Making mental care accessible

The Star

2 days ago

More must be done to make mental health services more accessible, says Malaysian Mental Health Association president Prof Datuk Dr Andrew Mohanraj.
One major barrier, he said, is the out-of-pocket cost of private psychiatric care.
'In Malaysia, private mental health care is generally paid out-of-pocket because insurance companies don't cover the costs adequately,' he said.
To ensure everyone who needs it benefits, insurance companies must play their part, he added.
'Insurance companies need to find ways to keep making a profit but also develop policies or premiums that actually cover mental health conditions,' he said, pointing to the urban-rural divide as another deep-rooted challenge.
Most mental health professionals are concentrated in urban areas, leaving rural communities underserved, he said.
Training local community leaders using the WHO's Problem Management Plus – a manual for basic mental health help that can be delivered by non-professionals – would be a step forward in making such services more accessible, said Sunway University School of Psychology Prof Alvin Ng Lai Oon.
He shared that other resources, like the WHO's 'Doing What Matters in Times of Stress' guidebook, can be used in refugee camps and to empower communities with simple stress management strategies.
Public psychology officers in the civil service, as well as other frontline health workers like social workers, community nurses and medical officers, can be upskilled with low-intensity cognitive behaviour therapy, Prof Ng added.
To make rural mental health work more attractive, Master's in Counselling student Tan Xin Yi urged the government to help set up more non-governmental organisations in underserved areas, especially those offering affordable care.
She also called on mental health professionals to take the lead through outreach programmes such as community talks, and free services to local fundraisers that support mental health initiatives.
Prof Andrew, however, stressed the importance of checking the credentials of mental health practitioners carefully as there can be confusion caused by unregulated practice.
This, he said, is to safeguard the public vulnerable against unscrupulous or unqualified practitioners.
'Many who claim to be psychologists may lack proper clinical training, so the public often doesn't know who to trust.
'Unlike psychiatrists and counsellors, clinical psychologists in Malaysia do not have a formal registration body so whether one is 'qualified' is a grey area.
'But you can always check if they are members of the Malaysian Board of Counsellors or whether they have a National Specialist Registration or Medical Council Registration.'
Fight the stigma
The stigma against those seeking mental health is another reason why sufferers are not seeking help, said Prof Andrew.
'Studies show that some 80% of people know they have a mental health issue but refuse to seek help because of stigma.
'That silence comes at a huge price,' he said.
Scaling up mental health services at primary care can help reduce stigma surrounding mental health, Prof Andrew added.
'Many are reluctant to approach specialist services because of stigma. They, however, may be more amenable to approach their general practitioners.'
Citing a 2018 study, Prof Andrew said Malaysia lost RM14.4bil in productivity due to mental health issues at work, a figure expected to soar to RM100bil by 2030.
'We've got to address stigma by also looking into workplace policies or non-discriminatory policies against employees with mental health issues,' he urged.
For real progress, Prof Andrew stressed that everyone must get involved.
'We can't just leave it to the government. It's a whole-of-society effort. The public and private sectors both have a role to play.
'That's the real turning point if we want to make mental health services truly accessible,' he said. Danger of 'AI therapy'
ARTIFICIAL intelligence (AI) can help people cope with mental health care but relying on it for serious issues could cause serious harm, warns Malaysian Mental Health Association president Prof Datuk Dr Andrew Mohanraj.
He said relying on AI chats or virtual self-help tools might cause people to avoid seeing a trained therapist altogether as there might be a perception that AI can give one all the 'right answers' to deal with one's problems.
But this, he said, trivialises real mental health care as people might say, 'Why bother seeing a professional if a chatbot can do the job?'
While he acknowledged that AI can complement the role of a psychologist in many ways, he said it cannot handle complex or high-risk situations, stressing that mistaking it for real help can be dangerous.
'Nonetheless, AI does have its place. Some may feel more comfortable opening up to a chatbot first, and it can offer some comfort for non-serious issues.
'It has proven useful for offering some relief to people with mental health issues,' he said, while cautioning that it can prove dangerous especially when the individual is suicidal, is having thoughts of self-harm, or is experiencing psychosis.
AI has not reached a level where it can offer the right support or direct people to resources and services available, as accurate mental health assessments require far more than just a few prompts on a screen, he said.
'Assessments include non-verbal cues – how a person presents themselves, body language, speech patterns, eye contact, and many more. None of this can be fully picked up by AI,' he said.