Local news reports and global headlines have diligently highlighted recent subjects on medicine, diseases and health, including topics related to cancer, obesity, diabetes, nutrition and exercise, vaccinations, as well as potential cures for diseases, to name only a few.

Media attention has been helpful in raising awareness of the importance of health amongst the public, but are good blood pressure readings and excellent cholesterol levels the sole parameters for good health?

Addressing the biopsychosocial model of health

The World Health Organisation (WHO) defines health as “a state of complete physical, mental and social well-being, and not merely the absence of disease,” inadvertently underlining that a holistic approach to health should reach beyond the biomedical dimensions of illness to also take account of the individual’s social and mental wellbeing.

Psychiatrists are health professionals who specialise in the field of mental health – a field that addresses the component of mental well-being in individuals, and focuses on mental healthcare, be it through prevention, treatment or rehabilitation, and the field of psychiatry has come a long way from the times of trepanning and lobotomy practices.

Unlike clinical psychologists, psychiatrists are qualified medical doctors, but the distinction does not solely lie in the fact that psychiatrists are allowed to prescribe medicines to patients. As clinicians, psychiatrists have acquired clinical skills and are medically trained to obtain a patient’s medical history, perform physical examinations and request for laboratory investigations, to diagnose and address the varied medical etiologies of psychiatric symptoms.

“Psychiatrists have a stronger sense of biology and neurochemistry,” according to Ranna Parekh, director at the American Psychiatric Association.

“Theirs is going to be a diagnosis of exclusion. For instance, before we call someone depressed, we’re going to make sure they don’t instead have some vitamin deficiency or thyroid problem.”

Need for more psychiatrists and awareness of mental health issues

The latest Global Health Estimates by the WHO further predicts that over 300 million individuals worldwide are affected by depression, an increase of over 18% between 2005 and 2015.

Consistent with the global trend, the 2015 National Health Morbidity Survey in Malaysia reported that 29.2% Malaysians above the age of 16 suffered from poor mental health – translating to 4.2million people – and the statistics have seen an increase compared to the 11.2% reported in 2006.

Unfortunately, stigmatisation and lack of awareness of the detrimental effects of mental health issues prevent individuals from seeking help, and despite the increase in numbers of mental health problems, too few doctors opt to specialise in psychiatry. Between 1995 and 2013, the total number of psychiatrists increased only by 12%, while the number of physicians jumped by 45%.

One reason may be because psychiatry is one of the lower-paying specialties. According to the American Association of Medical Colleges, while neurologists and neurosurgeons received a starting salary of $250,000 and $475,000 respectively, general psychiatrists earn $185,300.

“Most mental illnesses don’t improve on their own and, if left untreated, may get worse and cause other serious problems,” said Malaysian Deputy director-general of health Datuk Dr Lokman Hakim Sulaiman.

To address the growing concern of mental health issues, the Malaysian government initiated the five-year National Suicide Prevention Strategic Action Plan in 2012, under which the Health Ministry aims to increase availability and accessibility to mental health services through migration of such services from hospitals to community mental health centres. The plan also targets to improve the current ratio of psychiatrists to population from 1: 150,000 to a more ideal 1: 50,000.

Meanwhile in Singapore, the 2011 Mental Health Atlas revealed that there were 2.81 professionals working in the mental health sector per 100,000 population. In the recent Budget 2017 statement, Singaporean Finance Minister Heng Swee Keat announced that individuals with mental health issues will be provided with additional support, with the government projecting an additional expenditure of S$160 million on community mental health issues in the next five years.

“Mental health issues may not be easy to talk about, but we can make good progress when the community comes together,” he said. MIMS

Read more:
Most doctors with mental health issues do not seek treatment
NHMS: Mental health patients in Malaysia have doubled over ten years
One in three Malaysians have mental health problems as government action plan to be unveiled