Keeping the conversation going on mental health

With socioeconomic restrictions easing, many are facing the prospect of going back to their regular office routine, which may require some mental adjustment after the flexibility of working from home, as well as possible social anxiety over acts that might cause the spread of Covid-19. — AZHAR MAHFOF/The Star

Recently, Prime Minister Datuk Seri Ismail Sabri Yaakob said that the Attorney-General’s Chambers is examining the legal options and implications of removing attempted suicide as a criminal offence.

This is an indication that Parliament may consider reviewing Section 309 of the Penal Code, which makes attempted suicide a criminal act.

The Prime Minister also called for a holistic approach when examining the issue of suicide.

Mental health stakeholders have wholeheartedly welcomed this announcement.

The Green Ribbon Group had long ago initiated a public discourse on not only reviewing Section 309 of the Penal Code, but also for the courts to consider using the relevant provisions in the Mental Health Act 2001 and the Mental Health Regulations 2010, without the need to refer to Section 309.

To be fair to our criminal justice system, justice has always been tempered with mercy when it comes to cases involving suicide most of the time.

There have been only a few cases of prosecution and sentencing, but then again, even one can be considered too many.

This is particularly so when the Mental Health Act makes provisions for the examining psychiatrist to be responsible for the observation and treatment of the person involved, as well as to issue a recommendation that can be provided to the court.

We shall leave the matter in the hands of our parliamentarians on both sides of the fence to discuss the issue, with the hope that the House passes a resolution that is acceptable to all stakeholders.

Opening the conversation

Just around the corner, on Oct 10, World Mental Health Day will be commemorated in most countries in one form or another.

Each year, the World Federation for Mental Health (WFMH) proposes a theme to the World Health Organization (WHO) and other United Nations bodies, which then derive a suitable slogan to be used internationally.

Malaysia had the honour of having our very own Tengku Puteri Iman Afzan as the International Patron of World Mental Health Day 2020, whose term will come to an end this Oct 10.

Many milestones have been achieved during this period and the move to decriminalise suicide was only one of them.

This year’s slogan “Mental Health Care for All: Let’s Make It A Reality” or adapted in Malaysia as “Menuju Kesaksamaan Kesihatan Mental” will mark more than 18 months since the start of the Covid-19 pandemic.

The day provides another opportunity for government leaders, civil society organisations and many others to talk about the steps to take in support of making this slogan a reality.

WFMH president Dr Ingrid Daniels commented on the theme, saying: “Worldwide access to mental health services remains unequal and the lack of investment in mental health disproportionate to the overall health budget contributes to the mental health treatment gap.”

Former WFMH president and The World Dignity Project chair Professor Dr Gabriel Ivbijaro, in calling for action, said: “In the wake of Covid-19, millions of people have uncovered new mental health conditions and millions more have had their existing challenges exacerbated.

“While more people than ever before are comfortable discussing mental health, many fall through the cracks in the space between awareness and action.”

He added that the stigma and discrimination experienced by people who experience mental ill health also affects their educational opportunities, current and future earnings, and job prospects, not to mention the impact on their families and loved ones.

Yet, there is cause for optimism.

During the World Health Assembly in May (2021), governments from around the world recognised the need to scale up mental health services at all levels.

Some countries reported new ways of providing mental healthcare to their populations such as school-based socio-emotional learning programmes to improve mental health and prevent suicide in adolescents.

In Malaysia, the pandemic brought to the surface many mental health issues, and not just concern on the hike in suicide cases.

It broke open public discourse on all issues relating to mental health.

Typically, such issues are unintentionally sidestepped, partly due to the lack of conspicuous leadership in treating community mental health as a cross-cutting issue that goes beyond the conventional construct of health.

However, the pandemic saw the emergence of new mental health non-government organisations (NGOs) and research institutions combining forces with the government to usher in a willingness to openly discuss issues concerning mental health – a synergism that was not optimised during “normal” times.

Social anxieties

Even as the pandemic gradually gets normalised into an endemic, issues like workplace mental health will continue to linger on for some time.

Paradoxically, there is anxiety in returning to work with concerns of contagion, work schedules and changes in workspace.

Employees might have gotten used to the flexible work-from-home lifestyle that allowed them more freedom to also focus on family or work on individual goals.

Therefore, those who have had the opportunity of working from home may find it frustrating to get back to their previous in-office routine.

Reports from public universities also suggest that while students were initially keen to return to campus, some have expressed reservations doing so now.

Among their reasons are fear of being infected with Covid-19 in campus and hostels, as well as apprehension of having to use public transport.

Paradoxically, the predicted joy of returning to normalcy may cause more anxiety in terms of social life too.

Fears over maintaining physical distancing and interacting with someone whose vaccination status is uncertain can be overwhelming for some.

Questions on when to remove the face mask or that a refusal of a handshake might be deemed offensive, might also increase worry and anxiety.

For many, returning to the new normal will seem very much like the old normal with all its drawbacks and then some.

There is much work to be done.

Clearly it is not so easy as pressing the reset button.

Let us be innovative in our ways to tackle mental health issues, harnessing the great inner resilience of the Malaysian Family as we march into a new dawn.

We need to keep the momentum going with the hope that returning to normal life does not mean sweeping these hard conversations on mental health back under the rug.

Datuk Dr Andrew Mohanraj is a consultant psychiatrist, Green Ribbon Group policy advisor and Malaysian Mental Health Association president. For more information, email The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Mental health , suicide


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