TOMORROW, Oct 10, is the annual World Mental Health Day, as declared by the World Health Organisation.
The National Health and Morbidity Survey 2015 by the Health Ministry reported that mental health problems among adults aged 16 and above have increased from 10.7 per cent in 1996 to 29.2 per cent in 2015 and this includes university students.
International Islamic University Malaysia Psychology Department senior lecturer and clinical psychologist Dr Jamilah Hanum Abdul Khaiyom said that research has not found a single cause for this occurrence.
“However, studies have identified several risk factors which include having problems adjusting to the transition from school to university.
“The transition can impact a student’s well-being. They may not be fully prepared to lead an independent life at undergraduate level.”
Sunway University Psychology Department head and clinical psychologist Associate Professor Dr Alvin Ng Lai Oon said that from his experience, students have trouble adapting.
“There is lack of resilience among students in coping with the demands of tertiary education.
“At the undergraduate level, there is a lot more focus on independent study, innovative problem-solving and personal organisation. They may not have the adequate groundwork prior to entering university,” said Ng.
Jamilah added: “Dysfunctional families and traumatic life events also contribute to this issue. For example, coming from an abusive family, or being a victim of physical, mental and sexual abuse can have a long-term effect on mental health.
“Disorders can also develop in university due to physical inactivity. Being highly studious and exempting oneself from physical activities can lead to stress and worsen mental health,” she said.
To strengthen the mental well-being of university students, it is important for the campus community to be educated, dispel the stigma and support each other.
STIGMA
Due to the stigmatisation of mentally-ill persons, many often stay in the shadows and are afraid to seek help.
Jamilah said: “We can see patterns of disorders increasing among students. The stigma is one of the reasons why people do not come forward and choose to ignore the symptoms or go to alternative healers first to be treated. They view psychologists and psychiatrists as a last resort.”
Sunway Peer Counselling Volunteers president and Psychology student Jayashan Chinatamy, 21, noted the severity of mental health disorders and suicidal ideation in recent times.
“There is a causal relationship between stigma and suicide in addition to the prevalence of mental health disorders.
“While the youth are more aware about mental health in comparison to the past, many still do not seek help or utilise available resources due to this stigma that has developed into a cultural taboo,” said Jayashan.
IIUM Secretariat of Psychology president Eusoff Fitri Sarnin, 24, said that from a young age, Malaysians are taught that mental illness is unacceptable.
“As the negative perception increases, those with mental disorder symptoms are left feeling ashamed for fear of being judged.”
SIGNS
A good support system is important in battling mental illness. For most university students, the ones closest to them are their friends.
Ng, who is also a WHO Malaysia Office mental health consultant, said that there are several warning signs that students can look for to help their friends.
He said: “Signs of mental health issues include social isolation, change in eating or sleep patterns, difficulties with concentration, generally low mood and having difficulty enjoying activities that they typically enjoy.
“Students can help by checking in on their friends and asking if they are all right. It has been found that normalising the distress — by letting them know that it’s okay to be that way — can help.”
Acceptance is key, according to Ng.
“We help first by not downplaying their distress. It’s important to let them know that we accept them the way they are. Just be a friend — you don’t necessarily have to entertain or talk. Just be with them.
“Often they will feel that they are a burden to others so you need to assure them that you’re there to help willingly and that it’s okay to be helped. You can also suggest that they seek the help of a specialist.
“For those who are struggling, remember that when you need help, allow others to help you,” said Ng.
Shutting people out is another warning sign, Jamilah added.
“Those will mental illnesses usually push people away. These include acquaintances, friends and family.
“Students should be observant if their friends utter statements such as ‘there’s no point in life’ or ‘I don’t want to live anymore’.
“Listen when people talk about their problems and suicide. Don’t invalidate their feelings or give unsolicited advice. Just hear them out.
“Do not be judgemental. Being a human being, it’s normal to be vulnerable,” she added.
PEER SUPPORT
An IIUM fourth-year student, who wishes to only be known as Kamilah, said she was diagnosed with Bipolar I disorder.
“To cope, I take medicine at night. During the day, I do deep breathing and mindfulness exercises.”
Kamilah said that peer support is important especially for students who live far from home.
“I usually share my thoughts with family and a few friends. However, most of my friends do not really understand mental illness. Some think that depression is just normal sadness.
“I choose my friends carefully because if I share my problems with a person who is judgemental and has low understanding on mental health, it will only worsen my condition.”
Eusoff Fitri said peer support can be effective but it requires proper training and awareness.
Having recently completed his internship with the Universiti Kebangsaan Malaysia’s Medical Centre psychiatric ward, he recounted his experience: “During my stint there, I met a university student with social anxiety and suicidal tendencies. As an intern and psychology student, I participated in giving support and motivation. But I cannot give professional advice.
”Having someone to talk to when you have a problem helps.”
At Sunway University, Peer Counselling Volunteers (PCV) is a student body under the guidance of the Sunway Counselling and Wellness department.
