Nine out of 10 Asian workers experiencing a mental health condition will not seek help from their employer – and in most cases, their employer has no program in place to reach them anyway.
That dynamic, documented in a report published by insurer QBE, sits at the centre of what the company describes as a widening gap between employer awareness and meaningful action on workplace mental health. The findings carry direct relevance for insurance professionals. Workers’ compensation frameworks across Asia treat mental disorders inconsistently, liability exposure under occupational health and safety laws remains poorly understood by many employers, and the productivity losses tied to untreated conditions are large enough to affect the risk profile of businesses across virtually every sector.
Rachel Pu (pictured), QBE’s Asia head of workers’ compensation, said the pattern holds across markets and company sizes. “While there is much intent on the part of companies to support mental wellness, action remains limited. In our conversations with customers about this topic, overwhelmingly the largest barriers to promoting workplace mental wellness are knowing where to start, what to focus on – and in many cases, justifying spend,” Pu said.
The aggregate cost of workplace mental health conditions gives insurers and risk managers a concrete basis for concern. Depression and anxiety alone eliminate an estimated 12 billion working days annually worldwide, with the associated productivity loss put at US$1 trillion. Asia’s exposure is disproportionate. The report states that 82% of workers across the region carry moderate to high risk of developing a mental health condition – a figure that helps explain Asia’s productivity score of 47.2 out of 100, which trails the US at 66.7 and Europe at 60.1. The report draws a direct connection between the region’s mental health burden and that performance gap.
At the market level, the numbers are specific enough to inform underwriting considerations. Singapore recorded an estimated US$11.72 billion in productivity losses in 2022 tied to anxiety and depression. Beyond output, untreated mental conditions correlate with elevated absenteeism and staff turnover – two variables that feed directly into the risk calculations insurers apply to group health and workers’ compensation products. The operational effects also register at the customer-facing level. The report cites data showing that 37% of workers with mental health conditions are prone to conflict with colleagues, 80% experience difficulty concentrating, and 50% display impatience toward customers – patterns with implications for sectors where client-facing performance is a core underwriting consideration.
Worker sentiment data reinforces the picture of institutional underinvestment. In Singapore, 56% of workers in one study said their employer did not provide sufficient mental health support. In Vietnam, only 21% of workers reported satisfaction with their company’s culture of openness and psychological safety. Malaysia recorded 13% when workers were asked whether they were highly satisfied with available mental wellness resources.
Hong Kong posted the lowest figures in the report: approximately 12.5% of employees had received any form of employer support, according to data presented to the region’s legislature. The report cautions against the assumption that mental health challenges are concentrated among junior employees. Directors, senior managers, and business owners experience workplace mental health conditions as well – a point relevant to key-person risk assessments and executive benefit structures.
One gap the report identifies is the tendency for employers – and by extension, risk and HR functions – to focus narrowly on depression and anxiety while overlooking a much wider diagnostic landscape. The American Psychiatric Association recognizes more than 200 mental disorders, and the report draws on that figure to argue that employer awareness, and by extension risk management frameworks, need to reflect that breadth.
The conditions covered include anxiety disorders such as PTSD, OCD, social phobia, and generalized anxiety disorder; mood disorders including various forms of depression and bipolar disorder; neurodevelopmental conditions such as ADHD and dyslexia; personality disorders; psychotic disorders; eating disorders; and substance use disorders. The report notes that patients frequently experience more than one condition simultaneously, which can complicate both diagnosis and return-to-work timelines.
Psychosomatic conditions add another layer. Psychological stress can worsen a range of physical health conditions, including arthritis, diabetes, heart disease, high blood pressure, obesity, skin conditions such as psoriasis and eczema, seizures, and sleep disorders. For insurers writing workers’ compensation or group health coverage in construction, hospitality, and manufacturing – sectors where workers operate heavy machinery – the interaction between psychological distress and physical impairment represents a claims risk that is not always captured in conventional risk assessments.
The inconsistency of mental health coverage under workers’ compensation laws across Asia creates materially different liability profiles from one market to the next. The report maps the key provisions. Singapore amended its Work Injury Compensation Act (WICA) in 2019 to define the conditions under which mental disorders are compensable. Three criteria apply: the condition must be clinically diagnosed, caused by a workplace accident, and the accident must have arisen in the course of employment. Between 2014 and 2019, three claims meeting these criteria were compensated under the act – a low number that the report implies may not reflect actual incidence.
Hong Kong’s Employees’ Compensation Ordinance (ECO) excludes mental disorders outright. However, the Occupational Safety and Health Ordinance (OSHO) places a general duty on employers to protect worker health and safety, with no distinction drawn between physical and mental health. The report identifies this as a potential source of unrecognized liability: an employer who fails to address the causes of mental disorders could be found non-compliant and face compensation claims through that channel.
Malaysia’s Social Security Organisation (SOCSO) processes between 400 and 500 mental health claims each year. Eligibility requires a psychiatrist diagnosis, a finding that the condition is treatment-resistant, and evidence that it has reduced the claimant’s earning capacity by at least one-third. In Vietnam, the compulsory Social Insurance (SI) scheme may extend to inpatient care for severe mental health conditions. The report advises employers to seek jurisdiction-specific legal counsel, noting that regulations across all these markets remain subject to change.
The 90% non-reporting figure is among the more consequential data points in the report for anyone designing a workplace mental health program or assessing the adequacy of an employer’s risk controls. Fear of stigma is cited as the primary reason workers do not seek help – which means that visible program uptake is a poor indicator of actual need. That gap between reported and actual incidence has practical implications for claims management and for the assumptions that underpin group health and income protection pricing. Conditions that go unaddressed tend to worsen, extending treatment timelines and increasing the likelihood of long-term absence.
The report points to a set of observable indicators that managers can be trained to recognize: behavioural changes, difficulty concentrating, persistent fatigue, loss of appetite, musculoskeletal or chest pain, dizziness, restlessness, nervous twitches, and irritability. Given that self-reporting cannot be relied upon, the report places significant weight on equipping line managers to identify and respond to these signs. When a concern is identified, the recommended approach is a private conversation focused on specific observations rather than broad characterizations, with space given for the employee to respond. Treatment options referenced include professional therapy, antidepressants and anti-anxiety medication, and supplementary approaches such as yoga, meditation, tai chi, and aromatherapy.
The report recommends that businesses establish continuous measurement mechanisms rather than treating mental health as a periodic initiative. These include employee surveys, HR data analysis tracking absenteeism, turnover, and productivity trends, structured one-on-one check-ins with designated mental health champions, and focus groups facilitated by external specialists. QBE’s proposed employer response runs across three stages. Prevention centres on building an inclusive workplace environment, enforcing anti-harassment and anti-bullying policies, training line managers, encouraging work-life balance, and introducing a confidential employee helpline. Identification requires managers to recognize and act on the behavioural and physical warning signs outlined above. Action involves meeting promptly with affected individuals, exploring flexible working arrangements or adjusted deadlines, obtaining medical input while forming independent assessments, and maintaining confidential records of all relevant discussions.
With mental health legislation across Asia still evolving and employer liability remaining inconsistently defined from one jurisdiction to the next, the report’s broader implication for the insurance industry is that the risk landscape in this area is still being written – and that the employers best positioned to manage it are those who begin treating workforce mental wellness as an operational and legal priority now, rather than after a claim has been filed.
