One in three Malaysians is struggling with mental health issues and the government has realised the urgency of the situation. As such, a National Mental Health Strategic Action Plan (NMHSAP) is under development to lay out the best effective measures to tackle the problem.

Health director-general Datuk Dr. Noor Hisham Abdullah, said that the five year plan (2016 to 2020) will entail the programmes and strategies that are to be put in place for the government, non-governmental agencies (NGOs), employers, schools and the public.

"Once the plan is out, proper monitoring and implementation must be done," he said.

The 2015 National Health Morbidity Survey (NHMS) reported that 4.2 million Malaysians above the age of 16 (29.2%) suffered from the problem, compared to 11.2% in 2006. The Health Ministry also recently revealed statistics that showed worsening state of mental health problems among students in Malaysia, from one in ten individuals in 2011 to one in five in 2016. It is also expected that mental health problems will rank as the second biggest health problem after heart disease in Malaysia by 2020.

The rise in numbers could be due to increasing levels of stress in school or work environments, lack of emotional support and social stigma towards those with mental health problems.

Social stigma due to lack of mental health awareness

There is still a prevailing stigma in our society that equates people with mental health problems as those with mental illnesses, depicting them as crazy and cannot be helped, which makes it more difficult for them to come forward for treatment.

Dr Uma Visvalingam, a consultant psychiatrist at Putrajaya Hospital, said there was prejudice against those with mental health problems because most people had misconceptions about their condition.

"They do not really understand the difference between mental illness and mental health problems. The two conditions have different medical approaches.

"People are quick to judge and say they (mental health patients) are crazy, when they actually require monitoring by psychiatrists," she said.

The Malaysian Mental Health Association deputy president Datuk Dr. Andrew Mohanraj Chandrasekaran said that early detection of poor mental health and early treatment are extremely important to prevent further complications and the increased risk of developing mental illnesses. He added that a significant number of Malaysians suffered from a form of psychological distress, whether they realise it or not.

NHMSAP to promote awareness of mental health screening and early detection

Dr. Noor Hisham said that to address this issue, the NHMSAP will stress the need to put mental health on the agenda in all agencies, to obtain stakeholder engagement and to work closely with the NGOs. Previously, the National Mental Health Policy, the Mental Health Act 2001 and a National Strategic Suicide Action Plan had been developed.

"Now, we are developing this plan in line with the World Health Organisation's comprehensive mental health action plan (2013 to 2020) to deal with the increase in mental health cases in Malaysian society," he added.

The plan aims to create awareness, improve human resource management and strengthen research and screening for mental health, focusing on suicide and depression. As such, the plan is stated to be a public health approach, with cross-sectoral collaboration among agencies and training of NGOs, to offer accessible and comprehensive mental health care and services.

Dr. Noor Hisham said that mental health services should include mental health promotion, screening and early detection, treatment and care, and rehabilitation, including basic psychological aid during a crisis, research and surveillance.

Insurance should cover mental health issues too

In a recent interview, Ramsay Sime Darby Healthcare (RDSH) chief executive officer Bronte Kumm said that mental health was more broad-based than the public assumes. Individuals who are anorexic, bulimic or suffering from a certain eating disorder are most probably suffering from a mental health issue.

"We're all for evidence-based early intervention that would help ease those suffering in silence, but unfortunately, many who are in need of professional help are not getting therapy due to the costs," he said, adding that mental health issues are often treated lightly and are usually not easy to spot.

Kumm suggested that insurance companies in Malaysia should follow in the footsteps of healthcare development in Australia, whereby mental health treatment is included in their medical policies. With the ever-growing number of Malaysians suffering from various mental health issues, Kumm said that this would be a step in the right direction.

The prevalence of mental health problems is also the highest among teenagers and low-income earners, who therefore cannot afford the costs of treatment. Many suicide cases were also triggered by severe work and emotional stress, as well as unemployment, marital problems, financial crisis and drug abuse, contributing to a more than twofold increase in mental cases in Malaysia over the past decade.

Association of Private Hospitals of Malaysia (APHM) president Datuk Dr. Jacob Thomas agreed with Kumm's suggestion for insurance companies to include mental health in their policies.

Dr. Jacob said that the WHO defined health in a broader sense as "a state of complete, physical, mental, and social well-being and not merely the absence of disease or infirmity." As such medical insurance companies should review their medical policies to claim that they offer full health coverage.

MOH, MOE, NGOs and companies to work together

As mental health promotion should be stressed in schools and workplaces to ensure mental wellbeing and boost mental health awareness, Dr. Noor Hisham also said that the MOH will expand the Healthy Mind Programme at schools and work closer with the Ministry of Education (MOE) and NGOs to train teachers on coping skills and building up resilience.

In workplaces, he encouraged each company or organisation to establish a stress management programme for a healthy workforce.

The ministry also hopes to increase the number of psychiatrists, psychologists and nurses three-fold especially when the current ratio of psychiatrists is just 1:150,000.The number of treatment centres and community mental health centres is also hoped to be increased.

The plan has involved experts - including psychiatrists, family medicine specialists, clinical psychologists, psychologists, public health specialists, paramedics, caregivers, youth representatives, teachers and advocates of mental health - from all relevant bodies and agencies to draft the plan. MIMS

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