Jayashan said: “We act as a peer support network on campus. Our members are trained by professional Sunway counsellors.
We organise events centred on different aspects of mental health, such as positivity, self-care and suicide prevention.”
The purpose of peer counselling is to establish a support network that is approachable.
“We remain impartial to all our peers and focus on empathising, validating and supporting these students in the place of problem-solving.
“We try our best to help and guide them in overcoming their mental health challenges. Through our efforts, we hope to reduce the stigma associated with mental health.”
In terms of peer counselling, Jayashan said the PCV members act as listeners.
“Any Sunway University students can become PCV members. They undergo Personal Development sessions to better understand themselves and the importance of perspective in peer counselling.”
PCV offers both an online platform and a face-to-face counselling session to students.
“Through the online anonymous platform known as Peer-to-Peer, students can write in to us regarding the challenges that they are facing and how they are affected.
“We will provide a detailed reply within three to five working days after consulting the P2P team, led by counsellors from Student LIFE, the student service centre.”
If the online platform is not helpful enough, students can also schedule an appointment with the peer counsellors.
“Each session is conducted by two peer counsellors. Feedback has been positive, with many saying that they felt better after the sessions.”
However, Jayashan pointed out that peer counselling is not a substitute for professional help.
“Some students may require more professional counselling or may need to be referred to a psychiatrist or clinical psychologist for diagnosis. Sunway Counselling and Wellness has affiliations with external mental health platforms and it is more than willing to give referrals.”
Ng said that it is also significant to note that supporting a friend with mental health can be draining.
“If the helper is distressed, seeing a counsellor can help. It’s important to understand that one can get affected by other people’s distress. It’s a human condition.”
RAISING AWARENESS
It takes a community to address mental illness. Hence, it is crucial to raise collective consciousness on mental health.
Supported by Subang Jaya assemblywoman Michelle Ng, Sunway University, Taylor’s University and Monash University organised the Return to Light: Mental Health and Suicide Prevention Campaign last month.
PCV was the co-organiser with Sunway Counselling and Wellness and Student LIFE.
Jayashan said: “PCV’s responsibilities include facilitating the Youth Mental Health Forum. At the exhibition, we had a virtual reality activity where students learn what it’s like to suffer from schizophrenia.
“The main goal of the campaign was to increase awareness about mental health within the campus as well as with the public.
“Awareness is the first step for many youths to seek help. The campaign achieved this through workshops on active listening and peer support,” said Jayashan.
Jamilah agreed that that it is important to better educate helpers.
“For example, students need to know the difference between self-harm and suicide attempts. There are people who inflict harm on themselves because they want to feel pain or release pent-up emotions, not to stop living.
“Studies have shown that by talking openly about suicide, people will not desire to end their life. In fact, it has the opposite effect.”
Last April, Jamilah and postgraduate Psychology students also conducted a mental health screening campaign to raise awareness.
“The screening was a one-to-one process. A clinical psychology trainee first conducted a brief interview and administered psychological tests with a student.
“Then, we discussed the results with them and provided recommendations to follow up with the IIUM Counselling and Career Unit or the Psychological Service Unit.”
Another effort in spreading awareness was the #HereForYou campaign by the Secretariat of Psychology in collaboration with Befrienders, a not-for-profit organisation providing emotional support, last year.
For the campaign, they filmed a video of IIUM students who were struggling with mental illness.
Students who were diagnosed with borderline personality disorder and depression shared their personal experiences on camera.
Eusoff Fitri said: “It was difficult to get students to talk about their personal struggles. But this video helped to shed light on how anyone can be affected by mental illness.”
The IIUM Secretariat of Psychology has conducted a lot of trainings and programmes to spread awareness on mental health issues for their students.
This year, in conjunction with World Mental Health Day, the secretariat has planned a series of activities for Mental Health Week on Oct 6 to 11.
The programmes include a talk titled Fighting Against Mental Health Stigma, a mental health screening, mental health awareness training and a sharing session for those with mental illness.
Eusoff Fitri said: “The Secretariat of Psychology’s role is to provide the correct information to the university community. We aim to educate students so that they become more aware about the signs, symptoms and types of mental disorders.”
COLLECTIVE EFFORT
A concerted effort is required to address this issue of mental health among university students.
Jamilah said: “Lecturers can play a role. Before I start my class, I conduct some simple mental health-related activities.
“For example, I carry out mindful breathing and explain to students how ithese activities can help them to be more present and aware about mental health.”
“I personally hope that the university can have more clinical psychologists and counselors.”
Ng also said that more counsellors and psychologists are needed on campus.
He added that the university counselling unit should have referral platforms to external professionals.
“If it is not possible, the alternative is to empower students and staff through the PCV programme to handle the milder cases.
“There are evidence-based methods devised by WHO to train laypersons the skills to manage large-scale distress in communities. The same approach can be used within a university.
“The training can give social support to help people improve their functioning towards stronger resilience.
“Essentially, it’s about prevention and we need to work together. Mental health is everyone’s responsibility,” said Ng.