Keeping the spotlight on mental health — Lim Yi Wei

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OCTOBER 7 — The sharp jump in suicides during the Covid-19 pandemic has jolted many into talking about mental health. As of July 2021, 638 suicide cases were reported, compared to 262 cases over the same period in 2020. This week, deputy health minister YB Dr Noor Azmi Ghazali told the Dewan Negara that the Psychosocial Support Line received 223,990 calls as of 19 September. 80.8 per cent of the callers needed emotional support and counselling. 

As we gear towards an endemic phase, the Federal Government must keep mental health on the agenda by doing the following:

1.      Decriminalise suicide immediately

To date, amendments to Section 309 of the Penal Code have not been tabled in Parliament. The Federal Government must answer: What are the remaining considerations or challenges holding them back?   

While we wait, the Government should impose a moratorium on prosecution of attempted suicides. As sectors reopen, there will be new stressors and anxieties as people face an uncertain future with evolving challenges. One conviction is one too many and help, not persecution, must be offered to Malaysians. 

2.      More resources, more robust care

Awareness and education are good. But how do we increase support for people with a current psychiatric diagnosis? Helplines offer little relief when waiting times between psychiatric appointments have increased from three months to six. 

Health Minister YB Khairy Jamaluddin must address the issues brought by the #HartalDoktorKontrak movement to remedy the low ratio of psychiatrists to patients. — Bernama pic
Health Minister YB Khairy Jamaluddin must address the issues brought by the #HartalDoktorKontrak movement to remedy the low ratio of psychiatrists to patients. — Bernama pic

Health Minister YB Khairy Jamaluddin must address the issues brought by the #HartalDoktorKontrak movement to remedy the low ratio of psychiatrists to patients. Another proposal is to incentivise the private sector to take some of the load via subsidies. The Federal Government can subsidise a specific number of therapy sessions at private sector counsellors, clinical psychologists, or psychiatrists. My colleague YB Michelle Ng (ADUN Subang Jaya) and I have submitted a paper to the Selangor State Government and will be pushing this in the Selangor State Budget 2022 debates as well. 

Early steps are also being taken via the SEHAT Selangor initiative in the Selangkah app. App users answer 10 screening questions (which includes a risk screening) and are provided resources to learn more about mental health and opportunities to receive professional mental health help. 

We can also learn from the United Kingdom’s Improving Access to Psychological Therapies (IAPT) using the “stepped care” model. The stepped care model is a system for assessing, delivering, and monitoring mental health treatment so that the most effective and least resource-intensive treatment is delivered first before a more intensive, specialized service is needed. This approach offers a spectrum of evidence-based service interventions to ensure people receive the most appropriate care given the limited resources. 

3.      Cross-ministry cooperation and upskilling counsellors for Covid-19 orphans

In Parliament, Women, Family and Community Development (KPWKM) minister YB Datuk Seri Rina Harun revealed that since the start of the Covid 19 pandemic to 13 September 2021,4,422 children have lost a primary caregiver due to Covid-19. 154 of these children became orphans, having lost both parents to Covid-19. 

As schools reopen, cross-ministry and agency cooperation is important in ensuring these children receive quality emotional support. KPWKM has about 1,000 social workers and 150 counsellors stationed nationwide, while the Education Ministry (MOE) has 20,000 counsellors. Within the stepped care model, these counsellors can be upskilled to recognise signs of depression, anxiety, and post-traumatic stress disorder (PTSD) and provide mental health first aid and psychological care to all school aged children, particularly to those who have lost loved ones to Covid-19. 

4.      Recognising social inequalities as a component of mental health

Throughout the last 18 months, my office has helped people who face difficult life events such as domestic violence, sexual abuse, joblessness, illnesses and more. Most are in distress and cry openly on the phone or in person. 

Affordable housing is mental health. Job security and fair wages is mental health. Food security is mental health. Quality education is mental health. I echo my colleague YB Charles Santiago, Klang MP, in calling for social protection to be a key policy in the 12th Malaysia Plan. 

Instead of continuous performative activism and rhetoric of asking people to reach out to an overburdened and occasionally broken system or pinning green ribbons on expensive suit lapels, we must recognise and tackle societal inequalities as a key component of mental health. 

* Lim Yi Wei is Ahli Dewan Negeri (ADN) N35 Kampung Tunku | State Assemblywoman for N35 Kampung Tunku

**This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.

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