MORE than seven decades since Mental Health Awareness Month was first introduced in May 1949, one major question remains: how far have we come towards advocating better mental health?
Especially in Malaysia, where mental health is overlooked by the majority, given that it is often seen as being less important than physical health.
However, we all understand that being fully functional means more than just physical health.
Mental well-being is equally essential, especially when it comes to doing a basic routine, such as cleaning your room, running your errands and others.
In 1968, the Mental Health Association of Sarawak (MHAS) was established just a year after the Malaysia Mental Health Association (MMHA) was established.
The establishment of MHAS and MMHA shows their seriousness in raising awareness on mental health and providing support and assistance for individuals and families facing mental health challenges.
Despite slow progress, more people have been educated on mental health and how crucial it is for the well-being of a person, and individuals who have experienced mental issues have been speaking out instead being ashamed about it.
In fact, more people, especially the youth, are willing to come forward and seek help from the professionals; this is a positive sign towards breaking the stigma around mental health.
Despite that, the stigma around mental health is still strong, with some people who experience mental issues viewed as “crazy”, “weak” and “incapable” of getting things done.
This could be a challenge, especially for mental health advocates working on breaking the stigma and promoting awareness in the community.
Sarawak Tribune recently spoke with MHAS Chairman (Kuching Branch), Dr Ng Boon Seng, and secretary of Befrienders Kuching, Kelly Lee, on the trends in help-seeking behaviour alongside suicide-related calls and messages, public perception on mental health and what more could be done in advocating better mental health.
DOWNWARD TREND POST-COVID
While there was an upward trend during the COVID-19 pandemic for suicide-related calls and messages (2020-2022), Lee said they had been reduced post pandemic (2023-present).
“Yes, youth and students prefer to seek help through text messages and emails.
“Our callers are usually above 25 years as they are the ones who prefer to talk on the phone and tend to have chronic illnesses and on-going mental health issues,” she said.
Dr Ng, on the other hand, revealed that while MHAS did not have any helpline like Befrienders, the association offered free counselling.
“For those people who need counselling, they can reach out to us via WhatsApp, emails and Facebook. Then we will arrange appointments for them.
“However, if you talk about experiences working in a hospital, we do see a lot of increase in the distress presentation.
“They come in with emotional pain, self-harm, panic attack or even some suicidal behaviour, which is very concerning now, especially among the youth,” he said.
MORE SEEKING HELP, A PROMISING SIGN
With more people seeking help for their mental wellbeing, Dr Ng said it was good news, further showing that young people in Sarawak had started to realise the importance of mental health.
“Not only are they seeking help, they will also bring their friends along. Some people actually call us before they bring their friends and family members.
“Next, we ask them what the issue is, and if the issue is not acute on suicidal, we will categorise them as clients.
“However, if they are suicidal, we will direct them to health clinics nearby or the emergency department, and we will offer them ways to seek help.
“Of course, social media is playing a huge role in increasing awareness of help-seeking behaviour as there is a lot of information online,” he said.
Dr Ng stated that the majority of people seeking help are those aged 18 to 35, with most of them coming from different educational backgrounds.
USUAL ISSUES WHEN SEEKING SUPPORT
Lee said when individuals contact Befrienders, themes and issues they raise vary.
“There is no particular theme or issue that people raise when contacting us (Befrienders Kuching).
“However, many callers do call frequently due to debilitating chronic conditions and loneliness,” she said.
Dr Ng stated that common issues that people raised when they contacted MHAS were anxiety and depression.
“They are anxious about their work and academic performances and stressed with their family members. These are the common cases we see,” he said.
OPENNESS ON MENTAL HEALTH/PUBLIC PERCEPTION
Dr Ng felt that more people were now aware of mental health issues.
“We see young people attending seminars, workshops, ‘mind brew’ programmes, and so forth.
“We also welcome volunteers from various professions to be part of our mental health services
“This kind of awareness, especially among the youth is very encouraging, and we want to create a community that prioritises mental health,” he said.
Echoing the same sentiment, Lee said because people were more open to discussing their mental health now, they were slowly destigmatising it.
On public perception towards mental health, Lee said depending on the type of mental illnesses, people were more receptive of anxiety and depression compared to bipolar disorder, obsessive compulsive disorder and schizophrenia.
“Perhaps their awareness of mental illnesses has increased but the stigma still exists.
“When the government decriminalised suicide, this made a huge impact on public perception and also how the media reports suicide.
