pmid:36638754
- 37. Low L, Tan YY, Lim BL, Poon WC, Lee C. Effectiveness of assertive community management in Singapore. Ann Acad Med Singap. 2013;42(3):125–32. pmid:23604501
- 38. Ng TP, Nyunt MSZ, Feng L, Kumar R, Fones CSL, Ko SM. Collaborative care for primary care treatment of late-life depression in Singapore: Randomized controlled trial. Int J Geriatr Psychiatry. 2020;35(10):1171–80. pmid:32453449
- 39. Nyunt MSZ, Ko SM, Kumar R, Fones CCS, Ng TP. Improving treatment access and primary care referrals for depression in a national community-based outreach programme for the elderly. Int J Geriatr Psychiatry. 2009;24(11):1267–76. pmid:19319926
- 40. Ong JG, Lim-Ashworth NS, Ooi YP, Boon JS, Ang RP, Goh DH, et al. An Interactive Mobile App Game to Address Aggression (RegnaTales): Pilot Quantitative Study. JMIR Serious Games. 2019;7(2):e13242. pmid:31066682
- 41. Pat-Horenczyk R, Shi CSW, Schramm-Yavin S, Bar-Halpern M, Tan LJ. Building Emotion and Affect Regulation (BEAR): Preliminary Evidence from an Open Trial in Children’s Residential Group Homes in Singapore. Child Youth Care Forum. 2014;44(2):175–90.
- 42. Rawtaer I, Mahendran R, Yu J, Fam J, Feng L, Kua EH. Psychosocial interventions with art, music, Tai Chi and mindfulness for subsyndromal depression and anxiety in older adults: A naturalistic study in Singapore. Asia Pac Psychiatry. 2015;7(3):240–50. pmid:26178378
- 43. Saxena N, George PP, Teo KW, Tan WS, Ng C, Heng BH, et al. Evaluation of an integrated primary care-led dementia shared care program in Singapore: An effectiveness and cost-effectiveness study. Geriatr Gerontol Int. 2018;18(3):479–86. pmid:29193721
- 44. Shah LBI, Torres S, Kannusamy P, Chng CML, He H-G, Klainin-Yobas P. Efficacy of the virtual reality-based stress management program on stress-related variables in people with mood disorders: the feasibility study. Arch Psychiatr Nurs. 2015;29(1):6–13. pmid:25634868
- 45.
Shorey S. The effectiveness of a postnatal psychoeducation programme on outcomes of first-time mothers in Singapore. 2013.
- 46. Shorey S, Chee CYI, Ng ED, Lau Y, Dennis C-L, Chan YH. Evaluation of a Technology-Based Peer-Support Intervention Program for Preventing Postnatal Depression (Part 1): Randomized Controlled Trial. J Med Internet Res. 2019;21(8):e12410. pmid:31469084
- 47. Shorey S, Kua EH, Tam W, Chan V, Goh YS, Lim HM, et al. “Where-There-Is-No-Psychiatrist Integrated Personal Therapy” among Community-Dwelling Older Adults: A Randomized Pilot Study. Int J Environ Res Public Health. 2021;18(18):9514. pmid:34574438
- 48. Sim K, Chan YH, Chong SA, Siris SG. A 24-month prospective outcome study of first-episode schizophrenia and schizoaffective disorder within an early psychosis intervention program. J Clin Psychiatry. 2007;68(9):1368–76. pmid:17915975
- 49. Sim T, Choo H, Low-Lim A, Lau J. Adolescents’ and parents’ perspectives: A gaming disorder intervention in Singapore. Fam Relat. 2021;70(1):90–103.
- 50. Tan B, Kumar V, Devaraj P. Development of a new occupational therapy service in a Singapore prison. Br J Occup Ther. 2015.
