KUALA LUMPUR: Revelations that one in three Malaysians is grappling with mental health issues has prompted the government to formulate a National Mental Health Strategic Action Plan that will lay out effective measures to best tackle the problem.
Currently at the drafting stage, Health director-general Datuk Dr Noor Hisham Abdullah said the five-year plan (2016-2020) sets out key mental health priorities for the government, non-governmental agencies (NGOs), employers, schools and the public.
“It will be a comprehensive plan that entails programmes and strategies that will be put in place, as well as key performance indicators.
“Once the plan is out, proper monitoring and implementation must be done,” he told the New Straits Times.
The NST had, on Sept 26, reported that one in every three adults in the country was struggling with mental health issues, whether they realised it or not.
The 2015 National Health Morbidity Survey (NHMS), revealed that 4.2 million Malaysians aged 16 and above (29.2 per cent) suffered from the problem, from 11.2 per cent in 2006.
Dr Noor Hisham said the plan stressed the need to put mental health on the agenda in all agencies, to obtain stakeholder engagement, and to work closely with NGOs.
“We already have the National Mental Health Policy and the Mental Health Act 2001. A National Strategic Suicide Action Plan had also been developed.
“Now, we are developing this plan in line with the World Health Organisation’s comprehensive mental health action plan (2013- 2020) to deal with the increase in mental health cases in Malaysian society. The plan is a public health approach that takes into consideration cross-sectoral collaboration, task shifting and training of NGOs.
“It is crucial to create awareness, improve human resource management and strengthen research, and screening for mental health, as well as focus on issues like depression, suicide and mental health disasters.”
Dr Noor Hisham said the action plan encompassed several areas, among them the need to offer accessible and comprehensive mental health care and services, and to have cross-sector collaboration among agencies.
The plan, he said, also outlined the need to organise mental health promotion within settings and target groups to boost awareness, human resource development in mental health, basic psychological aid during a crisis (Psychological First Aid, better known as PFA), and research and surveillance.
“Mental health services include mental health promotion, screening and early detection, treatment and care, and rehabilitation,” said Dr Noor Hisham.
“We are also looking to work with government and non-governmental agencies, NGOs, women’s organisations and peer support groups.
“For example, we will train our Kospen volunteers on mental health coping skills to reach out to the masses.”
Kospen is a national health community programme under the Health Ministry that promotes a healthy lifestyle through exercise, good dietary practices and encourages people to go for health screenings.
PFA is an evidence-based tool used to provide psychological support to individuals in acute distress and those at risk of mental health problems during a crisis or disaster situations.
Dr Noor Hisham said the action plan also stressed the promotion of mental health in society, schools, and workplaces to ensure mental wellbeing and boost mental health awareness.
“To achieve this, we will continue to expand our Healthy Mind Programme at schools and work hand-in-hand with the Education Ministry and NGOs, and train teachers on coping skills and building up resilience.
“However, this will need further discussions with the Education Ministry.
“For the workplace, activities include the promotion of mental health wellbeing and a healthy workforce and ensuring that each workplace establishes a stress management at the workplace programme.”
Dr Noor Hisham said the effectiveness of the plan, however, could only be evaluated upon implementation as the strategies outlined were evidence-based.
He said mental health experts from the ministry, relevant government agencies and non-governmental agencies providing mental health services were involved in the drafting of the plan.
The experts include psychiatrists, public health specialists, family medicine specialists, psychologists, clinical psychologists, paramedics, teachers, caregivers, youth representatives, and advocates of mental health.
“The plan is now being drafted. Upon completion, it will have to be presented at several levels in the ministry for approval. We will try to speed up the process as much as possible,” he said, adding that the cost of implementing the plan has not been discussed.
Dr Noor Hisham said the ministry was looking at boosting the number of treatment centres and community Mental Health Centres, and increasing the number of psychiatrists, psychologists and nurses to better manage the issue.
“The ministry’s Mental Health Promotion Advisory Council has been playing an important role by providing input on the way forward and the development of policies and activities related to mental health promotion.”
He said at present, several programmes were in place, such as Minda Sihat Sekolah, Screening and Healthy Mind Intervention in Primary Health Care, Community Mental Health Rehabilitation Programme, Job Placement Programme, Mental Health and Psychosocial Response in Disasters and workplace Stress Management Programmes.
Younger children (5-9 years) showed a higher prevalence of mental health problems (13.1 per cent), compared with older children of between 10 and 15 (11.4 per cent), while poor mental health was reported to be highest among those between 16 and 29.
Meanwhile, the Health Ministry’s Mental Health Promotion Advisory Board member Datuk Dr Andrew Mohanraj Chandrasekaran said the government was committed to scaling up services at every level of care.
“Primary care physicians at primary health centres are well aware of community mental health needs. Adequate and up to date medications are available in Primary Care Centres.”
Complying with the recommendations of the Malaysian Mental Health Act 2001, community mental health centres have been set up with rehabilitation facilities.
“School mental health has been prioritised, with pilot projects in several schools where teachers have been given training in case detection and management. The government has also launched a National Suicide Prevention Strategic Action Plan,” said the consultant psychiatrist.
Dr Chandrasekaran, who is also Malaysian Mental Health Association (MMHA) deputy president, said non-governmental bodies, like MMHA ran daycare centres that focused on rehabilitation for people with chronic mental illness.
Befrienders, a non-profit organisation offering emotional support to the depressed and suicidal, has been a presence in suicide prevention, providing telephone counselling services, while Pengasih provided rehabilitation services for those with drug dependency, he added.