Mitigating the mental health crisis


IMAGINE constantly being shown moving images of your mother dying. All the while, a voice in your head berates you for having caused her death.

Imagine then the panic and anxiety you feel. You would immediately check on your mother to make sure that she is indeed alive, only to continue worrying even after being told that she’s all right.

That same voice in your head then tells you that you did not do it “right”, to check on her again, that your own mother hates you for nagging her for attention.

To shut this voice down, you find distraction, all the while reminding yourself that if you were honest in telling someone about this voice in your head, you would be deemed crazy and institutionalised, after all, when you told your mother about this voice you saw her recoil.

You then watch as your mother try everything in her power to “cure” you – visits to psychiatrists, bomoh, and even purchasing The Beatles’ vinyl records that your family cannot afford. But even after all that, the voice is still in your head and aggravates you for now having caused anxiety and financial distress in your mother.

Melati, the protagonist in Hanna Alkaf’s The Weight of Our Sky, has this scenario in her head all the time. Melati may be a fictional character, but what is poignant is the very fact that there are many others living like her.

Penang Institute’s Bridging Barriers report (https://penanginstitute.org/wp-content/uploads/jml/files/research_papers/PenangInstituteinKL_Bridging%20Barriers%20Report_LimSuLin_2ndJanuary2018_final.pdf) highlighted a three-fold increase of reported mental health prevalence in Malaysia, comparing cases from the National Health and Morbidity Survey in 1996 to 2015.

The report further argued that the increase reflects the increased awareness on mental health, that we now have the language to describe that same voice that Melati experience, thus able to record it more empirically.

The report showed that those who are in the low income group, unemployed or self-employed/are homemakers, are women and aged between 16 and 24 years old recorded the highest prevalence of living with mental health issues in recent years. While there is steep increase across all age groups over the 20-year period captured in the study, those in the 35-44 years old age group recorded the largest increase.

It is worth noting that this same age group (25-54 years old) is considered as “prime age” for labour-force participation, i.e. drivers of our nation’s economy. It can thus be deduced that ignoring the stresses that cause mental health issues would risk our country losing productivity.

The seriousness of mental health issues in Malaysia resulted in a National Mental Health Policy (1998), followed by the Mental Health Act (2001).

The Act provisions for patients to voluntarily admit themselves and seek therapy as needed – a compassionate approach that focuses on treating patients rather than punishing those with mental health issues.

On the other hand, Section 309 of the Malaysian Penal Code states, “whoever attempts to commit suicide, and does any act towards commission of such offence, shall be punished with imprisonment for a term which may extend to one year or with a fine, or with both”. A news report dated Aug 27, 2018 cited Hannah Yeoh, Deputy Women, Family and Community Development Minister, calling this law archaic.

I agree. For some of us who live with mental health issues, suicide ideation is unfortunately common.

Like Melati, persons living with mental health issues constantly think that we are a burden to our families and friends, spiralling our thoughts towards morbidity and the need to “disappear”. With this law still in place, instead of being afforded help and treatment, individuals risk incarceration when their mental health burden gets too heavy to bear.

Would it not have been more empathetic to repeal this law, instead enforcing the Mental Health Act for those who attempted suicide to be admitted for treatment? Can we go further by putting structures in place to prevent suicide attempts, perhaps start by having a toll-free number for our local Befrienders?

A recent article dated April 3, 2019 in The Star cited that 61% of Malaysians believe that the sufferer is to blame for their condition, while over three-quarters (76%) believe that there’s “no such thing as mental health”. These figures conflate the discourse on mental health, where the terms Obsessive Compulsive Disorder (OCD), bipolar and depression are sometimes used too loosely by the public, negating the very serious psychological nature of these conditions.

As we see a rising prevalence of those living with mental health issues, the socio-environment must keep up. Advocacy by groups like Relate and MindaKami should be supported and backed by the Health Ministry to ensure outreach beyond the Klang Valley.

Campaigns such as #StandTogether by The Star can advocate for empathy and kindness, as stresses to mental health can be caused by bullying experienced by sufferers, trauma dealt from death of a loved one and aggravated by stigma and discrimination for being “crazy”. No one should feel so alone as to them wanting to end their lives.

If you or your loved ones need someone to talk to, you can call Befrienders at 03-7956 8145 or email sam@befrienders.org.my.

Lyana Khairuddin is a virologist turned policy nerd living in Kuala Lumpur. The views expressed here are entirely her own.


   

Across The Star Online