• Articles
  • December 2023
  • 9 minutes

Bridging the Mental Health Gap in Asia: Challenges and opportunities

Asian woman in a red sweater looking out the window
In Brief

Mental illness in Asia is a significant and often poorly understood issue. The region faces a material protection gap, and the insurance industry is a key player in identifying opportunities to bring access and care to people in need.

This gap not only affects the quality of life of millions of people, but also poses challenges and opportunities for the local insurance industry.  

This article explores the systemic and individual barriers to mental healthcare in Asia and the implications for the insurance industry. It also provides some recommendations and considerations for insurers to close the mental health protection gap by offering more inclusive, affordable, and accessible products and services.

A pervasive, growing challenge 

According to the latest estimates, Hong Kong has more than two million people likely suffering from mental health disorders, which is 18% of the population. In China, about 170 million people likely suffer from mental disorders. The prevalence of mental health disorders and lack of diagnoses in these two examples are alarming and illustrate the diversity and severity of the problem across the region. 

The challenges are especially acute for the very young and very old, who have a higher prevalence of mental health disorders than the global average. These cases directly affect not only the patients themselves, but also their family members and care givers. Child and adolescent mental health problems, such as autism and ADHD, are often underdiagnosed and undertreated, leading to poor long-term outcomes. Similarly, dementia and associated elderly mental illnesses are often neglected and stigmatized, producing a heavy burden on caregivers and society. 

The overall prevalence of mental health disorders in Asia is likely underreported and outdated, given the lack of regular and comprehensive research in this area in the region. Furthermore, the impact of the COVID-19 pandemic, which has caused unprecedented stress, anxiety, and isolation for many people, has likely worsened the overall situation.

Systemic barriers to mental healthcare in Asia 

Several factors hinder the availability and quality of mental healthcare in Asia, including:

  • Continued stigma and discrimination associated with mental illness and treatment in many Asian cultures. Mental illness is often seen as a sign of weakness, shame, or dishonor, and therefore a taboo topic. This stigma prevents many people from seeking help early and also affects the attitudes and behaviors of family members, employers, and society at large. For example, in China, fear that a record of mental health diagnosis may be accessible through health screens and affect future employment opportunities may influence willingness to seek treatment.

  • Lack of mental health policies, laws, and funding in many countries. This results in a shortage of mental health professionals and facilities, especially in rural and remote areas, and low government expenditure on mental health services, compared to other high-income countries.

  • Inadequate integration of mental health services into primary healthcare and social welfare systems. Many people with mental health problems do not receive adequate care or support from the general health system and often face difficulties in accessing other essential services, such as education, employment, housing, and social security.

  • Low awareness and utilization of mental health resources and services among the general population. Many people are not aware of the signs and symptoms of mental health problems, the available treatment options, and the benefits of seeking help. Furthermore, many people do not utilize existing mental health resources and services, due to lack of knowledge, affordability, accessibility, or acceptability.

A woman leads a brainstorming session
RGA’s 2023 Global Mental Health Survey revealed several potentially actionable insights and highlighted the significant role insurers can play in shaping mental healthcare practices and outcomes moving forward.

Individual barriers to mental healthcare in Asia

In addition to the systemic barriers, individual barriers also influence the attitudes and behaviors of people toward mental health and seeking help:

  • Stigma and discrimination associated with mental illness and treatment in many Asian cultures. This stigma can affect the self-esteem, self-efficacy, and self-worth of people with mental health problems and make them reluctant to seek help or disclose their condition. It can also affect the social support and acceptance of people with mental health problems, making them vulnerable to isolation, rejection, and discrimination.
  • Financial uncertainty and hardship. The economic and social impact of the COVID-19 pandemic has exacerbated the mental health burden through increased financial stress for many people, especially those who have lost their jobs, income, or savings. Moreover, the cost of mental healthcare can be a significant barrier, especially for those who do not have insurance coverage or adequate social protection.
  • Lack of trust, communication, and understanding between mental health providers and clients. Many people may not feel comfortable or confident in talking to a mental health professional, due to language barriers, cultural differences, or personal preferences. Moreover, many people may not feel understood or respected by their mental healthcare providers, stemming from perceived or actual biases, stereotypes, or judgments.

Implications for the local insurance industry

The gaps and challenges in mental healthcare in Asia present both risks and opportunities for the local insurance industry. The low penetration and coverage of mental health insurance products and services, especially for outpatient and preventive care, indicates a huge unmet demand and potential market for insurers.  Some of the potential benefits of offering mental health insurance in Asia include:

  • Enhancing the social and economic resilience of individuals, families, and societies, by providing financial protection and support for people with mental health problems and reducing the burden on the public health and social welfare systems. 
  • Increasing customer loyalty and satisfaction with insurers by meeting the needs and expectations of consumers and providing value-added services that improve the customer experience. 
  • Reducing the claims and costs of physical health insurance, due to the comorbidity of mental and physical illnesses and the positive impact of mental health interventions on physical health outcomes. 
A profile image features Dr. Peter Farvolden
In a recent Inside RGA Q&A, Dr. Peter Farvolden, RGA's Mental Health Consultant, talks about his research into personality and temperament, why he is fascinated by the intersection of insurance and mental health, and more.

Reaping these benefits by offering mental health insurance in Asia also comes with its share of challenges, however, which include the following:

  • Managing the risks and uncertainties of underwriting and pricing mental health insurance – the lack of reliable and comprehensive data, the variability and complexity of mental health conditions, the potential for adverse selection and moral hazard, and more.
  • Developing and delivering culturally sensitive and tailored mental health insurance products and services that address the diverse and specific needs and preferences of consumers in different markets, segments, and contexts. 
  • Collaborating and competing with other stakeholders and players in the mental health ecosystem, such as mental health professionals, regulators, and community organizations, to ensure the quality and accessibility of mental healthcare and to comply with the relevant laws and regulations. 


Various cultural, social, and economic factors have created a significant protection gap around mental health in Asia. Insurers have a vital role to play in bridging this gap by raising awareness, providing education, as well as offering more inclusive, affordable, and accessible products and services. To do so, insurers – and other players in the mental health ecosystem – need to overcome the systemic and individual barriers to mental healthcare in the region and embrace the opportunities and challenges of offering mental health coverage to help improve not only the mental but also physical health of consumers. 

Contact us to learn more about how RGA is helping insurers meet the growing demand for mental health coverage. 

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Meet the Authors & Experts

Si Ning Zhao
Dr. SiNing Zhao
Regional Medical Director, RGA Asia Pacific