- 51. Tan CHS, Ishak RB, Lim TXG, Marimuthusamy P, Kaurss K, Leong J-YJ. Illness management and recovery program for mental health problems: reducing symptoms and increasing social functioning. J Clin Nurs. 2017;26(21–22):3471–85. pmid:28032918
- 52. Tan HLE, Chng CML, Lau Y, Klainin-Yobas P. Investigating the effects of a virtual reality-based stress management programme on inpatients with mental disorders: A pilot randomised controlled trial. Int J Psychol. 2021;56(3):444–53. pmid:32959431
- 53. Tan WJ, Lim XYH, Lee T, Wong SC, Koh HJ, Yeo D. The impact of the Arts and Dementia Program on short-term well-being in older persons with dementia from Singapore. Australas J Ageing. 2022;41(1):81–7. pmid:34382719
- 54. Teo DCL, Yan S, Tan MSQ, Tirtajana I, Lim HK, Saffari SE, et al. Impact of an integrated care programme on patient-reported outcomes for mild to moderate mental health conditions in Singapore: a pilot study. Singapore Med J. 2021;62(5):230–4. pmid:34409472
- 55. Verma S, Poon LY, Subramaniam M, Abdin E, Chong SA. The Singapore Early Psychosis Intervention Programme (EPIP): A programme evaluation. Asian J Psychiatr. 2012;5(1):63–7. pmid:26878951
- 56. Xie Y, Boon J, Sim WH, Fung D. A Singapore model – REACH. School Mental Health. Cambridge University Press. 2015. p. 202–17.
- 57. Yeo LS, Choi PM. Cognitive-behavioural therapy for children with behavioural difficulties in the Singapore mainstream school setting. School Psychology International. 2011;32(6):616–31.
- 58. Zhenru Z, Jern-Yi JL. Community mental health team in Singapore. ASEAN J Psychiatry. 2014;15(2):225–9.
- 59. Chandran G, Tang N, Ngo ELP, Huang S, Tong SI, Ong JX, et al. Comparing the efficacy of a multi-dimensional breast cancer rehabilitation programme versus a home-based exercise programme during adjuvant cancer treatment. BMC Cancer. 2024;24(1):361. pmid:38509471
- 60. Guna D, Milburn-Curtis C, Zhang H, Goh HS. Effectiveness of the Biography and Life Storybook for Nursing Home Residents: A Quasi-Experimental Study. Int J Environ Res Public Health. 2022;19(8):4749. pmid:35457616
- 61. Griva K, Rajeswari M, Nandakumar M, Khoo EYH, Lee VYW, Chua CG, et al. The combined diabetes and renal control trial (C-DIRECT) - a feasibility randomised controlled trial to evaluate outcomes in multi-morbid patients with diabetes and on dialysis using a mixed methods approach. BMC Nephrology. 2019;20(1):2.
- 62. He H-G, Zhu L-X, Chan W-CS, Liam JLW, Ko SS, Li HCW, et al. A mixed-method study of effects of a therapeutic play intervention for children on parental anxiety and parents’ perceptions of the intervention. J Adv Nurs. 2015;71(7):1539–51. pmid:25682703
- 63. Hoong JM, Koh HA, Wong K, Lee HH. Effects of a community-based chronic disease self-management programme on chronic disease patients in Singapore. Chronic Illn. 2023;19(2):434–43. pmid:35317664
- 64. Leow M, Chan S, Chan M. A pilot randomized, controlled trial of the effectiveness of a psychoeducational intervention on family caregivers of patients with advanced cancer. Oncol Nurs Forum. 2015;42(2):E63-72. pmid:25806893
- 65. Lim YC, Yobas P, Chen H-C. Efficacy of relaxation intervention on pain, self-efficacy, and stress-related variables in patients following total knee replacement surgery. Pain Manag Nurs. 2014;15(4):888–96. pmid:24957817
- 66. Lim SH, Chan SWC, Lai JH, He H-G. A qualitative evaluation of the STOMA psychosocial intervention programme for colorectal cancer patients with stoma. J Adv Nurs. 2019;75(1):108–18. pmid:30109721
- 67. Lim SH, Chan SWC, Chow A, Zhu L, Lai JH, He H-G. Pilot trial of a STOMA psychosocial intervention programme for colorectal cancer patients with stomas. J Adv Nurs. 2019;75(6):1338–46. pmid:30740765
- 68. Mahendran R, Lim HA, Tan JYS, Chua J, Lim SE, Ang ENK, et al. Efficacy of a brief nurse-led pilot psychosocial intervention for newly diagnosed Asian cancer patients. Support Care Cancer. 2015;23(8):2203–6. pmid:26001988
- 69. Merchant RA, Chan YH, Anbarasan D, Woo J. The Impact of Exercise and Cognitive Stimulation Therapy on Intrinsic Capacity Composite Score in Pre-Frail Older Adults: A Pre-Post Intervention Study. J Frailty Aging. 2024;13(2):131–8. pmid:38616369
