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Focus: Does Malaysia have a mental health problem?

Published on 23 April 2018|
2 min read

Mental health issues are of concern but conversation surrounding them is still severely stigmatised.

by Emily Mary Chin, Carrybeans

A few months ago, the Institute for Public Health (IPH) released an infographic that was part of the National Health and Morbidity Survey 2015 (NHMS 2015).  The survey—first conducted in 2015—pinpoints Sabah as the state with the leading number of mental health issues.  It estimates that about 42.9% of the Sabahan population is currently suffering from some kind of mental illness.

The same survey also notes an overall upturn in the prevalence of mental illness in Malaysia in the last decade.  While mental health problems only accounted for 10.7% of the population in 1995, the number had jumped to 29.2% by 2015.  That accounts for one third of the population and around 4.2 million Malaysians.  But despite that alarming number, there are only 360 psychiatrists registered in private and public sectors within Malaysia.  This means that there is only one psychiatrist to every 200,000 of our country’s population.  This is far less than the 1:10,000 ratio that the World Health Organisation (WHO) recommends.  In order to meet that ratio, Malaysia would need at least  3,000 registered psychiatrists.

Why are mental health resources in Malaysia so limited?

The sad truth is, mental health is still a considerably taboo subject here in Malaysia.  Because people are not talking about it, they are also not informing themselves on what mental illness really is.  And because people are not informed, they are not able to detect mental illness within themselves or the people around them.  As people are mostly unaware about issues regarding their mental health, they do not feel the need to seek treatment.  Hence, we end up with less resources than we truly need.

Credit: Morguefile

Mental illnesses like depression are hard to pin down due to their intangibility.  The NHMS 2011 estimated that only 1.8% of Malaysians suffer from clinical depression.  However, International Medical University’s consultant psychiatrist, Dr. Philip George, believes that number is seriously understated.  Based on his observations and experience, he believes that the number should be closer to 40%.

Emotional needs are not a factor in Asian culture

There have been various accounts from people within the Asian community expressing difficulty in understanding and communicating mental health concerns to their Asian families.  In typical Asian culture, emotions are considered weakness.  Most people growing up in Asian families do not discuss feelings of intense emotion because there is an added invisible layer of shame attached to it.

The difference is Asians do not talk about their problems.  Unlike Caucasians, Asians do not have the words for emotions and that is a huge barrier.

– Dr. Philip George, consultant psychiatrist (International Medical University)

Many Asians grow up not understanding or knowing how to express their emotions.  Their environment never taught them how to cope with intense emotions in a healthy and constructive way.  Thus, they end up creating unhealthy coping mechanisms to deal with them on their own.  Coping mechanisms can be especially harmful because they are usually addictive in nature.  Excessive substance abuse, promiscuity, sleeping too much or too little, excessive eating, self-mutilation, and even excessive shopping, are all examples of the dysfunctional methods of which people most commonly use to cope with their depression and anxiety.

Credit: Pixabay

These dysfunctional coping mechanisms may evolve into a personality disorder if left unchecked over an extended period of time.  We as human beings have the ability to adjust our personality for the sake of self preservation.  How a person deals with their mental health needs dictates their behaviour and decision-making.  A person who continuously fails to acknowledge their anxiety or depression will not be able to differentiate between emotional reactivity and rational thought.  This will inevitably cause them to make decisions and live a life that is skewed towards unconsciously shielding themselves from having to face their mental health issues head on.

Depression and anxiety are doorways to other disorders

Research has also found that people suffering from mental disorders like schizophrenia, bipolar disorder, autism spectrum disorder, as well as attention-deficit hyperactivity disorder, all share several of the same genes within their DNA.  What this means is that these mental illnesses could all be different variations originating from the same disorder.  It makes sense when you consider the implications of using unhealthy methods to cope with depression or anxiety.  Previous research has also shown that schizophrenia, bipolar disorder and depression, in particular, can be genetically inherited.

Depression and anxiety are common links between various mental illnesses and are oftentimes interchangeable.  In fact, bipolar disorder is actually considered a variation of depression and is also referred to as manic-depressive disorder.  Symptoms of borderline personality disorder are also starkly similar to symptoms of depressive and anxiety disorders.  With depression and anxiety being linked to so many different mental illnesses, it is clear that their treatment must be taken very seriously.

Credit: Pexels

According to WHO, depression is currently the leading cause of disability worldwide.  What this means is that people suffering from depression stand to lose the most years to their disability as compared to other disabilities.  Depression is debilitating and greatly reduces people’s ability to function consistently on a day-to-day basis.  What’s more, it is an illness that does not really ever go away.  People suffering from depression can often expect to have recurring symptoms throughout their life.

And if it doesn’t lead to other mental illnesses, we also have to consider possibilities of it triggering cases of suicide.  WHO reports that about 800,000 people commit suicide every year.  On average, this translates to one person committing suicide every 40 seconds.  And with every one person who dies of suicide, WHO estimates that there are another 20 people who unsuccessfully attempted it.  This is a huge problem that could be better resolved with treatment.

Mental illness is detectable

Fortunately, mental illness carries signs and symptoms that can be detected early on.  Deputy director-general of public health, Datuk Dr. Lokman Hakim Sulaiman, has advised the general public to look out for these few signs and symptoms of possible mental illness:

  • Prolonged sadness
  • Constant feeling of irritation
  • Difficulty maintaining concentration
  • Excessive feelings of fear, worry and anxiety
  • Loss of interest in keeping up with routine chores
  • Becoming withdrawn
  • Drastic changes in eating and sleeping habits

If you or anyone you know are currently experiencing any or all of the above symptoms, we recommend making an appointment with a psychiatrist to get a proper assessment.

Resources here may be limited, but there are resources

Some mental health resources available to people seeking information, treatment or support are:

A common reason why people choose not to seek treatment is also the financial cost it bears.  Private psychiatric treatment can be very costly.  However, if  you can get confirmation from a private psychiatrist that you are in fact suffering from some form of mental illness, they are able to refer you to a psychiatrist in the public sector, which will be significantly more affordable.

Mental illness does not always have the same face

However, it is important to note that mental illness expresses itself differently in different personalities.  There is such a thing as high-functioning mental illnesses.  A person may have their lives seemingly together despite deep mental and emotional suffering.  Mental health excludes no one.  Even public figures like Mariah Carey and Michael Carrick have confessed to suffering from mental illnesses in their respective lifetimes.

Credit: Pexels

Oftentimes, our loved ones may not be aware of any mental health issues we may be having.  They may not be able to detect any issues and instead assume that ‘it’s just you being you’.  Relying on other people’s opinion to tell us whether or not our condition requires psychiatric help can be damaging to our own self awareness and perception.

But whether or not there is a legitimate issue, there is no harm in going for a psychiatric assessment to find out for sure.  You shouldn’t have to second guess it.  Your mental health is your own responsibility and it requires attention and care just as much as your physical health does.  If your body were exhibiting symptoms of chronic illness, you would go to a doctor to get a physical assessment.  The same logic applies to your mental health.

So, a general rule of thumb: if you’re feeling like you need help or support in regards to your mental health, that’s already a good enough reason to seek it out.

Sabah is the leading state with the highest population of mental illness.  Read our thoughts here.

Featured Image Credit: Morguefile

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