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Ministry plans to involve communities in caring for mental health patients

KUALA LUMPUR: The reports on how four million Malaysian are struggling with mental health problems have shed a light on the dearth of facilities to provide psychiatric care and treatment.

Such a staggering figure came on the heels of an alleged case of abuse at a home for disabled children in Batu Gajah, Perak, where residents were reportedly placed in enclosures to prevent them from harming each other.

Suggestions have been made to establish public daycare centres or community-based psychiatric nursing homes.

Health Ministry director-general Datuk Dr Noor Hisham Abdullah told the New Straits Times that there was a need to broaden community-based healthcare.

He said the ministry was working on a plan to involve communities in caring for those with mental problems through the setting up of community-based psychiatric nursing homes.

While the statistics did not imply that everyone with mental health problems required hospitalisation, Dr Noor Hisham expounded on a greater intention to “bring the care back to the community, and from the community back to the individual”.

He said less than a third of the four million suffered from serious mental illness and, correspondingly, the mission now was to provide adequate healthcare in each state by pairing community health centres with psychiatric nursing homes.

“The Mental Act 2001 and Mental Health Regulation 2010 has provisions for community mental health centres and psychiatric nursing homes.

“The target is to have at least one community mental health centre and one psychiatric nursing home in each state.”

There are currently 671 health clinics and 22 mental health centres providing mental health services in the country.

As of December 2014, the Health Informatics Centre recorded 11,205 cases of schizophrenia, schizotypal and delusional disorders, while 3,193 patients with mood affective
disorders were discharged from
government hospitals.

“There are mental institutions that cater to long-term care and treatment. These centres also provide short-term and long-term hospitalisation at psychiatric wards.

“The ministry provides psychiatric and mental health services at 48 government hospitals, including outpatient treatments, non-pharmacological medium such as counseling, cognitive behavioural therapy.

“Pharmacologically, prescriptions include antidepressants and anti-psychotic drugs,” Dr Noor Hisham said, adding that general hospital psychiatric wards catered to short-term hospitalisation.

Malaysian Mental Health Advisory Council member Tan Sri Lee Lam Thye lauded the community-based approach, saying psychiatric patients could get treatment and, at the same time, still feel like they were a part of society.

“It is good if the community can include these patients in its activities and make them feel wanted.

“This will be a much healthier option than staying in a ward, where the environment could get stressful,” he said yesterday.

The Welfare Department is doing its best to provide shelter for the mentally ill, despite the fact the department is not equipped with facilities to care for or treat mental patients.

The department’s disability director, Nik Omar Nik Abdul Rahman, said there were many cases of people with mental health issues being abandoned and left homeless, some of whom the agency would place in welfare homes.

“For instance, there are two Desa Bina Diri homes, one in Mersing and the other in Jerantut. These people are placed there under the Destitute Persons Act 1977.”

Nik Omar said many of these homes were overcrowded, with 90 per cent of residents suffering from mental disorders that had yet to be diagnosed by doctors.

For example, he said, Desa Bina Diri in Jerantut had the capacity for 350 residents, but is housing more than 500, while the home in Mersing had 700 residents, even though it was supposed to accommodate only 450.

“The problem is if they are diagnosed as mental health patients, they can no longer stay at these homes. So, for now, we categorise them as destitute persons and allow them to stay at the centres.”

The department can also register mental health patients as “disabled persons” to get aid for families that can no longer cope with the expenses — RM200 for patients who are unable to work and RM350 for those holding jobs that pay less than RM1,200.

The department has registered 32,498 patients as disabled individuals.

Nik Omar urged the authorities to find solutions to alleviate the suffering of the mentally ill and their families.

“Giving them a monthly allowance eases their financial burden, but it does not do much. They need professional care and help.”

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