Many People With Anxiety Or Depression Aren't Getting Help — But There's A Reason To Be Hopeful
Most people dealing with anxiety or depression symptoms aren't getting professional help, and a new study puts a real number on that gap. Researchers surveyed adults who screened positive for anxiety or depression symptoms and found that the vast majority had never sought formal mental health care. Most of them, however, were open to something else entirely.
About the study
Peer support has been part of Singapore's formal mental health system for about a decade, yet uptake remains low, and there's been limited research into what people actually want from it. This study set out to fill that gap.
Researchers recruited 350 adults in Singapore who showed signs of anxiety or depression based on the Patient Health Questionnaire-4 (PHQ-4), a short, validated four-question screening tool. Participants were drawn from an online panel broadly representative of Singapore's population in terms of gender, ethnicity, and socioeconomic background.
The survey asked whether participants had used formal mental health services, whether they were interested in peer support, and, for those who were, what format and setting they'd prefer. Those who weren't interested were asked what was holding them back.
The study defined peer support as informal, non-professional support from someone with a similar lived experience, whether that's the same mental health diagnosis or treatment history. It's intended for non-crisis situations and isn't designed to replace professional care.
Most weren't getting help, but most wanted peer support
Of the 350 participants, 77% had not received any formal mental health care. Yet 62% said they were interested in peer support: 16% described themselves as "very interested" and 46% as "somewhat interested."
Among those who were interested, the preferences were clear. One-on-one support was the top choice (51%), compared to group support (21%). Virtual delivery was preferred over in-person (43% vs. 27%), with 29% expressing no preference either way. The most popular combination was one-on-one support delivered virtually (26%), followed by one-on-one in-person (18%).
What did people hope to get out of it? Emotional support topped the list (69%), followed by coping skills (52%), knowledge about treatment options (50%), and connection to relevant resources or people (47%).
Younger people, those in managerial roles, people who had recently used formal mental health care, and those who had previously served as a peer support mentor were all more likely to be interested in receiving peer support. Symptom severity and gender didn't make a difference.
Why so many people skip formal care & what peer support offers instead
The finding that 77% of symptomatic adults hadn't sought formal care isn't entirely surprising. Help-seeking is notoriously low across Asian countries, driven by stigma, fear of disclosure affecting career or social standing, and a general reluctance to acknowledge that a problem exists.
Peer support sidesteps many of those barriers. It's informal, lower-cost, and built around shared experience rather than clinical expertise. Talking to someone who has been through something similar, rather than a professional who is evaluating you, can feel less exposing. There's no diagnosis required, and unlike many depression treatment approaches, it doesn't require navigating a clinical system to get started.
The study also found that among those who had prior experience with peer support (either as a mentor or mentee), over 90% expressed interest in using it again, suggesting that once people try it, they tend to find it worthwhile.
For those who weren't interested, the top concerns were confidentiality (45%), wariness about talking to a non-professional (43%), and doubt that peer support would actually help (37%). These concerns point directly to what separates a well-run program from a poorly designed one.
What to look for in a peer support program
Not all peer support programs are created equal. Based on the study's findings and the concerns raised by those who weren't interested, a few things are worth looking for before joining one.
- Trained peer mentors: Peer supporters should receive formal training, not just share their personal experiences. That training should cover how to handle confidential information, how to recognize when someone needs professional care, and what falls outside the scope of peer support.
- Clear confidentiality policies: The top concern among those who declined peer support was confidentiality. A credible program will have explicit policies about what is and isn't shared, and with whom.
- A defined scope: Peer support is designed for non-crisis situations. Good programs make this clear upfront and have protocols for connecting participants to professional care if the need arises.
- A connection to broader care: Peer support works best as part of a wider system that includes professional services when needed, one layer in a stepped-care approach rather than a standalone solution.
How to find peer support for anxiety or depression
Look for programs affiliated with established mental health organizations, hospital systems, or nonprofits—these are most likely to have trained mentors and clear protocols. In some cases, peer support is offered directly through primary care or mental health clinics, which the study suggests may be a particularly effective access point, since people who have already sought formal care are more likely to engage.
When evaluating a program, ask about training requirements for peer mentors, how confidentiality is handled, and what happens if you need more support than the program can provide.
Virtual options are worth prioritizing—the data show that's where most interest lies, and online communities, app-based programs, and video-based one-on-one matching services have expanded significantly. Understanding how stress affects mental health can also help clarify what kind of support you're actually looking for, and thinking about mental and physical health together can help you see peer support as one piece of a larger wellness picture.
The takeaway
Peer support isn't a replacement for therapy or professional mental health care, but for the many people who aren't accessing formal care at all, it may be a more realistic first step. The data suggest that most people with anxiety or depression symptoms are open to it, and that format matters: one-on-one, virtual support is where interest is strongest. If you're considering it, look for programs with trained mentors, clear confidentiality policies, and a pathway to professional care if you need it.