Allocate more funds for mental health

MENTAL health is a growing concern in Malaysia. However, the Health Ministry (MOH) has only allocated 0.89% of next year’s budget for mental health, a reduction from the 1.11% allocated in Budget 2023.

According to a 2020 publication by MOH, approximately 37% of total disability experienced in Malaysia is due to issues related to mental health, particularly anxiety and depression.

In 2019, more than 470,000 Malaysian adults over the age of 18 suffered from depression. Meanwhile, data from 2022 showed that over 550,000 adolescents aged between 13 and 17 years old suffered from depression.

A disproportionate burden of mental health issues is also seen in households with low incomes. In 2015, 33.6% of adults and 13.9% of children in the B20 category (new classification) suffered from mental health problems. This is in comparison to 26.4% adults and 8% of children in the top (T30) group.

As of 2021, Malaysia had a ratio of one psychiatrist to 127,000 population, a far cry from the World Health Organisation’s recommendation of one to 10,000 population.

Given that there were about 580,000 new and follow-up mental health cases from the Covid-19 pandemic, that statistically implies over 2,000 cases on average for one MOH psychiatrist!

The distribution of psychiatrists is also uneven. In 2018, the psychiatrist to patient ratio in Kuala Lumpur was 5:100,000. In contrast, states such as Sabah and Kedah had fewer than one psychiatrist to 100,000 population.

Under-staffing in MOH facilities could lead to longer waiting times and lower quality of care. A higher allocation is needed to employ more mental healthcare workers in the public sector, but these should not be confined to psychiatrists. Psychologists, therapists and counsellors are also needed.

In 2023, RM3bil was allocated for the hiring of contract and permanent personnel, and in 2022, RM100mil was dedicated to specialist sponsorship programmes. It is still unclear how much will be allocated for this purpose in 2024.

Furthermore, a lack of streamlined, publicly accessible and timely mental health-related data prevents effective research from being conducted to understand the true mental health landscape in Malaysia.

Previous attempts to establish a mental health database, which would include information on the number of confirmed cases of mental disorders, human resources, and number of beds available or used in psychiatric departments, have met with administrative constraints, lack of manpower and budget cuts.

It cannot be denied that MOH has made significant efforts towards strengthening mental healthcare in the country. Prominent initiatives include the establishment of the National Centre of Excellence for Mental Health (NCEMH) and development of the National Strategic Plan for Mental Health 2020–2025.

The NCEMH, which serves as the coordination and control centre for mental health services, also partners with NGOs to engage in community-based activities and advocacy.

It is important to continuously monitor and evaluate the effectiveness of these initiatives, alongside reporting their findings to the public for accountability.

The prevalence of diseases in Malaysia is shared regularly through publications like the National Health and Morbidity Survey (NHMS).

However, the most recent technical report on mental healthcare performance was published way back in 2016. And this report shows that the uptake rate for mental health screenings in schools achieved an average of only 55.9% in 2015.

MOH has already acknowledged that the issue of mental health is a growing concern in this country. It must therefore make concrete fiscal commitments to develop, implement and maintain mental health services for the nation.

ILYANA MUKHRIZ

and DR RACHEL GONG

Researchers

Khazanah Research Institute