Groups urge government to address psychological, emotional fallout from pandemic

Isolation, joblessness, childcare and many other challenges severely affected the well-being of many Malaysians, translating to severe emotional distress.

Eighteen months have gone by since the first three COVID-19 cases were reported in Malaysia in January 2020. How have Malaysians been coping?

"The pandemic has made it difficult for some members of our collective to maintain stability and the pandemic response has been wanting, adding to the distress some of us are going through," according to a spokesperson of SIUMAN, a solidarity network of mental health patients and allies fighting for socioeconomic and political equity and equality for the mentally ill.

The group has been actively educating the masses on Twitter since June this year amid rising mental health issues following the enforcement of the third round of the Movement Control Order.

It said accessing mental healthcare services has become more difficult as the healthcare system becomes more strained and that its members are trying to cope as best as they can.

Suicide has been a long-standing issue, not only in Malaysia but also globally. It is a given that the issue should be properly addressed with a strong political will.

Institute for Democracy and Economic Affairs (IDEAS) social policy unit senior executive Vaisnavi Mogan Rao said managing the pandemic and socioeconomy is the main priority to lifting socioeconomic uncertainties.

She noted that the surge in suicide rates in Malaysia correlates with distress among the people over the last six months.

"However, without implementing appropriate evidence-based public health campaigns and increasing the capacity of mental health services across the community, more people are at risk of attempting suicide," Vaisnavi told Bernama.

According to Health director-general Tan Sri Dr Noor Hisham Abdullah, Malaysia recorded 468 suicide cases between January and May this year, compared with 631 throughout 2020.

There was an average of four suicide cases every day for the first three months of 2021, with 336 cases reported to the police.

SIUMAN pointed out that a more pertinent question is what is stopping the government from doing more.

"The psychological and emotional fallout from the pandemic will exact a heavy toll on the population in the years to come.

"We have barely started to acknowledge this, let alone address it," said its spokesperson.

The group noted that mental health was not just about emotional support hotlines and hospitals but also about ensuring that people have access to means of life and are able to live their lives in dignity and safety.

SIUMAN also called for the revival of the National Suicide Registry to formulate policy responses and legal reform.

Vaisnavi said disaggregated data from the suicide registry needs to be made openly available to allow non-governmental organisations, mental health professionals and researchers to have an accurate picture of the prevalence of suicide in order to support the government in implementing targeted prevention strategies.

The majority of suicides are preventable, said Relate Malaysia founder Dr Chua Sook Ning.

Relate Malaysia, established in 2015, is a not-for-profit organisation dedicated to the provision of mental health services, education, training and advocacy.

Chua said a review of suicide prevention interventions in 2020 found that these interventions reduced the number of completed suicides and suicide attempts.

"Mental health experts agree that the pandemic will have long-term consequences on mental health.

"The longer people are in distress, the more time and support they will need for recovery," she told Bernama.

Chua said the government needs to increase its investments into mental health research to understand risk factors of mental illness, as well as to develop preventive and treatment interventions for times of crisis.

Malaysia is one of the few countries where attempting suicide is illegal. Under Section 309 of the Penal Code, the penalty for attempted suicide is imprisonment for a term of up to one year or fine, or both.

SIUMAN said legal reform will take time and that it would not be possible for Parliament to decriminalise suicide in one sitting. For now, it said, Parliament should concentrate on COVID-19 management.

However, the opposition to decriminalising suicide has generally come from more conservative segments of the population, using the argument that suicide is a sin and decriminalisation would lead to more suicides.

SIUMAN disagrees with this stance. "What can be done in the short term is for the government to declare a moratorium on legal repercussions for attempted suicide under the Penal Code," said its spokesperson, adding that addressing socioeconomic inequity and inequality, which are the psychosocial determinants of mental health, would be much more effective in preventing suicides.

In February 2020, the Malaysian Bar had also requested the government to pardon those who have been prosecuted and convicted under this provision.

The Bar also called for consideration of rehabilitative solutions as well as review and strengthen support mechanisms available to those who find themselves in similar, seemingly hopeless situations.

Chua said decriminalisation of suicide is a necessary step recommended by the World Health Organisation as part of a national prevention strategy, but this step alone was not enough.

She said Relate Malaysia has partnered with people with real-life experiences to understand the stigma of suicide and a recurrent theme is that people are ill-treated and discriminated against when they come forward to seek help for suicidal ideations.

"Rather than receiving compassion, they are shamed and blamed for their distress.

"As a community, we need to recognise our own prejudices and discriminatory behaviours and change the status quo if we are serious about reducing suicide rates in Malaysia," she added.

Late last month, Minister in the Prime Minister's Department (Religious Affairs) Datuk Seri Dr Zulkifli Mohamad Al Bakri announced that the Malaysian Islamic Development Department (JAKIM) is placing 160 of its officers in hospitals nationwide to provide psychospiritual and ilaj syarie (Islamic treatment) services and guidance to patients with mental health issues.

He said the services would be expanded to agencies under the Ministry of Health to deal with spiritual and mental health problems among patients and hospital staff due to COVID-19 or other issues.

SIUMAN, however, feels that healthcare should be kept secular unless and until a patient requests for a spiritual or religious approach, and even then, there are ethical issues if this happens in a clinical setting.

IDEAS' Vaisnavi said religion and faith can be a protective factor against suicide and placing trained officers in hospitals could help increase accessibility to religious support for individuals who desire it.

She, however, stressed the importance of ensuring that JAKIM officers are not there to serve as a substitute to trained professionals that employ evidence-based methods.

Vaisnavi said the move may also be a consequence of the low number of mental health professionals in Malaysia, a structural issue within Malaysia's long-standing lack of investment in mental health professionals.

"The government needs to increase the capacity of mental health professionals in the country and create more positions for these professionals within the public health system," she added.

In the context of the ongoing pandemic, Vaisnavi said the government could employ more contract psychologists from the private sector to be integrated into the current response.

"The government could also roll out free and accessible mental health first aid training to ensure more people within the community are equipped with the skills to respond to signs of suicide or deteriorating mental health," she noted.