MENTAL health issues are wide-ranging: depression, bipolar syndrome, paranoia, schizophrenia and many other conditions which are often stress-related or genetic. Unfortunately, the country has seen more than a doubling of cases over the past decade leaving one out of three Malaysians grappling with mental problems; this according to the most recent National Health and Morbidity Survey (NHMS). Something needs doing urgently because it is affecting a wide spectrum of the population, including children.
The Health Ministry has started several initiatives like drafting an action plan involving all stakeholders, including the Education Ministry, given the prevalence of the problem among teenage schoolchildren and students. Some are primary schoolchildren, victims of turbulent marriage break-ups and the inevitable broken home. Given the surge in cases, it is understandable that Malaysia lacks the coping mechanism to ensure that adequate help is extended to all mental patients. The average ratio of psychiatrists to mental patients, for example, is a horrendous 1:100,000, which in absolute numbers amount to a mere 360 registered in both the public and private sectors. Hospitals dedicated to mental healthcare are few, the most well-known being in Tanjong Rambutan, Perak, and Tampoi in Johor.
The government intends to expand community-based care to allow patients to stay within his or her support system, which should be the more amenable compared to institutional care. With respect to the shortage of caregivers, the numbers are to be increased by encouraging those involved in the field to further their studies in related disciplines, especially clinical psychiatry. However, there is a timing mismatch. The conundrum then is how to fill the gap immediately in the way of psychiatrists and other mental health professionals. As has been the case in many other areas, manpower shortage has been overcome by employing foreign professionals. Mental health, however, is very much tied to the local socio-economic environment. Can trained professionals unfamiliar with the Malaysian social fabric understand what goes on in the disturbed mind of the patient and what are the push factors leading to the condition? The recent controversy surrounding the Batu Gajah facility for the mentally challenged, who are prone to violence, is an indication of how complicated the problem is. Buildings can be cobbled together but without the trained clinical personnel, as claimed, facilities are forced to resort to seemingly inhumane measures to protect the inmates from themselves. It then behoves the system to institute an enabler that can help in early detection, especially the stress-related conditions, to prevent deterioration and, thus, arrest the affliction.
The authorities are attempting to expand access to care to match the increase. Meanwhile, however, families and friends must be vigilant. Support is essential: a shoulder to cry on, a sympathetic ear and physical presence. But the urban rats are caught in a vicious cycle of desires driven by materialistic allure for little more than merchandise leaving individuals trapped in cages of stress leading to mental disorders when expectations are unmet. Given this narcissistic self-absorption, genes merely facilitate the tipping over into insanity.