In 2015, the Health Ministry published a report stating that 30 percent of Malaysians have a mental health condition. This figure is alarming and reflects a three-fold increase since 1996.
Yet we have not heard much from the government to address this issue. The silence from the authorities is disappointing, to say the least. Imagine if the statement had been that three out of 10 people had cancer, or some other physical disease, would not the sense of urgency and urging for action be so much greater?
In 2016, the Health Ministry released its Plan of Action for health care for 2016-2020. The only mention of what is being done/planned to address mental health care was on page 24, which showed that 90 percent of patients with a mental health condition failed to get a job even after going through the Individual Placement and Support-Supported Employment (IPS-SE) at the Pusat Komuniti Kesihatan Mental (Mentari).
The government has neglected to publicly address the issue time and time again, and to provide effective solutions to the mental health care crisis. Very few public figures have openly advocated for mental health issues, which perpetuates the stigma against mental illness, and decreases the likelihood of people getting treatment. Moreover, even if patients sought for assessment and treatment, mental health care in the public and private sector is severely lacking.
The Malaysian Medical Council recently stated that there is only 1 psychiatrist per 200,000 people in Malaysia. What a dire situation we find ourselves today - 9 million people in Malaysia have a mental health condition and with only have one psychologist and half a psychiatrist per 100,000 people to meet the nation’s needs.
We have paid and will continue to pay a high price for turning a blind eye to mental health care.
Mental illness costs the economy millions of dollars in terms of loss of income. It is so high that the Agency for Healthcare Research and Quality estimated a cost of US$57.4 billion per annum in mental health care in the US, which is equivalent to the total cost of cancer care.
The difference? The bulk of the cost of cancer care comes from the treatment of cancer, whereas the bulk of the cost of mental illness comes from unemployment and unpaid leave, expenses for social support, and other indirect costs caused by the disability.
Mental illnesses are the leading causes of disability adjusted life years (Dalys) worldwide, accounting for 37 percent of healthy years lost from non-communicable diseases. In Malaysia, depression ranks as the top 5 cause of Dalys (4.1 percent; one Daly can be understood as one lost year of ‘healthy’ life).
Mental illnesses increases suicide risk and decreases life expectancy.
Over 90 percent of people of commit suicide experience mental illness. Researchers place rate of suicide close to 10 people a day commit suicide in Malaysia.
The reduction in life expectancy for many mental illnesses on average is 13.8 years. This is higher than the reduction in life expectancy associated with moderate to heavy smoking (average of 9 years).
There are 9 million Malaysians who need help, and our government cannot remain silent any longer. We must address the elephant in the room.
The stigma of mental illness needs to be addressed in schools, through public education and anti-discrimination campaigns; mental health care must be improved with accessible and affordable evidence based assessments, prevention and clinical treatments; and patients’ rights not to be discriminated against and to make informed choices about their treatment have to be legally protected.