KUALA LUMPUR, October 4 – The Ministry of Health (MOH) should establish a dedicated department for mental health to tackle Malaysia’s rising rates of depression, self-harm, and suicide in adolescents and adults, Syed Saddiq Syed Abdul Rahman has recommended.
The MUDA president has called for a larger proportion of MOH’s budget to be directed to mental health and for the federal government to replicate efforts in Thailand and West Australia where departments devoted to mental health have been established.
“In order to stop this (mental health crisis), we need a separate, specialised unit to deal with mental health issues, similar to Thailand or West Australia that have dedicated departments in their respective ministries for mental health,” the Muar MP told CodeBlue in a written response.
In 2010, the West Australian government set up a Mental Health Commission to lead mental health reform throughout the state. The Commission was set up initially by transferring existing resources of the Mental Health Division of West Australia’s Department of Health.
The Commission’s role is to commission, provide, and partner in the delivery of prevention, promotion and early intervention programmes; mental health treatment, services and supports; as well as research, policy and system improvements.
In Thailand, the Mental Health Department is the national mental health authority, providing advice to the government on mental health policies and legislation, sets the standard of care and develops and transfers mental health technologies to all stakeholders.
According to a 2016 WHO report on the mental health system in Thailand, about 3.5 per cent of Thailand’s health expenditure in 2004 was directed to mental health services.
Thailand has three separate social insurance schemes for labour, health, and civil servants that cover all severe and some mild mental disorders, the WHO report stated.
About 93 per cent of Thai people have free access to essential psychotropic medicines, while those who pay out-of-pocket for medicines pay only two per cent of the one-day minimum wage for the cheapest antipsychotic medication. For the cheapest antidepressant medication, the cost is one per cent of the one-day minimum wage.
Although the country does not have a dedicated mental health department, efforts to set up a National Centre of Excellence for Mental Health (NCEMH) are underway in Malaysia. The NCEMH aims to reduce the gap in mental health care and increase the quality of the nation’s mental health services through promotional, prevention, and intervention activities intended to increase literacy, reduce stigma and make mental health services more accessible.
Syed Saddiq pointed out that MOH spends less than one per cent of its annual budget on mental health, a far cry from 2.4 per cent spent by upper middle-income countries on average for mental health, as reported in the World Health Organization’s (WHO) “Investing in Mental Health: Evidence for Action” 2013 publication.
According to the estimated federal expenditure for 2022, the allocation for psychiatry and mental health was RM319.58 million, just under one per cent of the MOH’s RM32.4 billion budget. However, the WHO’s “Mental Health Atlas 2020” country profile for Malaysia stated that the government spends about 1.1 per cent of its health expenditure on mental health.
Last week, Health Minister Khairy Jamaluddin said the government is seeking to boost federal spending on mental health by 2.5 per cent in the upcoming Budget 2023, following a spike in mental health cases, including suicides, during the Covid-19 pandemic.
“It is not merely the fact that we don’t spend enough money on addressing mental health issues. We are addressing it the wrong way. Far too often, mental health is addressed the same way that physical health issues are addressed,” Syed Saddiq said.
The Muar MP attributed poverty as a root cause for many mental health issues – from children not getting enough attention from parents due to long working hours to poor work-life balance in working adults.
The National Health and Morbidity Survey (NHSM) 2019 found that 424,000 children had mental health problems in Malaysia, of which 9.2 per cent were children from low-income families, while 8.8 per cent involved children from rural areas.
In another report by New York-based company Kisi titled “Cities with the Best Work-Life Balance 2022”, Kuala Lumpur ranked the third most overworked city in the world ahead of Singapore, which ranks fourth. A 2016 article by The Malaysian Insider reported that many people in Malaysia work two jobs just to support themselves.
“In order to battle mental health issues, [especially] among kids and teens, socio-economic issues have to be [addressed] too to give parents enough space to [spend time with] their children,” Syed Saddiq said.
The former minister for youth and sports minister also called for specific training to be offered to parents, teachers and school children so that mental health issues can be “properly identified”, and for the public to be well-informed of ways to address them.
“Even though there are syllabi in the Pendidikan Kesihatan (health education) textbook to theoretically educate the students on mental health, it is not enough for them to understand the downside of poor mental health. Therefore, there should be a specific class to educate parents and children on understanding mental health issues.”