- 70. Neo SH-S, Mok N, Ng X-H, Zhu X. Enhancing palliative care for advanced cancer patients: evaluating implementation and impact of a virtual nurse-led symptom monitoring and telehealth initiative. BMC Palliat Care. 2024;23(1):238. pmid:39379996
- 71. Ramazanu S, Lim Chiang VC, Valimaki M. The Experiences and Evaluation of a Complex Intervention for Couples Coping With Stroke. J Neurosci Nurs. 2021;53(1):18–23. pmid:33252412
- 72. Tan EPG, Tan ESL, Ng B-Y. Efficacy of cognitive behavioural therapy for patients with chronic pain in Singapore. Ann Acad Med Singap. 2009;38(11):952–9. pmid:19956817
- 73. Tan NC, Gong PP, Lee CS, Goh SKL, Ang SB, Koh GCH. Theory-based behaviour modification of Asian adults with type-2 diabetes mellitus after participating in a novel telemonitoring system: a qualitative research study. BMJ Open. 2024;14(12):e080830. pmid:39719282
- 74. Teo I, Vilardaga JP, Tan YP, Winger J, Cheung YB, Yang GM, et al. A feasible and acceptable multicultural psychosocial intervention targeting symptom management in the context of advanced breast cancer. Psychooncology. 2020;29(2):389–97. pmid:31703146
- 75. Teo I, Tan YP, Finkelstein EA, Yang GM, Pan FT, Lew HYF, et al. The Feasibility and Acceptability of a Cognitive Behavioral Therapy-Based Intervention for Patients With Advanced Colorectal Cancer. J Pain Symptom Manage. 2020;60(6):1200–7. pmid:32574657
- 76. Teo I, Tan YP, Goh A, Pan FT, Tan TJ, Ozdemir S, et al. The Renewing Intimacy and SExuality Intervention for Female Cancer Survivors: A Feasibility Study. Psychooncology. 2024;33(12):e70037. pmid:39638564
- 77. Wang YT, Kwok KFV, Tan SM, Yek MH, Ong WC, Barbier S, et al. Comprehensive psychological intervention to improve outcome in functional gastrointestinal disorder: a cohort study. Singapore Med J. 2015;56(7):385–92. pmid:26243975
- 78. Wang W, Lim JY, Lopez V, Wu VX, Lee C-H, He H-G, et al. The effect of a self-help psychoeducation programme for people with coronary heart disease: A randomized controlled trial. J Adv Nurs. 2018;74(10):2416–26. pmid:29992600
- 79. Wong KC, Tan BWZ, Tong JWK, Chan MY. The Role of Music Therapy for Children Undergoing Cancer Treatment in Singapore. Healthcare (Basel). 2021;9(12):1761. pmid:34946487
- 80. Woo BFY, Tam WWS, Rangpa T, Liau WF, Nathania J, Lim TW. A nurse-led integrated chronic care e-enhanced atrial fibrillation (NICE-AF) clinic in the community: A preliminary evaluation. Int J Environ Res Public Health. 2022;19(8):4467.
- 81. Yang S-Y, Moss-Morris R, McCracken LM. iACT-CEL: A Feasibility Trial of a Face-to-Face and Internet-Based Acceptance and Commitment Therapy Intervention for Chronic Pain in Singapore. Pain Res Treat. 2017;2017:6916915. pmid:28326196
- 82. Zhang F, Bang D, Visperas CA, Tun MH, Tay SS. Feasibility, User Acceptance, and Outcomes of Using a Cancer Prehabilitation App for Exercise: Pilot Cohort Study. JMIR Form Res. 2025;9:e64427. pmid:39871116
- 83. Bernard-Opitz V, Ing S, Kong TY. Comparison of behavioural and natural play interventions for young children with autism. Autism. 2004;8(3):319–33. pmid:15358873
- 84. Fitriya SNF. Evaluating the longitudinal progress of a large sample of dyslexic children in reading, spelling and writing. APJDD. 2021;8(2):238–49.
- 85. Fitriya SN. The effectiveness of reading, spelling and writing support for a large sample of school-aged children with dyslexia: factors influencing efficacy. Asia Pacific J Dev Differ. 2022;9(2):204–22.
- 86. Lim CG, Lee TS, Guan C, Fung DSS, Zhao Y, Teng SSW, et al. A brain-computer interface based attention training program for treating attention deficit hyperactivity disorder. PLoS One. 2012;7(10):e46692. pmid:23115630
- 87. Ooi YP, Lam CM, Sung M, Tan WTS, Goh TJ, Fung DSS, et al. Effects of cognitive-behavioural therapy on anxiety for children with high-functioning autistic spectrum disorders. Singapore Med J. 2008;49(3):215–20. pmid:18363003
- 88. Tan YN, Lokananthan T, Yow WQ. Effectiveness of Mobile Assistive Technology on Improving the Self-Perceptions of Students with Dyslexia in Singapore. APJDD. 2022;9(2):248–79.
