Mental Illness Among The Urban Poor In Malaysia Requires Serious Attention — Amanda Yeo

Greater emphasis on mental healthcare among the urban poor is required – continuing the spirit of providing universal healthcare for the benefit of all Malaysians.

There is an increasing fear that the second wave of job retrenchment would cause more urban poor in Malaysia falling into mental illness. This can be seen in the cities of Kuala Lumpur, Selangor and Kota Kinabalu – the heads of households (HOH) had to pretend going out for work even though they lost their source of income; people committed suicide due to job losses; people might even commit crimes to survive.

According to the Department of Statistics (DOSM), there were 764,400 unemployed persons in November, which result in a rise of unemployment rate by 0.1 percentage point month-on-month to 4.8% in November 2020.

The recent EMIR Research third quarterly poll (3Q20) also revealed a worrying figure of National Worry Index (NWI) at 0.79, which is just one notch below the unhealthy level of 0.80 of maximum worry.

In addition, the Ministry of Health (MOH) recorded 465 attempted suicide cases between January to July. The National Health and Morbidity Survey 2019 (NHMS 2019) also revealed that close to half a million population in Malaysia have had their mental health affected by the Covid-19 pandemic.

As the economy is yet to recover to the pre-pandemic level, The Befrienders Kuala Lumpur revealed there are more people suffering in distress and feeling suicidal between July to September compared to April, May and June.

This is especially apparent among the urban poor households with family obligations.

According to the latest United Nations Children’s Fund (Unicef) “Families on the Edge” survey released on Oct 30, there is increased tensions between spouses and between cares of children in some households where almost one in five HOH and roughly one in three of female-headed households (FHH) in the low-cost flats around Klang Valley felt depressed and experienced unstable emotions.

Their emotional distress along with their worry of being able to put food on the table for their family and meeting the children’s education-related expenses, and having insufficient savings and now, the loss of jobs, have heightened the pressure further.

The long isolation arising from the health crisis also causes more Malaysian youths and children to suffer from mental illness. Even before the pandemic emerges, NHMS 2019 survey also recorded there are 424,000 youths and children suffering from mental health related problems, including one in ten children aged between ten and 15 years. Another study also revealed there are secondary school students who are as young as 13 years old – attempting to commit suicide.

The latest Unicef survey also showed there is a significant proportion of the families reported difficulties in meeting the costs associated with school attendance, especially among FHH. About four in ten of all HOH and one in two of FHH reported difficulties in providing face masks to their children.

With inadequate access to education, the children who are originally from urban poor families would find challenging to make ends meet when growing up and their self-esteem would remain low.

The rising unemployment among Malaysian youths is also another factor that could result in mental illness, especially among youths who come from urban poor families. The Ministry of Higher Education (MOHE) estimated 25 per cent or 75,000 potential graduates would have their employment opportunities disrupted, six months after they graduated. This poses a greater financial burden among vulnerable urban youths who are trying to cope with the continuous rise of living costs.

With the rising mental distress among the urban poor, it has indirectly contributed to a high number of psychosocial hotlines call received by the MOH since the lockdown measures imposed in Malaysia – 37,009 calls as of 11 November.

Up to now, the helpline received 53.3 per cent on requests for emotional support related to psychology, 12.6 per cent on Covid-19 related enquiries, 4.6 per cent on domestic issues, 4.98 per cent on financial assistance, 2.7 per cent on domestic violence.

As the number of psychiatrists in Malaysia (410 psychiatrists in 2018) is much lower than the World Health Organisation (WHO)’s recommended ratio of one psychiatrist per 10,000 population, the government should increase the funding allocation of mental healthcare by training more mental health professionals, with the provision of free consultancy service to urban poor who can’t afford to pay mental illness related treatment.

As mental illness is expected to be the second biggest health problem affecting Malaysian after heart disease by 2020, now is the time for the government to work closely with mental health practitioners, schools and community groups – expanding mental health infrastructure to support urban poor in managing the mental illness problem.

The mental health practitioners thereby could organise door-to-door visits to understand inner needs and problems among the urban poor, in addition to providing psychological first aid-based helplines for urban poor to express their psychosocial concerns. Schools and community groups could create a supportive and enabling environment for the urban poor to have a greater sense of belonging in the community.

In turn, schools may help students from urban poor families to cope with stress better by adapting teaching styles, offering safe emotional spaces within classrooms and improved services for diagnosis and referrals.

Moreover, community groups involving social workers could play a preventive role by working together with counsellors, psychiatrists and clinical psychologists – improving mental health literacy through parenting workshops and peer assistance groups focusing on urban poor.

Although the current administration acknowledges the mental illness issue by allocating RM24 million under Budget 2021, greater emphasis on mental healthcare among the urban poor is required – continuing the spirit of providing universal healthcare for the benefit of all Malaysians.

Amanda Yeo is Research Analyst at EMIR Research, an independent think tank focused on strategic policy recommendations based on rigorous research.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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