Despite the varied lived experiences of Sharif, Bhing, and Maw Lwin in Singapore, our conversations with them delineate a common thread: the mental health of migrant workers is inextricably tied to their access to basic labour rights. As a construction safety supervisor, Sharif explains that mental wellness is fundamentally tied to a “worker’s place to stay, transportation, salary, healthcare, and the value of his time.” Similarly, Bhing and Maw Lwin emphasise how freedom, care, and rest are only available to domestic workers during their off-days. Yet, as argued by State representatives like Yeo Guat Kwang, the concept of migrant rights is deemed irrelevant in the face of profit maximisation and economic growth. This normative disregard for migrant well-being manifests in the precarious living and working conditions of migrant labour—unsafe workplaces, dangerous transport practices, poor housing standards, debt-financed employment, domestic abuse. The sacrifice of migrant rights for economic profit thus becomes a cost exacted on the physical and mental well-being of migrant workers, rendering them especially vulnerable to harm and loss during periods of crisis.  

The crisis of the COVID-19 pandemic is crucial to our discussion about migrant mental health because it has shown how structural inequities are heavily associated with the risk factors for physiological and mental health.¹ Differences in social, economic, and environmental circumstances result in systemic health inequalities, causing the poor and disadvantaged to suffer disproportionately from common illnesses and disorders.² In the context of Singapore, the pandemic exposed and exacerbated the vast socio-economic inequalities between the migrant labouring body and the citizen population in Singapore. Consequently, migrant workers were subjected to prolonged conditions of stress, fear, and insecurity, ultimately putting them at risk of severe mental illnesses. In 2021, a MOM report highlighted that the overall rates of unnatural death and suicide among Work Permit Holders were higher in 2020—during the height of the pandemic—than in the preceding 4 years.³ This finding is further supported by our data, which shows a sudden spike in the number of migrant worker suicides in 2020 as compared to previous years; out of the 18 reported cases of male migrant worker suicides that we could find from 2000 to 2022, 7 of them happened in 2020 alone.

Despite the State’s pre-emptive and “gold standard”⁴ response towards the initial phases of the pandemic, its public health measures were heavily skewed towards the care of the citizen population and neglectful of its low-wage migrant workers. These measures did not account for the fact that a significant number of male migrant workers (MMWs) are housed in overcrowded and squalid dormitory conditions, with approximately 10-20 workers sharing a room and poorly sanitised toilet facilities.⁵ This oversight eventually led to a major outbreak of COVID-19 cases in migrant worker dormitories, despite warnings of the consequences of unsanitary living conditions from NGOs like TWC2. By April 2020, the number of COVID-19 cases amongst MCWs constituted around 90% of the national infection count—even though MMWs only make up about 5% of Singapore’s total population.⁶ Although this outbreak was eventually curbed with the complete lockdown of dormitories, relocation of essential workers, active testing and contact tracing, there was little regard for how these measures would affect the emotional and psychological well-being of the workers. There were reports of a wave of suicide attempts and deaths in the dormitories during the last week of July 2020, some of which were not reported in local media outlets⁷. Recent studies on the well-being of MMWs during the pandemic have highlighted the overall deterioration of their mental health due to health disparities, communicative inequalities, and extended periods of isolation.⁸ One study conducted by researchers from Yale-NUS found that “[c]omplete movement restrictions were associated with increased depression and stress symptoms … Participants who harboured fears about their health or job, perceived their health to be poorer, or had greater exposure to COVID-19 rumours reported higher depression, anxiety, and stress levels.”⁹

In an interview with the BBC, Alex Au from TWC2 discussed an incident where 16 workers were not immediately tested for COVID-19 despite being in close contact with a confirmed case.¹⁰ These workers were instead isolated in their rooms and would only be tested if they developed viral symptoms. Similarly, a frontline doctor who worked in the dormitories during the pandemic shared with us that many dormitory operators had chosen not to disclose COVID-19 test results to workers after they were tested, regardless of the result. While this was done to minimise the potential anxiety that infected workers might have felt, the withholding of information left many workers feeling stressed and confused; without the test results, workers were unable to tell if they were well or asymptomatic, infected with COVID-19 or the common flu. This uncertainty was further complicated by the lack of information given to workers about quarantine measures; workers were often confined or shifted around without any explanation about where they were being shifted to, whether they will return to the same dorm, the duration of quarantine, and why they were being moved. A worker tells us that he watched his dorm-mates removed from his room one by one without knowing where they went or when they would return, and he felt like he was waiting for death. Another worker shared that after 3 weeks of being quarantined alone in a windowless hotel room and not knowing when quarantine will end, all he wanted was to be able to see the sky. Workers also had difficulty accessing regular non-COVID related medical care during periods of quarantine.