- 89. Tan SZK, Shendyapina M, Tay LNS. Evaluating the use of immersive interactive mixed reality (I2MR) technology in special needs education in Singapore. Technol Knowl Learn. 2024;29(2):781–802.
- 90. Yap DF-F, Nasir N, Tan KSM, Lau LHS. Variables which predict maternal self-efficacy: A hierarchical linear regression analysis. J Appl Res Intellect Disabil. 2019;32(4):841–8. pmid:30714663
- 91. Ang LPA. Reducing inpatient suicide rates: The success of a suicide management programme in a general hospital. Gen Hosp Psychiatry. 2018;54:60–1. pmid:29807670
- 92. Shandra Bos L, Shorey S, Kulantaipian TS, Sng JSP, Tam WWS, Koh SSL. Effectiveness of the Neonatal Discharge Program for Very Low-Birth-Weight Infants on Parental Efficacy and Psychological Distress. J Perinat Neonatal Nurs. 2018;32(4):E11–21. pmid:29782436
- 93. Chong JHS, Chee JY, Goh ZZS, Lee HH, Chee TG, Tan EXX, et al. Perceptions and experiences of a multi-domain preventive health programme: a qualitative study informing future community-based health interventions in singapore. BMC Public Health. 2024;24(1):2954. pmid:39448998
- 94. Gan DZQ, Zhou Y, Abdul Wahab NDB, Ruby K, Hoo E. Effectiveness of Functional Family Therapy in a Non-Western Context: Findings from a Randomized-Controlled Evaluation of Youth Offenders in Singapore. Fam Process. 2021;60(4):1170–84. pmid:33449378
- 95. Keng S-L, Chin JWE, Mammadova M, Teo I. Effects of Mobile App-Based Mindfulness Practice on Healthcare Workers: a Randomized Active Controlled Trial. Mindfulness (N Y). 2022;13(11):2691–704. pmid:36160038
- 96. Kit PL, Teo CT, Tan M, Park Y. Singapore children’s online counselling experiences on a live chat portal. Br J Guid Couns. 2019;47(3):304–16.
- 97. Lee T-S, Goh SJA, Quek SY, Phillips R, Guan C, Cheung YB, et al. A brain-computer interface based cognitive training system for healthy elderly: a randomized control pilot study for usability and preliminary efficacy. PLoS One. 2013;8(11):e79419. pmid:24260218
- 98. Lee T-S, Quek SY, Goh SJA, Phillips R, Guan C, Cheung YB, et al. A pilot randomized controlled trial using EEG-based brain-computer interface training for a Chinese-speaking group of healthy elderly. Clin Interv Aging. 2015;10:217–27. pmid:25624754
- 99. Lee JJ, Nadkarni NV, Teo I, Ozdemir S. The Effect of Social Norm-based Intervention with Observable Behaviour on Physical Activity among Adolescents: A Randomized Controlled Trial. BMC Sports Sci Med Rehabil. 2020;12:52. pmid:32874593
- 100. Leong KS, Klainin-Yobas P, Fong SD, Wu XV. Older adults’ perspective of intergenerational programme at senior day care centre in Singapore: A descriptive qualitative study. Health Soc Care Community. 2022;30(1):e222–33. pmid:34028921
- 101. Li C, Wu Y, Ong Q. Enhancing attitudes of college students towards people with intellectual disabilities through a coursework intervention. J Dev Phys Disabil. 2014;26(6):793–803.
- 102. Lim SYW, Loh RJ, Teo YH, Chong EY, Tan ZC, Du SDX, et al. Impact of Youth Health Ambassador Programme on health awareness in youths in Singapore. J Educ Health Promot. 2024;13:306. pmid:39429836
- 103. Lim SWE, Chong JHS, Chee JY, Lew CCH, Lee HH, Chua LKW, et al. Impact of a Community-Based Health Intervention on Health Knowledge, Lifestyle Goals, Dietary Practices, and Physical Activity in Older Adults: A Multisite Cohort Study. Healthcare (Basel). 2024;12(24):2588. pmid:39766015
- 104. Chan ML, Gustafsson L, Liddle J. An intervention to support professional driver retirement transition: Results of a pilot study for older taxi drivers in Singapore. Br J Occup Ther. 2015;78(6):391–400.
