Mental Health Awareness Month is a crucial time to focus on understanding mental health, recognizing the signs that someone might need help, and knowing how to support loved ones experiencing mental health issues. This blog post will guide you through key concepts, determinants, challenges in access and delivering mental health services.
Key Facts About Mental Health
Mental health is essential for our overall well-being, enabling us to cope with life's stresses, realize our abilities, learn effectively, and contribute to our communities. It is a state of well-being that is influenced by a complex interplay of individual, social, and structural factors.
Importance of Mental Health
Mental health is more than the absence of mental disorders; it exists on a continuum and is experienced differently by everyone. It includes mental disorders, psychosocial disabilities, and other mental states causing significant distress or impairment. Mental health is a fundamental human right and crucial for personal, community, and socio-economic development.
Challenges Surrounding Mental Health
Mental illness is one of the leading causes of disability and health loss in Malaysia, accounting for 8.6% of total disability-adjusted life-years (DALYs). The prevalence of mental disorders among adults has significantly increased, with 29% of the population affected, a threefold increase since 1996. The rural region of East Malaysia has the highest prevalence at 43%, followed by Kuala Lumpur at 40%. Rapid urbanization, cultural shifts, and increased levels of perceived stress contribute to this rise. Social stigma and lack of awareness remain major barriers to accessing mental health care, with only 20% of Malaysians with a mental disorder seeking professional help.
Additional challenges include:
High Costs of Healthcare Services: Many individuals cannot afford the necessary treatments and services for mental health care.
Limited Availability of Services: Particularly in rural and remote areas, mental health services are scarce and difficult to access.
Inaccessible Physical Environments: Healthcare facilities often lack accessibility features such as proper medical equipment, bathroom facilities, parking areas, and walkways.
Lack of Professional Training: Healthcare practitioners often lack adequate training in providing care for persons with disabilities.
Ableist Practices: There is often inadequate understanding of disability among healthcare workers, leading to discriminatory practices such as disregarding the rights of people with disabilities to make decisions about their health and denying life-saving treatments.
Poor Access to Preventive Health Services: Preventive services such as health screenings, vaccinations, and health counseling are often inaccessible.
Inadequate Health Information: There is a lack of accessible information about general health and sexual and reproductive health issues.
Inconvenient and Costly Transportation: Transportation to healthcare facilities is often inconvenient, inaccessible, and expensive.
Discrimination and Gatekeeping: People with disabilities often face discrimination, such as not being prioritized in life-saving medical procedures, vaccination and screening programs, and mental health programs.
Improving Access to Mental Health Treatment
Addressing the needs of people with mental health conditions involves providing community-based mental health care through a network of interrelated services. These include integrated mental health services in general healthcare, community mental health centers, and services in social and non-health settings. Innovative approaches, like non-specialist psychological counseling and digital self-help, are necessary to bridge the care gap for common mental health conditions.
Making healthcare services accessible to everyone, not just people with disabilities, will significantly improve the experiences of navigating healthcare services, which can be overwhelming and complicated. Patients with and without disabilities and their caregivers or care partners will better understand the importance of taking medication as instructed, feel comfortable asking questions, and feel less anxious in a hospital.
Some adaptations for accessibility are simple and easy to make to the existing mode of healthcare provision, while others require more planning. Accessibility should ideally be considered from the beginning, in the design of physical buildings and the procurement of equipment. Involving and listening to individuals from diverse disability groups in any planning of healthcare services, from start to finish, is best practice. This includes plans to retrofit or renovate existing facilities for accessibility and building new healthcare facilities. Similarly, co-designing and co-delivering disability-related healthcare training with persons with disabilities will enhance the skills and knowledge of healthcare providers.
Basic strategies to make healthcare services accessible to all include:
- Accessible Healthcare Information:
- Medication instructions and labels in accessible formats such as Braille, large print, easy-read written information, and sign language interpretation (Bahasa Isyarat Malaysia - BIM) in videos.
- Closed captions or subtitles in videos and audio formats.
- Communication with Persons with Disabilities:
- Provide sign language interpretation (BIM).
- Use plain language explanations and avoid jargon.
- Avoid using ‘baby’ tone/speak with individuals with disabilities, especially those who are no longer toddlers.
- Communicate directly with the individual with a disability and allow them time to respond to questions or complete tasks.
- Removing Physical Barriers:
- Ensure wheelchair-accessible paths, including dropped curbs, safety-compliant ramps, wide doors, and accessible and clean toilets.
- Provide simple, clear signage for directions and accessible medical equipment, such as height-adjustable examination tables and mammography equipment.
- Make reasonable adjustments to reduce sensory overload (e.g., noise, lighting, crowd, temperature).
- Implement an accessible public transport system to healthcare facilities.
- Predictable Environment:
- Organize an appointment system to reduce anxiety by avoiding unexpected long waiting times.
- Clearly explain medical and administrative procedures in advance.
Challenges in Delivering Mental Health Services in Malaysia
In Malaysia, mental health services face challenges due to limited budget allocations. The WHO Mental Health Atlas 2017 reported that upper-middle-income countries spend a median of 2.4% of their health budget on mental health, but Malaysia allocated only 1.3% in 2017 and 2018. The current model of care is divided into in-patient and community care, with significant reforms transitioning from custodial to community care. However, there is a significant deficit of psychiatrists, with only 1.27 per 100,000 population, far below the WHO recommendation of 10 per 100,000. Social stigma and misconceptions about mental illness further hinder access to treatment, with many Malaysians turning to traditional healers instead of medical professionals.
Conclusion
People with disabilities have the right to access quality health care services that improve their quality of life and a health care provision that is accessible in all aspects, including communication, information, affordability, facilities, and infrastructure. A total transformation of health care services in Malaysia is necessary, not just because the survival, health, and quality of life of people with disabilities depend on it, but also because disability-inclusive health care services benefit others: those without disabilities and those with temporary or situational disabilities.
Mental Health Awareness Month is an opportunity to highlight the importance of mental health, recognize signs that someone may need help, and learn how to support those struggling with mental health issues. By understanding key facts, concepts, determinants, and strategies for promotion and prevention, we can contribute to a more informed and supportive community. Let’s work together to ensure better mental health for all.
For more information, call us at +613-249 0069 to book an appointment with our Clinical Psychologist.
Sources:
Raaj, S., Navanathan, S., Tharmaselan, M. & Lally, J. (2021). Mental disorders in Malaysia: an increase in lifetime prevalence. BJPsych Int. https://doi: 10.1192/bji.2021.4.
n.a. (2022). Mental Health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response/?gad_source=1&gclid=Cj0KCQjw3tCyBhDBARIsAEY0XNnHRWlA5OM_Gpn0iTBi_SGVMBaFyNxbNSNG43Cuao7c8zy6C_LOEtIaAgIIEALw_wcB (Accessed: 28 May 2024).
コメント