A shortage of psychiatrists

Reports by DIYANA PFORDTEN, ILI AQILAH and FATIMAH ZAINAL

PETALING JAYA: There are enough mental health facilities in the country to support those in need, but more professionals in the field are needed, say experts.

The stigma that continues to be associated with mental illness and its hospitals also discourages patients from accessing these facilities, they said.

Universiti Malaya Specialist Centre consultant psychiatrist Assoc Prof Dr Amer Siddiq Amer Nordin said the country has public and private mental health facilities that are fairly accessible and affordable to most, if not all, Malaysians.

“In the public sector, we have Mentari, health clinics and also most hospitals have a psychiatrist even in the smallest towns.

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“Our NGOs also provide some level of support including counselling services.

“For the private side, we have psychiatrists, psychologists and counsellors available,” he said.

He said that in terms of medications, Malaysia is among the few countries where there are plenty of options for all types of mental illnesses.

“Some of them are supported by our government. Some countries like Indonesia, they have limited options for medications, and in others, they do not have enough psychiatrists, with only 10 or so for the whole country.”

However, with the increasing number of children in need of mental health support, Dr Amer Siddiq believes there needs to be more specialists and services that cater to this category.

In general, the country is short of psychiatrists.

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“We have about 500 psychiatrists in Malaysia and the ratio is not according to what is recommended by the World Health Organisation,” he said.

The recommended World Health Organisation ratio is one psychiatrist serving 10,000 people. Malaysia has less than one (0.52) psychiatrist per 100,000 persons.

Dr Amer Siddiq said Malaysia also lacks allied health support such as having sufficient psychologists, especially in public universities.

He said insurance companies need to consider incorporating health coverage for mental illness, while more funding is needed to train mental healthcare providers.

“We also have to continue supporting NGOs to assist in reducing the stigma on mental illness.”

Malaysian Mental Health Association president Datuk Dr Andrew Mohanraj said while the country has acceptable government mental health facilities that cater to both outpatient and inpatient services, it is not the same with the private sector.

“Private mental health clinics that cater to outpatient services are largely concentrated in the Klang Valley and Penang.

“There are only two private hospitals with inpatient facilities for psychiatric patients in the entire country.

“Private hospitals appear to be reluctant to incorporate mental health inpatient services,” he said.Dr Andrew added that this is largely due to limited financial resources in the private sector, with extremely limited private insurance coverage for mental health services in general and inpatient psychiatric services in particular.

“The public is advised to be aware of which public hospital has an inpatient psychiatric facility as this would facilitate admission if needed, rather than being transferred to another hospital with such facilities in case admission is deemed necessary,” he said.

He said general practitioners (GPs) also need to be empowered to examine and treat mental health cases and refer patients to a psychiatrist when needed.

“This will also decrease the burden of specialist psychiatrist services which can then focus on more serious and difficult cases,” said Dr Andrew.

Child psychologist Katyana Azman said the stigma associated with mental health hospitals causes many people to avoid such services.

“People are shocked to find how many facilities for mental health we have in the country.”

She said mental health facilities need to improve in terms of dissociating themselves from the stigma of a “mental hospital”.

“We can start by calling them centres rather than clinics or hospitals, or having independent centres that are not attached to hospitals,” said Katyana.

She added that psycho-education should also be improved, such as through outreach programmes to improve the community’s awareness.