Wrapping one’s mind around mental health

 

Many media outlets have been writing about the mental health epidemic, and across various media, to overwhelmingly positive responses from the public. Most notably, MISI: Solidariti has been debunking myths relating to mental health on their Instagram page, and publishing testimonials from Malaysians who have been struggling with their psychological wellbeing.

This is a stark departure from the usual way. As is the norm not only here in Malaysia, but in other Asian cultures, many of us were told to ignore psychological anguish — to stiffen our upper lip, to stop whining, to pray more, or to think about how much worse it could be.

That is not to say, however, that all is well. Most recently, PAS politicians have been claiming that mental illness is caused by Korean dramas, drawing satirical remarks from the entire nation.

None of this does anything to help but rather sends the patient further into despair, further convincing them that their condition is nothing but a joke, and that nobody understands what they are going through, and that there is only one way out.

The truth is that mental illness is just like any other illness, and will not go away just by ignoring it. However, with the help of licensed professionals, it can be managed and treated.

The proposed decriminalisation of suicide attempts that has come up at the last few parliamentary sessions, just in time for World Mental Health Day on Oct 10, was met with what felt like a collective exhale among the young, after years of fighting for visibility and championing a more modern approach to the issue.

It seemed like we were, at last, making headway.

The criminalisation of suicide attempts does not decrease suicide rates, and the government has finally acknowledged this truth. In fact, studies show that the criminalisation of suicide increases the rates of more violent suicide attempts, and subsequently an increase in deaths by suicide. As suicide cases are the highest they have ever been in Malaysia, this decriminalisation could not have come at a better time.

However, the health ministry’s acknowledgement of World Mental Health Day was underwhelming. While minister Khairy Jamaluddin addressed the link between physical and mental wellbeing, he and his ministry also very slyly sidestepped the World Federation for Mental Health’s theme of “Mental Health in an Unequal World” in favour of “Let’s Talk Minda Sihat”.

The federation’s theme is chosen by a global vote including members of the MFMH, and was adopted due to the widening gap in the quality of health, and economic and social inequalities. It is a little strange that the Ministry of Health chose to ignore this when it had no problems using the MFMH theme last year: “Greater Investment — Greater Access. Everyone, everywhere.”

It only shines a brighter spotlight on the disparity between the present government’s words and actions.

After all, how can people struggling with mental health reach out to professionals, when the distribution of services is inequitable? Government psychiatrists are few and far between, forcing the rakyat on waiting lists that are often over six months long before they can be seen. Most of them don’t have six months before they choose to take matters into their own hands.

There is also the issue of how criminally underfunded psychiatry and psychology is in Malaysia. How doctors and counsellors are taking on cases for free, and burning themselves out emotionally, just to try to catch a few people who have fallen through the cracks of the broken system.

Many resources have been diverted towards handling the pandemic at the expense of other “less essential” services, including psychotherapeutic services. This has naturally led to patients being pushed to seek help within the private sector.

However, “going private” is often far easier said than done. There are only about 300 psychiatrists in Malaysia, or approximately one psychiatrist for every 100,000 Malaysians.

The high demand has caused prices to skyrocket, and a single session with a private psychiatrist often costs more than RM300. For those who need urgent semi-intensive care, that means coughing up about RM1,000 a month, which is absurd when one recalls that the minimum wage nationwide is RM1,200.

It becomes easier to see why the current government would prefer to avoid this difficult conversation because it is easy to talk about mental wellbeing when we don’t follow it up with improving infrastructure. After all, how would the health minister even begin to discuss the role that public policy and infrastructure play in the mental health crisis, when his party depends on racial and economic inequality to stay in power.

Social factors influence the health of the population, but their distribution is determined by forces outside of their control. And just like the pandemic exposed the ugly underbelly of economic disparity, it also exposed the psychological anguish that Malaysians have faced for years.

The reality is,and will be for the foreseeable future, that individuals cannot do much for their mental health when their survival is uncertain, and their livelihoods insecure. Measures that run on the backs of individuals, such as #BenderaPutih (#WhiteFlag), can only ever be a stopgap measure. It is up to the government to implement lasting change, by proposing good political solutions to these socioeconomic problems.

When people have their material needs met, they will be able to devote time and resources to ensuring their psychological wellbeing. When they are ready to look for help with their mental health, however, there needs to be a system that supports and encourages them in their journey towards recovery.

Mental health does not exist in a vacuum. The government needs to step up to the plate and do something about it before they completely lose the confidence of the public. - FMT

The views expressed are those of the writer and do not necessarily reflect those of MMKtT.