The Health | March , 2021

BY AMANDA YEO

second wave of job retrenchment would cause more urban poor in Malaysia falling into mental illness .

This can be seen in Kuala Lumpur , Selangor and Kota Kinabalu where the heads of households ( HOH ) had to pretend going out for work even though they lost their source of income ; people committed suicide due to job losses ; people might even commit crimes to survive .

According to the Department of Statistics Malaysia ( DOSM ), there were 764,400 unemployed persons in November , which resulted in a rise of the unemployment rate by 0.1 percentage point month-on-month to 4.8 per cent in November 2020 .

The recent EMIR Research third quarterly poll ( 3Q20 ) also revealed a worrying figure of National Worry Index ( NWI ) at 0.79 , which is just one notch below the unhealthy level of 0.80 of maximum worry .

In addition , the Health Ministry ( MoH ) recorded 465 attempted suicide cases between January and July . National Health and Morbidity Survey 2019 ( NHMS 2019 ) also revealed that close to half a million of ther population in Malaysia have had their mental health affected by the Covid-19 pandemic .

As the economy has yet to recover to the pre-pandemic level , The Befrienders Kuala Lumpur revealed there were more people suffering in distress and feeling suicidal between July to September compared to April , May and June .

This was especially apparent among the urban poor households with family obligations .

According to the latest United Nations Children ’ s Fund ( Unicef ) “ Families on the Edge ” survey released on Oct 30 , there is increased tension between spouses and between cares of children in some households where almost 1 in 5 HOH and roughly 1 in 3 of female-headed households ( FHH ) in the low-cost flats around Klang Valley felt depressed and experienced unstable emotions .

Mental illness factors

Their emotional distress along with their worry of being able to put food on the table for their family and meeting the children ’ s education-related expenses , and having insufficient savings and now , the loss of jobs , have heightened the pressure further .

The long isolation arising from the health crisis also causes more Malaysian youths and children to suffer from mental illness . Even before the pandemic emerges , NHMS 2019 survey also recorded 424,000 youths and children as suffering from mental health related problems , including 1 in 10 children aged between 10 and 15 years . Another study also revealed there are secondary school students as young as 13 years old – attempting to commit suicide .

The latest Unicef survey also showed there is a significant proportion of the families reported difficulties in meeting the costs associated with school attendance , especially among FHH . About 4 in 10 of all HOH and 1 in 2 of FHH reported difficulties in providing face masks to their children .

With inadequate access to education , the children who are originally from urban poor families would find challenging to make ends meet when growing up and their self-esteem would remain low .

The rising unemployment among Malaysian youths is also another factor

According to the Department of Statistics Malaysia ( DOSM ), there were 764,400 unemployed persons in November , which resulted in a rise of the unemployment rate by 0.1 percentage point monthon-month to 4.8 per cent in November 2020 .” that could result in mental illness , especially among youths who come from urban poor families . The Ministry of Higher Education ( MOHE ) estimated 25 per cent or 75,000 potential graduates would have their employment opportunities disrupted six months after they graduated . This poses a greater financial burden among vulnerable urban youths who are trying to cope with the continuous rise in living costs .

With the rising mental distress among the urban poor , it has indirectly contributed to a high number of psychosocial hotline calls received by the MoH since the lockdown measures imposed in Malaysia – 37,009 calls as of Nov 11 .

Up to date , the helpline received 53.3 per cent on requests for emotional support related to psychology , 12.6 per cent on Covid-19 related enquiries , 4.6 percent on domestic issues , 4.98 per cent on financial assistance and 2.7 per cent on domestic violence .

Creating a supportive environment

As the number of psychiatrists in Malaysia ( 410 psychiatrists in 2018 ) is much lower than the World Health Organisation ( WHO )’ s recommended ratio of one psychiatrist per 10,000 population , the government should increase the funding allocation of mental healthcare by training more mental health professionals , with the provision of free consultancy service to urban poor who can ’ t afford to pay mental illness related treatment .

As mental illness is expected to be the second biggest health problem affecting Malaysians after heart disease by 2020 , now is the time for the government to work closely with mental health practitioners , schools and community groups by expanding mental health infrastructure to support the urban poor in managing mental illness problems .

Mental health practitioners could thereby organise door-to-door visits to understand inner needs and problems among the urban poor , in addition to providing psychological first aid-based helplines for urban poor to express their psychosocial concerns . Schools and community groups could create a supportive and enabling environment for the urban poor to have a greater sense of belonging in the community .

In turn , schools may help students from urban poor families to cope with stress better by adapting teaching styles , offering safe emotional spaces within classrooms and improved services for diagnosis and referrals .

Moreover , community groups involving social workers could play a preventive role by working together with counsellors , psychiatrists and clinical psychologists – improving mental health literacy through parenting workshops and peer assistance groups focusing on urban poor .

Although the current administration acknowledges the mental illness issue by allocating RM24 million under Budget 2021 , greater emphasis on mental healthcare among the urban poor is required – continuing the spirit of providing universal healthcare for the benefit of all Malaysians . — The Health

Amanda Yeo is Research Analyst at EMIR Research , an independent think tank focused on strategic policy recommendations based on rigorous research .