Education on mental health issues needed

THERE has been an average of almost four suicide cases a day in the first three months of 2021, totalling up to 336 cases reported to the police.

As revealed by Health director- general Tan Sri Dr Noor Hisham Abdullah, this is more than half of what was reported throughout 2020. Last year saw 631 suicide cases recorded, an increase from the 609 recorded in all of 2019.

What is more worrying, say mental health professionals, is that this number might only be the tip of the iceberg because suicide cases in Malaysia are likely underreported.

According to Mental Illness Awareness and Support Association (Miasa) president Anita Abu Bakar, this is largely due to the stigma attached to struggles with mental health issues and disorders, self-harming and suicidal thoughts and ideation as well as substance abuse.

“Internalisation of stigma due to religious or cultural reasons, or judgement and labelling, fear of criminal persecution, a general lack of awareness or barriers to appropriate resources remains a challenge,” she says.

Anita also points out that the suicide figures released do not include those that have self-harmed or attempted suicide and died in hospitals.

Anita: Suicide cases in Malaysia are likely underreported ‘largely due to the stigma attached to struggles with mental health issues’. — Filepic/The StarAnita: Suicide cases in Malaysia are likely underreported ‘largely due to the stigma attached to struggles with mental health issues’. — Filepic/The Star

“Our National Registry of Suicide is in a stage of development currently according to a representative from the Health Ministry. From what I understand, this registry stopped recording in 2009. We need it to be revived fully to get more accurate data,” she says, adding that there is an increase in the number of people reaching out to Miasa for help.

Even those who have not faced any mental health challenges before are now experiencing some aspects of it, with many falling into depression, having anxiety and going through bouts of panic. Others are battling increased suicide risks, with some resorting to harmful coping mechanisms.Miasa, which offers free peer support for the B40 (lower income) group, has recorded 43,997 people reaching out to them from August 2020 to May 2021 via its remote services.

“One out of every three callers presents suicidality. The most common issues include anxiety, then depression and stress, followed closely by borderline personality disorders and schizophrenia and bipolar disorders,” says Anita.

To create a more inclusive environment in Malaysia, she suggests empowering the public to stop the stigmatisation by providing psychoeducation in schools and workplaces as well as having people with lived experience be a part of policy and decisionmaking at all levels of society.

Anita also cautions against unsafe, unethical and sensationalised reporting of suicide cases in the media, adding that making pictures and videos of such cases go viral on social media would lead to “suicidal contagion” and encourage suicide “copycats”, a documented phenomenon.

“Also, mental health is definitely underfunded and under-invested and we still lack many resources with much of the National Health Budget for mental health being given to the four big psychiatric hospitals housing those with chronic mental health conditions even though such conditions only account for about 1% of those struggling with mental health disorders. Hence, many are undertreated and not helped in the community,” says Anita.


Concurring that suicide cases tend to be underreported due to stigma, psychologist Dr Anjhula Mya Singh Bais says this is also true based on worldwide trends. She also believes that the numbers are higher than presented as the world is going through an unprecedented mental and emotional health crisis.

“In psychology, there’s this idea of collective consciousness and there have been amazing studies on it – for example, you can feel the collective emotion of joy and pride when Malaysia wins sports medals or during the last general elections. The same concept could be linked to pain and suicide.

“Worldwide, we are seeing an uptick in the need for mental health services and discussions,” she says.

Dr Anjhula adds that while each person understandably has a different level of resilience, many are reaching a tipping point, with Malaysians in all income brackets affected by the Covid-19 pandemic. The current social and economic restrictions especially are causing a tsunami of mental health issues.

“B40 struggles are going to be different from those of the M40 (middle income group) or T20 (top 20% income earners’ group), but everybody is struggling. There are people struggling to put food on the table while on the other end, someone is thinking about how to let 2,000 workers go.

“The government must put psychology and mental health into play in its pandemic response and management instead of just implementing lockdowns as they come at great psychological costs,” she says.

Besides therapy, counselling interventions such as exercising, the grounding method (find five things you can see, four things you can feel, three things you can hear, two things you can smell, one thing you can taste), and the emotional freedom technique which involves tapping with fingertips to stimulate energy points on the body, can help with stress and anxiety relief, she says.

“I’m not asking you to have a solution or plan for a year from now. I’m talking about taking it one hour or one minute at a time,” says Dr Anjhula.

“Research has shown that the dark impulse that tells you life is not worth living lasts about 45 seconds. Find a way to distract yourself and buy time until that impulse passes.

“Our ancestors have gone through the bubonic plague in the 14th century, the 1918 flu pandemic and one day, hopefully soon, we will cross over to the other side where it is a post Covid-19 world,” she says.

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