“This changes how people talk about and respond to suicide,” she said.
Lee added that the topic was being destigmatised, thanks to the efforts of the government and non-governmental organisations (NGOs) in continuously promoting mental health awareness and suicide prevention during World Mental Health Day, World Suicide Prevention Day and Suicide Prevention Month.
“The good efforts made by the government, we at MHAS, and Befrienders have made people realise the importance of mental health,” said Dr Ng.
“We are actively promoting and advocating mental health, it is encouraging to see that awareness about mental health has improved a lot,” he said.
ROLE OF SOCIAL MEDIA/MAINSTREAM MEDIA
Lee said the social media had significantly influenced mental health awareness in Sarawak as a whole, serving both as a catalyst for positive change and a source of concern.
“The positive impacts include community engagement and storytelling, organisation outreach, conducting educational forums and workshops whereas some of the risks associated with social media are cyberbullying, copycat suicides and spread of misinformation,” she said.
Dr Ng also felt the same, stating that awareness was done through promotional activities via the mainstream media radio, televisions, flyers and even social media posts.
“The contents actually have helped a lot in promoting mental health awareness among the population,” he said.
STIGMA AND CHALLENGES IN ADVOCATING FOR MENTAL HEALTH
Since Befrienders was an NGO, Lee said it had been struggling with manpower concerns ever since COVID-19 with the decline in number of volunteers within the community.
“We rely heavily on volunteers and funding from the public, so not only do we struggle with lack of manpower, donations also have reduced significantly as well post COVID-19, perhaps owing to economic struggles nationwide,” she said.
Dr Ng said there was a need for MHAS to establish its own helpline, similar to Befrienders and Talian Kasih 15999 and Talian HEAL 15555, a nationwide helpline.
“It has not been realised because we don’t have enough staff. We have limited funding because MHAS is an NGO.
“We need to provide incentives for the volunteers, especially if they are working beyond office hours. So funding is very important here.
“We depend a lot on donations, and at this point, we need a lot of donations from the public, either from other NGOs, or the state/federal government.
“We need such funding to run our operations,” he said.
Dr Ng said that the stigma around mental health still ran deep in the community despite the advocacy, stating that people still felt that mental health was not as important as other needs.
“They feel there are important things that need to be handled like financial and housing needs, and work.
“What they don’t realise is mental health will directly affect their functions at work.
“The other aspect is that people view those who have mental issues as being generally weak, crazy and possessed.
“So this kind of misunderstanding about a person suffering from mental issues can actually restrict them from accessing help,” he said.
MOVING FORWARD
To support mental health and prevent suicides, Lee said at the community level, mental health literacy needed to be expanded by collaborating with community and religious leaders to normalise conversations surrounding emotional well-being and mental health hygiene.
“We want to ensure that mental health first aid is taught to all in school and in the community by equipping each individual with knowledge in recognising early warning signs of mental health concerns and suicidal thoughts.
“This is crucial as a preventive measure.
“We want to encourage peer-led support groups in schools, universities and workplaces as a form of gate-keeping and part of occupational health and safety procedure,” she said.
At the policy level, Lee wants more allocations from the national health budget to mental health services, including hiring of more clinical psychologists, counsellors and community-based psychiatric outreach teams.
Government funding should be given to NGOs for their operations and outreach programmes.
“We also want the National Suicide Prevention Strategy to be implemented within Sarawak.
“Most importantly, we want the School-Based Mental Health programme to be mandated, implementing life-skills classes and age-appropriate emotional regulation curriculum in schools.
“We also need to have a systematic one-stop community centre that provides holistic support to those who are in need in every municipality, something like UTC, but for mental health and wellness, like Community Mental Wellness Centre (CMWC) or Mental Health Transformation Centre (MHTC),” she added.
Dr Ng, on the other hand, felt while promotional advocacy activities were effective for increasing awareness on mental health, the programmes needed to be sustained.
“It needs to be, if possible, taught in primary and secondary schools as well as on occasions and at programmes and events where the general public can participate.
“The programmes can be community-centred.
“We also continue to receive invitations for talks involving mental health as well as radio podcast invitations,” he said.
Dr Ng wants the conversations to keep going, stating that people with mental issues don’t have to feel bad.
“They don’t have to feel ashamed about having mental health issues.
“There are ways we can help them even if we cannot solve the problems instantly.
“If we in the association cannot help in our capacity, we will help them find resources, referring them to the professionals,” he said.
