KUALA LUMPUR: People suffering from severe mental illness, after a comprehensive psychological screening, can be placed under forced hospitalisation, even if it is against their will or the wishes of their families and relatives.
Deputy Health Minister Dr Lee Boon Chye said institutionalisation of people was only necessary if the patients showed chronic suicidal symptoms, apart from incurring injuries on themselves, people around them or properties.
Institutionalisation of persons with mental illness, Dr Lee said, was provided for under the Mental Health Act 2001.
“If the psychiatric assessment showed people experiencing suicidal tendencies and that they can endanger themselves or society, then they should be treated, even it is against their wishes or that of their relatives.
“Most of the long-term institutionalised patients are persons suffering from schizophrenia, which is a severe mental disorder,” he said.
Section 11 of the act allows police or social welfare officers to “apprehend” people whom they believed are suffering from mental disorder and pose a threat to other people and property.
“There are cases of people who have been institutionalised according to the act at four of our specialised psychiatric hospitals in Perak, Johor, Sarawak and Sabah,” he said.
Dr Lee, however, could not produce the exact number of cases involving patients institutionalised under the act.
“We admit them (patients with chronic mental illness) regularly.”
Tan Sri Lee Lam Thye, a member of the Mental Health Promotion Advisory Council, said cases of people causing hurt and, sometimes death, to others have become more common, which was a call to action for greater intervention not only from the authorities, but also from the society.
Lee, who has been raising mental health and psychosocial issues, said there were more than 200 classified forms of mental illness, and some of the more common disorders included depression, bipolar disorder, dementia, schizophrenia and anxiety disorders.
“Murder cases that allegedly involved suspects with mental disorders have shown how serious the issue is and the need to deal with it at the community level.
“Like a time bomb, those who are suffering from mental health problems may explode any time, affecting their family and community.
“Physical and mental health are inseparable, which are the foundation of good health.
“Despite its increasing significance, the reality is that governments, public health practitioners and citizens devote little attention and consequently fewer resources to create awareness about mental health and mental illness.”
Lee: We don’t have enough psychiatrists in Malaysia
Mental Health Promotion Advisory Council member Tan Sri Lee Lam Thye has raised his concerns about the insufficient number of psychiatrists to help people dealing with mental issues.
Lee, who is the patron of the Malaysian Psychiatric Association (MPA), justified his concerns following reports that mental illness will become the second biggest health problem affecting Malaysians after heart disease by 2020.
“It was reported that the number of psychiatrists in Malaysia until March 2017 was only 381. A total of 207 psychiatrists are from the Health Ministry, followed by public universities (84), private universities (22), armed forces (5) and the private sector (63).
“The normal psychiatrist to population ratio is 1:10,000. However, in Malaysia, the ratio is 1:100,000... And what is more worrying is that mental disorders are affecting more youngsters.”
More young adults, he said, were experiencing symptoms of stress-related illnesses, such as anxiety or depression, due to life experiences or environmental factors.
MPA vice-president Associate Professor Muhammad Muhsin Ahmad Zahari said people living in urban areas had better access to mental healthcare due to the availability of a greater number of psychiatrists.
“For instance, we have almost 100 psychiatrists in the Klang Valley. But the number drops in states like Perlis.
“Hence, the distribution is not balanced, hindering treatment for the needy.”
Lee called on the Health Ministry to provide allocation for preventive programmes to combat the stigma against those with mental illness.
“Based on a Harvard report in 2015, Malaysia spends only 1.3 per cent of the health budget to treat mental illness compared with an international average of 2.8 per cent.
“This is something not to be taken lightly as, according to the Health Ministry’s 2016 Malaysia Health Systems Research, mental health issues leave a large impact on the economy,” he said.
He proposed for a special division to beef up the mental health unit in the ministry and to implement and monitor the strategy on mental health development.
He also proposed for greater collaboration between the police and other agencies, such as the Health Department, to collect relevant information and establish a database on cases involving people with mental illness who inflict injuries to others.