Invest in mental health for all
A lack of resources for mental healthcare can lead not only to terrible human misery but also huge economic losses.
WORLD Mental Health Day is celebrated on Oct 10 each year. The day is significant in drawing attention to issues concerning not only mental illness but mental wellbeing as well. The day has also been declared a green ribbon day and people are encouraged to wear one for a few days to a week to increase awareness of mental health.
In Malaysia we had the extraordinary occasion when the King consented to have the green ribbon pinned on him, thereby highlighting the importance of giving attention to the issue of mental health not only in Malaysia but globally as well.
This year’s theme is “Greater investment, greater access: Mental health for all”. This theme invites a multisectoral approach to removing barriers to mental healthcare. It also highlights the long-term cost effectiveness of investing in interventions to prevent mental disorders and promote mental wellbeing.
It is high time that mental health issues become a global concern, particularly in the context of the unprecedented global Covid-19 health crisis that has impacted the mental health of millions of people.
We know that anxiety and fear from isolation, distancing and other restrictions are causing emotional distress that has become widespread as the world struggles to bring the virus under control.
Investing in mental health
Globally, there is huge inequity in the distribution of skilled human resources for mental health. Shortages of psychiatrists, psychiatric nurses, psychologists and social workers are one of the main barriers to providing treatment and care in low- and middle-income countries.
In Malaysia, we have come a long way in scaling up mental health services. Almost every government hospital has a functioning psychiatric unit with at least one psychiatrist but the numbers are still small compared with those in developed countries. We are extremely short of clinical psychologists who are needed to complement the services of psychiatrists.
With the country’s burgeoning urban population plus stressful environments in educational institutions and workplaces, we have witnessed an exponential increase in cases of anxiety, depression, alcohol and drug abuse, and suicide.
There is also a need to strengthen the voice of users of mental health services and their role in advocacy to ensure that the rights of people with mental disabilities are fully represented. In Australia, Britain and the Scandinavian countries, there are junior ministers for mental health. While representation in the executive may be a far cry for us in Malaysia for now, a voice in the Upper House of Parliament should be feasible. The time has come for a representative of the mental health non-government organisation (NGO) sector to be a voice in the legislature.
The gap between the burden of mental illness and the resources used to address the problem may be significant but the obligation to narrow this gap should not only lie with the government but should also involve NGOs, foundations, communities, families, and mental health professionals.
Mental health strategies
Investments in primary care services have proven to be very cost effective in treating burdensome mental illnesses like chronic schizophrenia. Detection and suitable intervention for depression, delinquent behaviour, suicidality, and substance abuse in childhood and adolescence will result in the mental wellbeing of the potentially productive adult population.
Individuals, groups, charities and businesses should also be looking to see what can be done to improve our mental health and wellbeing. CSR, or corporate social responsibility, in mental health issues in Malaysia is dismal compared with some other countries in the region.
In addition, corporations have not woken up to the fact that depression in the workplace, often disguised as physical complaints, can result in absenteeism and loss of productivity.
In the United States, it has been estimated that 35% to 45% of absenteeism from work is due to mental health problems, namely depression and substance abuse. In Malaysia, according to government statistics, the projected economic burden due from all categories of mental illness will be a staggering US$25.3bil (RM104.7bil) by 2030.
Social benefits and insurance schemes do not adequately address the needs of people with mental illness. However, this is a work in progress, with one major insurance company in Malaysia committing to giving adequate and appropriate coverage for mental illness.
The call for investing in mental health is a timely one in recognition of the huge cost in terms of human misery, disability, and economic losses due to mental illness. A caring society must be able to look after the needs of all people with disabilities, including those with mental disabilities.
Prof Datuk Dr Andrew Mohanraj is president of the Malaysian Mental Health Association and a board member of the World Federation for Mental Health.
Those in need of emotional and mental health support can contact the Befrienders service nearest to them. For a full list of nationwide numbers and operating hours, go to befrienders.org.my/centre-inmalaysia.