Peeling away the medical jargons and textbook descriptions of what constitutes a mental illness such as depression, social anxiety disorder, schizophrenia and many more – how exactly do these "diseases of the mind" devastate the life of the individuals?

Answers from that basic question should form the foundation of how healthcare professionals and relevant governing bodies strategise against mental illnesses. Unfortunately, due to the lack of awareness and support, those suffering from mental illnesses often endure relentless emotional onslaught from both within themselves and the outside world – and, more often than not, problems that originate from the latter are normally overlooked.

A war on two fronts

The prevalence of mental health problems among Malaysian adults increased 172% from 1996 to 2015. In addition, on average, 68 people call Befrienders Kuala Lumpur daily for help – in which 20 have suicidal thoughts.

That is only a small handful, as many suffering from mental illnesses do so – in silence – often, battling themselves. Other threats also exist, which may compound the situation: the near absence of social benefits and health insurance exclusion.

In Malaysia, laws and regulations that govern and protect the well-being and rights of mental health patients are relatively archaic, in comparison to other developed nations. Although individuals suffering from mental illnesses still have some legal recourse under the Persons with Disabilities Act 2008 – which include any long-term mental impairment that interferes with effective participation in the society as part of the definition of disabilities – the protection is far from ideal.

Laws governing mental health discriminations are very loose, therefore employers may exploit loopholes in existing regulations to dismiss employees with mental disabilities.
Laws governing mental health discriminations are very loose, therefore employers may exploit loopholes in existing regulations to dismiss employees with mental disabilities.

For example, the Act does not protect against discrimination – direct or indirect – of patients with mental diseases. As succinctly summarised by Relate Malaysia, individuals suffering from mental health may be at higher risks of being excluded from education or employment opportunities. Moreover, certain employers may exploit loopholes in existing regulations to dismiss employees with mental disabilities.

"It appears that (Employment Act) 1955 tends to favour the employer rather than the employee… the laws in Malaysia do not protect you (mental health patients) from being bullied or harassed because of your mental health…"

Apart from that, patients with mental illnesses also have to endure great financial burden when it comes to treatment for their diseases.

No insurance for mental health

The health insurance industry as well, has been widely criticised for listing mental illnesses as an exclusion to insurance coverage. In other words, policyholders most likely will not be able to claim against their insurance policy for any medical bill incurred due to mental illnesses – despite paying premiums.

There are many factors as to why insurers hesitate to cover for mental health issues. As insurance companies operate on a for-profit basis, there is an absolute need for them to evaluate the profitability in the mental health market. What hinders them from making a comprehensive evaluation of the lucrativeness of this market is the glaring lack of empirical evidence to support any business endeavour.

Not only does research in this field receive less attention, but there are indications that many states in Malaysia do not even have sufficient qualified specialists to service the population.

The lack of financial support from the government leaves many who suffer from mental illnesses to foot the expensive medical charges levied by the private sector.
The lack of financial support from the government leaves many who suffer from mental illnesses to foot the expensive medical charges levied by the private sector.

The situation is made worse by the expensive medical charges levied by the private sector. According to local sources, psychotherapy sessions can vary from RM250 to RM800 per session. When such patients cannot claim any payment from their existing health insurance, these hefty bills have to be paid out-of-pocket and cause a further drain on their finances.

Taking an example of the Australian healthcare development, Bronte Kumm, chief executive officer of Ramsay Sime Darby Healthcare Sdn Bhd (RSDH) suggested that insurance companies in Malaysia should consider including mental health treatment in their medical policies.

He advised that this would be a step in the right direction especially after a recent national survey revealed one in three Malaysians grappled with mental health issues.

“The prevalence of mental health problem is highest among teenagers and low-income earners,” said Health Minister Datuk Seri Dr S. Subramaniam recently.

However, the current situation is not hopeless. On contrary, mental health awareness is on the rise and various institutions are investing resources to improve the quality of treatment and care for our patients. With the introduction of the Mental Health Act 2001, it is hoped that the regulation can serve as the turning point in the provision of mental health care in the country. MIMS

Read more:
Malaysia’s stigma of people with mental health problems: a pressing concern
From the public to the healthcare community: Addressing the shortage of psychiatrists in Malaysia
NHMS: Mental health patients in Malaysia have doubled over ten years
Spotlight on mental health as depression becomes top cause of disability worldwide

Sources:
https://relate.com.my/what-are-your-mental-health-rights-in-malaysia/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618914/
https://www.ncbi.nlm.nih.gov/pubmed/15276949
http://www.tandfonline.com/doi/abs/10.1080/09638230500059997
https://www.themalaysianinsight.com/s/29094/
http://penanginstitute.org/v3/files/research_papers/Bridging%20Barriers_PenangInstituteinKL_LimSuLin.pdf
http://www.themalaymailonline.com/malaysia/article/less-than-400-psychiatrists-to-treat-over-4-million-malaysians-says-expert#s82r3hErcPsJCk3H.97
https://www.nst.com.my/news/2016/10/177661/why-insurance-companies-should-cover-mental-health-treatment-msia
https://www.whatclinic.com/psychotherapists/malaysia/counselling
http://huibee.com/2017/02/statistics-mental-health-in-malaysia/
https://www.nst.com.my/news/exclusive/2017/05/243354/suicide-rise-among-malaysian-youth