- 105. Metrat-Depardon CD, Teo CT. Exploring the effects and benefits of a pilot school-based happiness mentoring programme with polytechnic students in Singapore. Curr Psychol. 2023;42(9):7020–30.
- 106. Muckle J, Lasikiewicz N. An exploration of the benefits of animal-assisted activities in undergraduate students in Singapore. Asian J Soc Psychol. 2017;20(2):75–84.
- 107. Ng KST, Sia A, Ng MKW, Tan CTY, Chan HY, Tan CH, et al. Effects of Horticultural Therapy on Asian Older Adults: A Randomized Controlled Trial. Int J Environ Res Public Health. 2018;15(8):1705. pmid:30096932
- 108. Yeo PS, Nguyen TN, Ng MPE, Choo RWM, Yap PLK, Ng TP, et al. Evaluation of the Implementation and Effectiveness of Community-Based Brain-Computer Interface Cognitive Group Training in Healthy Community-Dwelling Older Adults: Randomized Controlled Implementation Trial. JMIR Form Res. 2021;5(4):e25462. pmid:33904819
- 109. Shahwan S, Lau JH, Goh CMJ, Ong WJ, Tan GTH, Kwok KW, et al. The potential impact of an anti-stigma intervention on mental health help-seeking attitudes among university students. BMC Psychiatry. 2020;20(1):562. pmid:33238951
- 110. Shorey S, Chan SW-C, Chong YS, He H-G. Perceptions of primiparas on a postnatal psychoeducation programme: the process evaluation. Midwifery. 2015;31(1):155–63. pmid:25174540
- 111. Shorey S, Lau Y, Dennis C-L, Chan YS, Tam WWS, Chan YH. A randomized-controlled trial to examine the effectiveness of the “Home-but not Alone” mobile-health application educational programme on parental outcomes. J Adv Nurs. 2017;73(9):2103–17. pmid:28276086
- 112. Shorey S, Law E, Thilagamangai Mathews J, Lim SH, Shi L, et al. Evaluating the Effectiveness of the Supportive Parenting App on Parental Outcomes: Randomized Controlled Trial. J Med Internet Res. 2023;25:e41859. pmid:36645699
- 113. Sia A, Tam WWS, Fogel A, Kua EH, Khoo K, Ho RCM. Nature-based activities improve the well-being of older adults. Sci Rep. 2020;10(1):18178. pmid:33097785
- 114. Subramaniam M, Shahwan S, Abdin E, Goh CMJ, Ong WJ, Tan GTH, et al. Advancing research to eliminate mental illness stigma: The design and evaluation of a single-arm intervention among university students in Singapore. Front Psychol. 2020;11:1151.
- 115. Suyi Y, Meredith P, Khan A. Effectiveness of Mindfulness Intervention in Reducing Stress and Burnout for Mental Health Professionals in Singapore. Explore (NY). 2017;13(5):319–26. pmid:28780213
- 116. Tan ASY, Mankiewicz PD. Does a brief contact-based video intervention reduce public mental health stigma associated with psychosis in a collectivistic society? A randomised control study. JMHTEP. 2023;19(1):21–35.
- 117. Tan GTH, Shahwan S, Abdin E, Lau JH, Goh CMJ, Ong WJ, et al. Recognition of Depression and Help-Seeking Preference Among University Students in Singapore: An Evaluation of the Impact of Advancing Research to Eliminate Mental Illness Stigma an Education and Contact Intervention. Front Psychiatry. 2021;12:582730. pmid:34054591
- 118. Tay JL, Goh YSS, Sim K, Klainin-Yobas P. Impact of the HOPE Intervention on Mental Health Literacy, Psychological Well-Being and Stress Levels amongst University Undergraduates: A Randomised Controlled Trial. Int J Environ Res Public Health. 2022;19(15):9772. pmid:35955126
- 119. Tay JL. Online HOPE intervention on help-seeking attitudes and intentions among young adults in Singapore: A randomized controlled trial and process evaluation. Arch Psychiatr Nurs. 2022;41:286–94. pmid:36428062
- 120. Wong KF, Teng J, Chee MWL, Doshi K, Lim J. Positive Effects of Mindfulness-Based Training on Energy Maintenance and the EEG Correlates of Sustained Attention in a Cohort of Nurses. Front Hum Neurosci. 2018;12:80. pmid:29545746
- 121. Wong MHM, Keng S-L, Buck PJ, Suthendran S, Wessels A, Østbye T. Effects of Mental Health Paraprofessional Training for Filipina Foreign Domestic Workers in Singapore. J Immigr Minor Health. 2020;22(3):571–9. pmid:31183593
- 122. Yap D, Lau L, Nasir N, Cameron C, Matthews J, Tang HN. Evaluation of a parenting program for children with behavioural problems: Signposts in Singapore. J Intellect Dev Disabil. 2014;39:214–21.
