SHAH ALAM - Mental health issues are now more openly discussed, but does that really make it easier to seek help? With one in three Malaysian adults suffering from mental health problems, and reports showing high levels of stress, anxiety, and depression among students, it is time to take this matter seriously.
It is easy to recall childhood as a carefree, idyllic time, before the burdens and responsibilities of adulthood set in. However, growing up today is very different.
Around the world, many young people struggle with poor mental health. An estimated 86 million young people aged 15-19 live with a diagnosed mental health condition. Among these, 50 per cent begin by the age of 14 and 75 per cent by their mid-20s.
What does this mean for our young people? It means that mental health issues strike while they are in the prime of their academic lives, spanning the years from secondary school into college and university.
And before we assume that these problems stem from foreign lifestyles and philosophies, let’s take a look at local statistics – the National Health and Morbidity Survey found the prevalence of mental health problems is highest among those aged 16-19 years, with 18.3 per cent having depression and 10 per cent have suicidal thoughts.
What is more worrisome is the steady increase, from 10.6 per cent in 1996 to 29.2 per cent in 2015 among those 16 years and above. Some of the factors associated with this increase include unemployment, financial difficulties, and family and relationship problems, which in turn are compounded by poor coping skills and insufficient social support.
While the pandemic shone a spotlight on mental health issues, and avenues of support are available, there are also many barriers to treatment such as poor understanding of mental health problems, fear of social stigma or embarrassment, lack of social support, and difficulty accessing professional services.
For tertiary students who travel abroad to complete their studies, this could become an even more prevalent problem. To circumvent this issue, universities like the International Medical University (IMU) often work closely with their partner schools to ensure full support and care for the well-being of their students, and to provide benchmarks on how their students are actually coping overseas.
Support can come in the form of student-led initiatives like peer-to-peer support when students effectively reach out to one another, and counseling sessions with academic leads, senior tutors, and/or professional advisers.
From the perspective of Goh You, an IMU transfer student now in her fifth year at the University of Edinburgh, issues like depression, anxiety, insomnia, and burnout are commonplace among students for a variety of reasons that are only heightened by being far from home.
Moving from sunny Malaysia to chilly Edinburgh, she found that even the simplest thing was a reminder that she was far from home, such as her first and last name being mixed up and difficulty understanding the Scottish accent. During the winter months, the constant cold and early sunsets were also difficult to bear.
"There were many days when I wouldn’t see the sun at all, between being in the hospital wards at 8am and leaving at 5pm, when the sun would have set.
"All these things contribute to feeling like you just don’t belong, and you really have to put in a lot more effort to form relationships in the face of cultural and social differences. Overall, it makes a huge difference when you develop proper support systems and get to know when, where, and how to get the help we need,” she said.
Prior to her move, Goh had taken full advantage of IMU’s pre-departure briefings, and meet-and-greet sessions with Partner Schools under the IMU Academic Council meetings, to prepare herself for the upcoming changes.
Once she arrived in Edinburgh, she made sure to embrace her new life away from home, by participating in welcoming activities like the senior-junior picnic that encouraged opportunities to connect with fellow students, and explore the city with her university mates to familiarise herself with her new surroundings.
However, while Goh’s experience has been generally positive, many others – both local and abroad – have a much more difficult time coping with matters of mental health, which can sometimes manifest in chronic (long-term) behavioural changes. Often, these signs can be most easily noticed by family, friends, and others such as peers or teachers, such as sleeping difficulties, being easily angered or withdrawing from social activities.
Here are some behavioural changes to look out for, according to the IMU Self-Development Unit counsellors:
• Disturbed sleep patterns. These may include difficulties falling asleep or waking up, waking up in the middle of the night, or excessive sleep
• Emotional outbursts such as being very sensitive, easily irritated, or angry
• Persistent fatigue or being constantly tired
• Poor concentration. This includes losing track of conversations
• Significant changes in their eating habits and/or weight change that are not caused by a health issue
• Social withdrawal: A person may avoid or withdraw from social activities, be less active, significantly quieter, or not participate when in social groups. They may also avoid making eye contact with others
• The behaviour patterns indicated above appear continuously rather than just at one point in time or for a short occasion Some of these warning signs can be easily misunderstood or misconstrued in different social contexts. Hence, it is important to have patience in understanding a person’s behaviours when these could indicate possible mental health risk.
However, recognising the warning signs is only the first step. The next step is to offer support to someone who is struggling, and the IMU Self-Development Unit counselors say that listening to our intuition is very important – very often, the signs are there that tell us something is wrong but we may turn a blind eye and ignore them. In some instances, we may even feel concerned about our own safety.
Here is their advice, based on the NEC model: Notice – tell the person what you’ve observed that has worried you, such as ‘I noticed that you haven’t been eating/sleeping much lately.
• Express concern – let them know that you are worried about them and offer them space and privacy to listen to them and support them in any way such as ‘I’m worried about you. What happened? I’m here for you'.
• Connect them to someone who can help – suggest a person or resource where they can get the help they need, or offer to accompany them when they are ready to seek professional help. For example, ‘I might not know how to solve this now, but I know a friend who got help from XYZ; maybe we can go there together?”
Getting the right support is an important part of managing mental health, but at present, only an estimated 20 per cent of Malaysians with mental health problems receive professional care. To help, there are several options available to individuals and/or their caregivers. These include:
o Non-governmental organizations (NGOs). Many organisations offer mental help support with affordable fees such as AGAPE counseling, SOLS 24/7 and All Women's Action Society (AWAM)
o Government hospitals. These require a referral letter that can be obtained from a general practitioner (GP)
o Counselling units of respective institutes of higher learning
o Private mental health practitioners (including psychiatrists, clinical psychologists, and counselors) o Practicum/internship programmes from certain universities such as IMU For a more comprehensive list of mental health resources across Malaysia, check https://sites.google.com/view/psymalaysia/.
In the coming years, these resources will likely become more comprehensive as the National Mental Health Strategic Plan 2020-2025 aims to further develop the country’s mental health services, moving towards community-based care so that more people will be able to seek help.
Meanwhile, with continued efforts by individuals as well as organisations to build greater awareness and understanding of mental health at all levels of society, it is hoped that the barriers to treatment will be removed so that anyone who needs it will be able to come forward and receive the help they need.