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INTRODUCTION
A few months back, I had a consultation with a young lady, Anna (not a real name). She’s a student, the youngest among her siblings and her parents are retired civil servants. Anna struggled with an unstable mood and hearing voices (which happened every day). Long story short, whenever she asked her mother to send her to the hospital, Anna’s mother refused. The mother consistently questions and denies whenever she tries to explain;
“Which part of the body is actually in pain?”
“What kind of sickness do you have?”
“You’re just being lazy and weak..”
“Don’t embarrass our family with any weird sickness..”
“People will talk about this, and it is humiliating…”
The mother relentlessly excuses herself and her husband getting old and will not live that long. She insists for Anna to wait until her last breath (before getting treatment at a hospital). Despite that, Anna still went to the nearest hospital and was admitted for treatment. Unfortunately, the mother’s words came true. Around a month later, Anna’s father died of a heart attack. And the mother blamed Anna for that.
Sadly, Anna’s story is just one of the others. A lot of families and people out there are still judgmental towards mental health issues. Despite being highly educated and having a professional career, some people are still close minded when it comes to mental health.
Even after years of working as a professional helper, I’ve never once thought that mental health is an easy topic to discuss with just anybody. Its taboo for some people and some won’t even bother to understand. Even though mental health issues have received more attention nowadays, there are still people being judgmental and ignorant towards the issue.
From my experience, 90% of my previous clients keep their family and friends in the dark about their mental health conditions. They are conscious if I would ever inform their parents or guardians. Which, I won’t tell unless a certain situation (self harm behavior, suicidal behaviour or attempt, etc.) occurs.
Here’s what we should know about mental health, in the hope the readers will find it informative and useful to lend our hand to people around us.
WHAT IS MENTAL HEALTH?
Some people are still confused between mental health and mental illness. It is different yet fall under the same topic.
Mental health is like our physical health. Our mental health can decrease or get better depending on how we take care of ourselves. Mental health is our well-being that includes social, emotional and psychological. A good condition of mental health affects the way we think, feel and act. It indirectly shows in our daily lives as we handle stress, empathize with others and make decisions.
According to the World Health Organization (WHO),
“Mental health is a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”
Based on research by Galderisi, Heinz, Kastrup, Beezhold & Sartorius (2015)
“Mental health is a dynamic state of internal equilibrium which enables individuals to use their abilities in harmony with universal values of society. Basic cognitive and social skills; ability to recognize, express and modulate one’s own emotions, as well as empathize with others; flexibility and ability to cope with adverse life events and function in social roles; and harmonious relationship between body and mind represent important components of mental health which contribute, to varying degrees, to the state of internal equilibrium.”
In other words, if we have a tendency to get physical disease, there’s also a chance for us to get a psychological illness. Especially when we are continuously exposed to stress, traumatic events, crisis, anxiousness, neglect, emotional damage, and/or the list goes on.
WHY MENTAL HEALTH DETERIORATE?
Our mental health condition is not static. It can get weak or function maximally depending on different stimuli. We might have:
- Biological inheritance – genetic, unstable hormones, etc. or
- External significant events – trauma, bullying, racism, abuse, family negligence, brain injury, death of loved ones, loss of job, bankruptcy, etc. or
- Physical disease – cancer, diabetic, kidney failure, injury caused by accident, etc. or
- Others – any daily stressor from work/study or environment that occur continuously
The Signs
Based on Michaud and Fombonn (2005) these are some common signs to pay attention to and in need of assessment:
- Signs of overt mood depression (low mood, tearfulness, lack of interest in usual activities)
- Somatic complaints such as headache, stomach ache, backache, and
- sleep problems (lack or over sleeping)
- Self-harming behaviours
- Aggression
- Isolation and loneliness
- Deviant behaviour such as theft and robbery
- Change in work/school performance or behaviour
- Use of psychoactive substances, including over the counter medications
- Weight loss or failure to gain weight with growth
SUPPORT AND MENTAL HEALTH
Family
Parents and family members are one of the most important backbones for our mental health. They being judgmental to us is the last thing we ever hope for. Like Anna, a lot of people are experiencing the same struggle. Parents questioning their children being depressed without reason, set high expectations, while some are neglectful, toxic and/or abusive.
Research by Piat, Sabetti, Fleury, Boyer, & Lesage (2011) found that the majority of their patients with serious mental illnesses reported that their families were their primary source of strength.
As for ourselves, what kind of parent or family members we want to be? The supportive or the toxic ones? If we choose to be caring and supportive, let’s start equipping ourselves with the right knowledge about human psychological development and parenting skills.
Community
Be it our friends, neighbours, colleagues, people you meet offline or online, each one of them matters and gives added value to our life.
We’re in a world where anything can be accessed on the tip of our finger. You can be a kind and supportive person or choose to be the jerk keyboard warrior, using nasty words to hurt others. Our words alone are enough to ‘kill’ or leave a scar on a person’s heart.
Mental health is quite tricky and most of the time invisible. Naturally, it’s hard to spot if people around us are struggling. People can put a façade of happy face yet drowning inside.
Research done by Kohrt, Asher, Bhardwaj, Fazel, Jordans, Mutamba, Nadkarni, Pedersen, Singla, and Patel shows that;
“Community components are vital to address global mental health needs and to rectify the stark gap between the burden of mental disorders and access to appropriate evidence-based interventions in low and middle income countries. First, community components extend the reach of mental health services in settings where primary care and specialty services exist. Second, community components are part of filling the gap in settings where mental health services do not exist in primary care.”
Individual
Mental health for the self is the most important part. I believe people who are struggling can relate to this song lyric,
“If you’re looking at it in a certain way, it’s harder to love yourself than to love someone else.” – Answer: Love Myself, BTS
Having mental health problem will be affecting our daily routine if we don’t cope with it properly. When we’re in pain emotionally, the wound is not visible. How do we tend to this pain and wound?
Self-care is the key:
- Physical and/or outdoor activity – walking, gardening. go to gym, hiking, etc.
- Seek help when in need – reach out to people you trust
- Keep engaging with your surrounding and be mindful – read, learn and practice
- Aware of your emotions – check on your emotional changes
- Check your spiritual journey – practice pray, mindful and meditate
AID FOR MENTAL HEALTH
In Malaysia, we can find mental health services (counsellor, clinical psychologist, and/or psychiatrist) through government sectors or private practices in Malaysia.
In government sectors you can look in to these government department or ministry:
- Ministry of Health – Klinik Kesihatan Daerah and district hospitals (only accept emergency and/or referral cases). Minimum fee for registration.
- University hospitals (statutory body) – any public universities with attached hospitals, University of Malaya Medical Centre (UMMC), Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), etc.
- Ministry of Women, Family and Community Development – LPPKN and JKM.
Or if you have an extra budget for mental health treatment, you can subscribe to any private practices. Now, a lot of centres provide online services too. With a good internet connection, you can get decent counselling and therapy services. Time efficient and cost saving.
MENTAL HEALTH CHALLENGES
Since mental health is not something visible, it’s challenging to explain, convince and educate people about it. It is influenced by a variety of views including socioeconomic, cultures, religions and politics.
Research by Ainul and Bortel (2015) stated that;
“Stigma manifests itself most often in forms of labelling, rejection, social exclusion and in employment. Family, friends and workplace staff are reported to be the main perpetrators of discriminatory conducts.”
In order to reduce and/or avoid stigma, instead of looking at others, try asking ourselves;
“Am I being judgmental towards my sister?
“Have I ever spent time and being there for my son when he shares his problem?”
“What do I understand about mental health and how can I help people with mental problems?”
“If I have a mental health problem, what can I do to help destigmatize?”
As a counsellor, my role as a mental healthcare practitioner is to support and spread awareness through psycho-education surrounding mental health to decrease stigma. Nevertheless, it could be beneficial if people with personal experiences advocate to the communities about their mental health journey and us to be supportive towards each other struggles.
CONCLUSION
It is my hope to see all Malaysians to be more accepting towards mental health concerns above all to people close to us. It’s crucial for each of us to have a better understanding about mental health. As a start, don’t hesitate to seek help if you need to. Take care and love yourself first therefore you can do the same for others.
A regular 6 to 12 months check-up can rule out the symptoms. An appointment with a mental health professional will be beneficial for us no exception including for a counsellor or therapist. The interview and following process will be very helpful to determine the most obvious symptoms and severity of mental health conditions. In certain cases, an intervention may include our family and friends. If you or someone you know needs help, email me at asyikin.tmp@gmail.com to get more information on our mental health services.
Written by:
Asyikin Sayed, Registered Counsellor; M. Soc. Sc. Counselling Psychology, UKM; B. Soc. Sc. Psychology (Hons.), UKM
REFERENCE:
Anon. 2018. What Is Mental Illness? Published by: American Psychiatric Association. https://www.psychiatry.org/patients-families/what-is-mental-illness
The Government of Malaysia’s Official Portal. Managing Family Institution: Counselling Services. https://www.malaysia.gov.my/portal/content/28902?language=my
Official Portal: Ministry of Women, Family & Community Development. https://www.kpwkm.gov.my/kpwkm/index.php?r=portal/index
World Health Organization. Promoting Mental Health: Concepts, Emerging Evidence, Practice (Summary Report). Geneva: World Health Organization; 2004. [Google Scholar]
Galderisi, S., Heinz, A., Kastrup, M., Beezhold, J. & Sartorius, N. Toward A New Definition Of Mental Health. Published Online, 4th June 2015. World Psychiatry: 14(2): 231-233. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471980/
Piat, M., Sabetti, J., Fleury, M.J., Boyer, R., & Lesage, A. “Who Believes Most in Me and in My Recovery”: The Importance of Families for Persons With Serious Mental Illness Living in Structured Community Housing. J. Soc. Work Disabil Rehabil. 2011: 10(1): 49-65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4835237/
Kohrt, B.A., Asher, L., Bhardwaj, A., Mina Fazel, M., Jordans, M.J.D., Mutamba, B.B., Nadkarni, A., Pedersen, G.A., Singla, D.R., & Patel, V. 2018. The Role of Communities in Mental Health Care in Low and Middle-Income Countries: A Meta-Review of Components and Competencies. Published: Int. Journal of Environmental Research & Public Health.15(6): 1279. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025474/
Ainul Nadhirah Hanafiah & Bortel, T.V. 2015. A Qualitative Exploration Of The Perspectives Of Mental Health Professionals On Stigma And Discrimination Of Mental Illness In Malaysia. International Journal of Mental Health Systems. 9:10 DOI 10.1186/s13033-015-0002-1. https://ijmhs.biomedcentral.com/track/pdf/10.1186/s13033-015-0002-1.pdf
Michaud, P.A. & Fombonne, E. 2005. Common Mental Health Problems. BMJ Clinical Research 330(7495):835-8. https://www.researchgate.net/publication/7918340_Common_mental_health_problems
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