We need immediate strategies to deal with the mental health crisis the Covid-19 pandemic has triggered.
IN the last two decades, several pandemics worldwide have yielded insights on the mental health impact of such events. However, the current Covid-19 pandemic has been somewhat less predictable.
In addition to the sudden psychological decompensation (reflected by the increase in number of consultations and calls to helplines), a spike in the number of suicides could have been related to loss of income, loneliness and the sudden change in lifestyle. Based on these recent experiences, and given the magnitude and peculiarity of the current pandemic, this scenario is likely to stay with us for some time, even when the pandemic starts to resolve.
Indeed, the Covid-19 public health crisis has turned into a mental health crisis.
Help needed
There is a need to have workplace mental health strategies and mechanisms to protect the mental health of both government and corporate sector employees grappling with working in the new normal.
Massive economic losses have occurred due to decline in productivity and loss of business opportunities.
There is a need to boost the morale of the workforce to regain optimism and competitive spirit.
Mental health interventions are urgently needed to minimise psychological sequelae and provide timely care to affected individuals like school children and youth.
The elderly who are the most vulnerable both physically and psychologically, need to be protected from further effects of neglect and isolation.
Issues concerning mental health that confront us today need to be taken out of the purely medical domain.
Increased electronic gadget usage leading to addiction, stigma towards mental health, problems of substance abuse, coping skills and mental resilience, particularly among the rural population and urban poor, can also be addressed through community participation and synergistic approaches involving a variety of stakeholders.
Repeated calls to scale up mental health services in the public sector by recruiting more psychiatrists, clinical psychologists and counsellors, have become cliché.
This is easier said than done. Increasing positions in the civil service involves a huge expenditure, among other factors.
The skewed concentration of private mental health professionals in urban areas does not help the situation either.
Despite these constraints, the Health Ministry has done a remarkable job by augmenting its overstretched clinical services.
An example of its collaborative approach is the Mental Health and Psychosocial Services (MHPSS), rolled out via a hotline for Covid-affected communities and medical front-liners.
Let’s Talk Minda Sihat is another ministry initiative that brings together families, caregivers and counsellors, thereby taking a community approach in mitigating mental health problems.
So how do we expand and enhance such efforts to meet the needs of the nation reeling in psychological decompensation?
The National Rehabilitation Council may want to capitalise on existing resources not only to address immediate mental health needs, but to also offer proactive interventions to promote resilience, particularly among the rural youth and urban poor. The Women, Family and Community Development Ministry has about 1,000 social workers and 150 counsellors stationed throughout the country.
The Education Ministry has a whopping 20,000 counsellors placed in 10,000 schools around the country. And this figure does not include counsellors stationed in public and private universities.
In addition, the Youth and Sports Ministry has its own psychologists and counsellors.
This huge workforce may only require minimal capacity-building to scale up expertise.
Task-shifting can help close the anticipated treatment gap, leaving only cases requiring clinical intervention to be referred to clinical psychologists and psychiatrists.
This body of mental health personnel can also be utilised to reach out to community leaders and empower them to act as agents to promote mental health awareness. Community leaders can then offer appropriate help or direct those in need to the relevant services.
This tactic would be better than adopting the conventional, but inadequate, clinical approach to mental health.
An example of one such intervention is the suicide prevention programme called “A Conversation on Suicide” initiated by the Green Ribbon Group, the Malaysian Mental Health Association and the Making it Right Movement.
This programme aims to train the community in how to reach out and offer support to those who are suspected to be suicidal.
The community leaders targeted are members of Residents’ Associations, Rukun Tetangga, People’s Housing Project (PPR) committee members and other high-rise building resident groups.
Mental revolution
Prime Minister Datuk Seri Ismail Sabri in his address to the nation upon assuming office, emphasised his intention to put the war effort on Covid-19 at top of his list.
This concerted effort must include support and action by multi-sectoral stakeholders to assist in the healing and rehabilitative process of nation-building.
This phase of rehabilitation efforts in mental health and well-being should include embarking on a “mental revolution” in the country, particularly among the youth who have become weary, cynical and dismissive of everything. The term “mental revolution” is a management term used to refer to the change in thinking of both management and workers, to be less suspicious of each other and to cooperate to increase productivity, resulting in greater income for both parties.
We need to turn this phase of rehabilitation and resilience-building into a national movement of mental revolution similar to what was initiated by President Joko Widodo of Indonesia.
Robust mental health leadership is required to spearhead such efforts in our country. Our youth need to be empowered with character development, knowledge, expertise and high moral values.
These values are important to build resilience and to have optimism, respect and a sense of belonging to the country. The dynamic and creative side of our youth need to be teased out to prepare them to be future leaders of this beloved land of ours.
The new government needs to establish a template for greater engagement between youth leaders and cultural, religious and political figures. Include too, sportspersons and captains of industry to jointly promote mental well-being for a greater, prosperous and dignified Malaysia. This is the only way to find common ground and build consensus in the Malaysian Family.
We cannot let 64 years of Independence be in vain.
Dr. Andrew Mohanraj 