Research conducted during the pandemic revealed that mental health issues among Malaysians increased by twofold, compared to the baseline data from National Health and Morbidity Survey 2019.
The outcome of this was a worrying figure of 2,800 suicide cases occurring throughout the pandemic.
Low-income groups that experienced double financial hardship are of particular concern, for their likelihood of developing mental health issues.
The critical mental health issues are a reflection of existing gaps in accessing mental health care.
Poor help-seeking behaviour stems from high mental health stigma, and low mental health literacy hinders an individual from getting the needed treatment.
By realising stigma, a threat to successful prevention and treatment, high-income countries like the United Kingdom have adopted online low-intensity psychosocial therapy as one of the mainstays for mild common mental health issues.
Their research has shown that online therapy reduces stigma and promotes the uptake of treatment.
An online culturally sensitive health tool, ReSHApe (Recognise, Self-help and Help-seeking), developed by a group of researchers from the University of Malaya, has shown a positive uptake from the low-income group and reduced mental health issues through a positive psychology approach.
This health promotion tool was developed and used during the pandemic.
Digital mental health has an advantage of reaching out to underserved audiences with low budgets, less stigma, and with minimal professional assistance.
The drawback is high dropout rates, but this is offset by the massive outreach. Hence, here are a few policy recommendations for mental health digitalisation:
1. Anti-stigma mental health promotion intervention for vulnerable communities should be the policy priority and explicit in the national mental health policy and strategic plan.
2. Task-shifting leverage on non-professional workers to implement less structured mental health intervention that promotes positive psychology in the community setting. Such an approach is culturally appropriate, less stigmatised, and less labour-intensive, and can strengthen Malaysia’s limited mental health care workforce.
3. Improving network coverage on the internet will benefit rural areas in East Malaysia and low-cost housing areas with more subsidised charges. By reducing network inequity among the poor, access to quality online mental health care is enabled.
4. Invest in online research in a real-world setting to understand poor help-seeking behaviours. Research done by social scientists has shown that the human belief system can defy evidence-based intervention and opt for less scientific options. Human behaviour may elucidate vaccination hesitancy in the community, despite adequate health education.
Digitalising mental health care can resolve unmet needs and provide vulnerable groups with quality health care through sound technology. It is hoped that optimising digitalisation will close the global mental health inequality gap.
References
Griffiths, K. M., Christensen, H., Jorm, A. F., Evans, K., & Groves, C. (2004). Effect of web-based depression literacy and cognitive–behavioural therapy interventions on stigmatizing attitudes to depression: Randomised controlled trial. British Journal of Psychiatry, 185(4), 342-349. doi:10.1192/bjp.185.4.342
NICE. (2009a). Depression in adults with a chronic physical health problem: recognition and management. Retrieved from https://www.nice.org.uk/guidance/cg91/chapter/Recommendations#step-2-recognised-depression-in-primary-care-and-general-hospital-settings-persistent
NICE. (2009b). Treatments for mild to moderate depression. Retrieved from https://www.nice.org.uk/guidance/cg90/ifp/chapter/treatments-for-mild-to-moderate-depression.
NICE. (2021). Improving Access to Psychological Therapies (IAPT). Retrieved from https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/iapt
Sweeney, G. M., Donovan, C. L., March, S., & Forbes, Y. (2019). Logging into therapy: Adolescent perceptions of online therapies for mental health problems. Internet Interventions, 15, 93-99. doi:https://doi.org/10.1016/j.invent.2016.12.001
Dr Wong Min Fui, Dr Mas Ayu Said and Dr Hazreen Abdul Majid are from the Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, and Dr Rozmi Ismail is Deputy Dean of the Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia Bangi.
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