The health of these workers was further threatened by the worsening of squalid dormitory conditions—it is estimated that around 19,800 workers were housed in rooms with cockroach infestations and toilets overflowing with urine.¹¹ Given the overcrowding in these dormitories, workers were often cramped together in rooms without sufficient space for safe-distancing. MMWs were thus constantly exposed to the threat of infection and deprived of proper living conditions in a lockdown that was claimed to be safe and beneficial for migrant health. 

While Foreign Domestic Workers (FDWs) were isolated in relatively better material conditions than  MMWs, many were completely confined in their employer’s homes and unable to find respite from their space of employment. This circuit breaker period saw multiple cases of employers blatantly abusing their power over domestic workers; some employers coerced their workers into staying at home by threatening to cancel their Work Permits, and others withheld salaries when their workers left the house on off-days.¹² As FDWs often lack the power and agency to navigate out of exploitative labour conditions, they become inundated with the stressors of extended work hours, restricted freedoms, wage insecurity, verbal abuse, and disrupted social networks.¹³ During the circuit breaker period, HOME saw a 20% increase in distress calls from FDWs, a majority of which were related to being overworked, having insufficient rest, and sustaining verbal abuse.¹⁴

The Psychological Toll of COVID-19

In the wake of the COVID-19 pandemic, the State has established a new task force known as Project Dawn to improve the mental health support provided to migrant workers—“Dawn” being an acronym for “depression, awareness, wellness, and normalisation”. Aimed at developing a “support ecosystem”, some of the task force's initiatives include supplementing the Settling-In-Programme with mental health education, equipping employers and supervisors with supportive skills, and improving workers’ access to professional care.¹⁵ Additionally, government authorities have also assembled mental health resources and helplines for the low-wage migrant population. 

However, while the State may frame its efforts as part of a “support ecosystem”, most of the proposed measures appear to adopt an individual-level approach towards mental wellness. These measures approach health disorders in terms of an individual’s behaviour and personal responsibility while glossing over the role of systemic problems in producing poor health outcomes. And this is especially apparent in the resources available on MOM’s website: 

The Ecosystem of Migrant Mental Health

What is purported to be a “mental health resource” here is essentially a compilation of self-management tips constrained within 5 minutes of a person’s day. These tips are wholly inadequate in addressing the stressors of wage insecurity, dangerous workplaces, abuse, inaccessible healthcare and other aspects of the migrant labour regime. It is undeniable that improved access to helplines and care services is important in improving migrant mental health. But without accounting for how labour injustice affects the body, these reactive measures only build a facade of effective intervention around the structural and material inequities of migrant life. Mental health will not flourish in an ecosystem populated by predatory loan mechanisms and extractive labour policies. 

For instance, financial debt is possibly one of the largest sources of stress for migrant workers in Singapore. In spite of growing research evidence around the relationship between financial debt and common mental disorders, little has been done to reduce the circulation of debt in the migrant labour economy—which is possible through labour protections like minimum wage laws, subsidised healthcare, and stricter pro-worker safeguards around salary claims. Research has shown that Bangladeshi workers approximately pay between $5,000 to $15,000 in recruitment/agent fees while earning the lowest salaries of $350 to $800 a month.¹⁶ And while salaries in the construction and marine sector are declining or remain stagnant, recruitment fees continue to rise.¹⁷ Coupled with the urgent need for loan repayments and remittances back home, the vast differences between wage and loan amounts forces some workers to pay their employers kickbacks of around $1000 to informally ensure that Work Permits will be renewed.¹⁸ Yet, the worker’s ability to repay their debt may be further compromised by their vulnerability to wage theft and unfair repatriations by employers. In a 2015 study conducted by SMU, debt incurred from unpaid agent fees was identified as one of the main causes of serious mental illness amongst regular South-Asian MMWs; the study highlights that the paying of an agent fee led to a 50% increase in the chance of developing a serious mental illness.¹⁹ Similarly, a 2015 report published by HOME demonstrates that debt is one of the prevailing risk factors for the mental health of FDWs, regardless of race or nationality.²⁰ For FDWs, the accumulation of debt is interlocked with the complicities between MOM’s labour regulations and the exploitative hiring practices of employment agencies (See ‘Agents of Exploitation’). While some may consider financial debt to be an individual factor of migrant mental health, it is evident that the repayment of debt and its associated health risks are prolonged or compounded through wage insecurity and other structural mechanisms that perpetuate the current transience and flexibility of migrant labour. 

To get a sense of the average salary breakdown of a migrant worker, we conducted a survey amongst construction and domestic workers to collect information about their monthly expenditures. Below are some of the respective breakdowns that we have received: