Minding mental health
A two-pronged community-based programme aims to destigmatise mental health problems.
IN her first few months of service, Subang Jaya assemblywoman Michelle Ng found herself attending the funerals of people who had committed suicide.
“One big issue I noticed was suicides happening in clusters within my constituency and that they tend to involve those in their teenage to college years, so that got me really concerned,” shared Ng, when met for an interview.
She then did some research, spoke to the family members and realised that most of the victims were suffering from some form of mental illness.
“One response I usually got was how the families often felt helpless and didn’t know what to do. So then the question was, is knowledge about mental health something that can be learnt?”
After speaking to some medical professionals and Health Ministry officials, Ng realised that there are steps one can take to help someone who is going through mental health problems.
That’s how her idea of the SJ Care Warriors programme came about. Officially launched on March 31, it focuses on empowering the community to self-help as well as help others.
World Mental Health Day falls on Oct 10 every year. The National Health and Morbidity Survey 2015 conducted by the Health Ministry found that the prevalence of mental health problems among Malaysians aged 16 and above stood at 29.2%. This means that one in three Malaysians experiences issues related to mental illness.
A similar study was conducted in 2017, targeting youth health issues, and showed that anxiety (39.7%), depression (18.3%) and stress (9.6%) were among the three main mental illnesses plaguing adolescents.
The SJ Care Warriors programme adopts a two-pronged approach – gatekeeper training led by a team of clinical psychologists and psychiatrists for community leaders on how to identify warning signs of suicide and where to get help (Suicide Prevention programme); and secondly, a wellness-oriented approach to building resilience among youths (Building Resilience programme). With resilience, youths are empowered to better manage their mental state of wellbeing and are able to impart the wisdom of mindfulness, build resources, spread loving-kindness.
Currently, mental health issues are addressed mainly in hospitals and also at the primary care level.
Complementary community-based mental health initiatives and advocacy need to be much more well integrated into the mental health service ecosystem, said Dr Amer Siddiq Amer Nordin, Assoc Prof with the Department of Psychological Medicine in Universiti Malaya.
“The SJ Care programme literally gives permission to people to talk about mental health in a more open, non-judgemental platform. In the past, the issue of mental health might be present but there was a lot of taboo attached to it. But now, with the programme in Subang Jaya, the community at large is able to talk about it freely, at least with reduced stigma,” said Dr Amer, a member of the SJ Care Warriors Advisory Council.
Ng added that, collectively, we all have the responsibility to cultivate an environment that helps a person who is going through a mental health problem.
“One thing that feeds into the stigma is the labelling of mental health problems as something unnatural, as opposed to other health problems. When you view it as something unnatural, then it’s unlikely that a person wants to fall into that category, which means not telling anyone you have that problem or seeking help for it,” she said.
“In Asian culture, traditionally, we are taught to be tough and not bring up our problems. So there is a lack of emphasis on vulnerability, which is not exhibited, and when that happens you don’t know how to deal with it, so it compounds itself until it becomes a problem.
“We want to show that mental health does not need to reach the stage when it becomes a problem. There is the earlier part as well whereby we learn how to deal with stress before it compounds into a problem. When we are able to look at it as an entire spectrum, then it normalises and naturalises mental health issues,” Ng emphasised.
Dr Amer, who is a consultant psychiatrist at Universiti Malaya Medical Centre, explained that prior to an individual having a mental health illness, there is often a stage where change can be made.
“You often have a mental health issue at that point but it’s not a mental health illness yet. However, these people are struggling and it could be due to genetic factors. But there is also another group of people whom when given the right ingredients to become depressed, can become depressed. You put them in an environment that’s very negative, give them more stress sources – one after the other – and that can eventually cause individuals to be clinically depressed.
“So the ones who are more vulnerable tend to get it earlier, while the ones who are more resilient, once they lose all their coping mechanisms, will also get it. So we don’t want this to happen because once you are at the illness stage, function is lost. When function is lost, particularly among young people, countrywide we are going to have a problem,” he added.
To date, the Suicide Prevention programme has reached 69 community leaders. By the end of this year, the programme hopes to reach 80 leaders. Meanwhile, the Building Resilience programme, piloted in July with 14 Sunway University student leaders, was also held on Oct 5 in another private college. By the end of the year, they hope to roll out the programme to the first batch of 200 students.
“Our vision is, once the two programmes stabilise, if another community wants to do it, they can implement it. The question is how to get communities interested and how do we have that kind of support system of resources and professionals to facilitate the programmes. So, that’s the long-term vision,” said Ng.
On Oct 10, the International Mental Health Short Film Festival 2019 will be launched together with #Letstalkmy. For more info, visit facebook.com/sjplus.youth/