- 123. Yap AF, Kwan YH, Tan CS, Ibrahim S, Ang SB. Rhythm-centred music making in community living elderly: a randomized pilot study. BMC Complement Altern Med. 2017;17(1):311. pmid:28615007
- 124. Yeo LS, Goh VG, Liem GAD. School-Based Intervention for Test Anxiety. Child Youth Care Forum. 2015;45(1):1–17.
- 125. Zheng H, Li J, Salmon CT, Theng Y-L. The effects of exergames on emotional well-being of older adults. Computers in Human Behavior. 2020;110:106383.
- 126. Zheng Q, Shi L, Zhu L, Jiao N, Chong YS, Chan SW-C, et al. Cost-effectiveness of Web-Based and Home-Based Postnatal Psychoeducational Interventions for First-time Mothers: Economic Evaluation Alongside Randomized Controlled Trial. J Med Internet Res. 2022;24(3):e25821. pmid:35275078
- 127. Zhou YQ, Chew QRC, Lee M, Zhou J, Chong D, Quah SH, et al. Evaluation of Positive Parenting Programme (Triple P) in Singapore: Improving parenting practices and preventing risks for recurrence of maltreatment. Children and Youth Services Review. 2017;83:274–84.
- 128. Beemer CJ, Stearns-Yoder KA, Schuldt SJ, Kinney KA, Lowry CA, Postolache TT, et al. A brief review on the mental health for select elements of the built environment. Indoor and Built Environment. 2019;30(2):152–65.
- 129. Cianconi P, Betrò S, Janiri L. The Impact of Climate Change on Mental Health: A Systematic Descriptive Review. Front Psychiatry. 2020;11:74. pmid:32210846
- 130. Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun. 2020;89:531–42. pmid:32485289
- 131. Subramaniam M, Chong SA, Vaingankar JA, Abdin E, Chua BY, Chua HC, et al. Prevalence of Dementia in People Aged 60 Years and Above: Results from the WiSE Study. J Alzheimers Dis. 2015;45(4):1127–38. pmid:25672767
- 132. Proctor EK, Landsverk J, Aarons G, Chambers D, Glisson C, Mittman B. Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Adm Policy Ment Health. 2009;36(1):24–34.
- 133. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50. pmid:19664226
- 134. Ng CH. Mental health and integration in Asia Pacific. BJPsych Int. 2018;15(4):76–9. pmid:30524129
- 135. Glasgow RE, Green LW, Taylor MV, Stange KC. An evidence integration triangle for aligning science with policy and practice. Am J Prev Med. 2012;42(6):646–54. pmid:22608384
- 136. Das JK, Salam RA, Lassi ZS, Khan MN, Mahmood W, Patel V, et al. Interventions for Adolescent Mental Health: An Overview of Systematic Reviews. J Adolesc Health. 2016;59(4S):S49–60. pmid:27664596
- 137.
Samaritans of Singapore. Suicide numbers decline in Singapore, but vigilance must continue. 2024. [Cited 2025 October 27]. https://www.sos.org.sg/pressroom/suicide-numbers-decline-in-singapore-but-vigilance-must-continue/
- 138. Proper KI, van Oostrom SH. The effectiveness of workplace health promotion interventions on physical and mental health outcomes - a systematic review of reviews. Scand J Work Environ Health. 2019;45(6):546–59. pmid:31134284
- 139. Wu A, Roemer EC, Kent KB, Ballard DW, Goetzel RZ. Organizational Best Practices Supporting Mental Health in the Workplace. J Occup Environ Med. 2021;63(12):e925–31. pmid:34840320
- 140. Subramaniam M, Vaingankar JA, Tan B, Abdin E, Chang S, Tan Y, et al. Examining psychological distress among youth in Singapore: Insights from the National Youth Mental Health Study. Asian J Psychiatr. 2025;105:104405. pmid:39987652
- 141. Chang S, Vaingankar JA, Tan B, Tan YWB, Samari E, Archana S, et al. Prevalence and correlates of nonsuicidal self-injury among youths in Singapore: findings from the National Youth Mental Health Study. Child Adolesc Psychiatry Ment Health. 2025;19(1):27. pmid:40119451