Mental Health Stigma in Malaysia
The article below appeared in the October 13 issue of Health with Perdana, a regular column in The Star by Perdana University faculty members. This week’s article is contributed by Dr. Dhanya Pillai, Ms. Darlina Hani Fadil Azim and Ms. Nur Arfah Zaini (Psychology & Behavioral Science Unit), PURCSI
“Mental illness only happens to certain kind of people”
“People with mental illness are violent and unpredictable”
“Mental illness is caused by a personal weakness”
“Mental illness is incurable and lifelong”
“Children do not experience mental health problems”
These are all misconceptions that surround mental health in our society despite mental health problems being common in Malaysia. According to the 2015 National Health and Morbidity Surveys, the prevalence of mental health problems among adults in Malaysia showed an increasing trend; from 10.7% in 1996 to 29.2% in 2015.
People with mental illness face multiple challenges- firstly, managing the symptoms and difficulties associated with their condition. Secondly, dealing with the consequences of the above mentioned misconceptions. Mental health stigma involves people holding negative stereotypes towards people with mental health problems. This in turn can result in discrimination whereby people with mental illness are treated differently. For instance, difficulty in attaining employment, housing, as well as accessing healthcare. Stigma and discrimination also affects a person’s self-esteem and may cause them to experience shame, embarrassment and hopelessness. All this put together often leads to reluctance in asking for help as well as delay in seeking treatment.
These days, we are seeing more mental health awareness initiatives. People are sharing useful information from the right sources; a number of people with mental illness are disclosing their challenges; there is more participation in mental health awareness programs and some concerned employers have taken efforts to improve the work environment to promote positive well-being. Despite all these initiatives, stigma still exists and we wonder why.
Social learning theory suggests that learning is achieved not only through direct experience but also through observation. Mass media such as television and social accounts have become a source for people to obtain information about behaviours, and may reinforce their beliefs on how to treat people with mental illness. Mass media plays a big role in shaping people’s expectations on society and way of life, which then reflects public attitudes towards certain issues.
Studies on cinematic stereotypes and media images of mental illness identified that people with mental illness are homicidal maniacs and need to be feared; or they are held accountable because they have weak characters; or their child-like perception of the world is something that should be marveled. If we reflect on films with mental illness characters, we may notice that the films focus on the persons with mental illness rather than displaying mental illness as societal issue. They could be portrayed as being weak and helpless or even disruptive and should be kept isolated from society. Either that, or they are pictured as being heroes.
While in fact, there are people with mental health issues that have no desire to hurt others or even themselves. They can be successful people and the only thing they lack could be effective coping skills or social interaction skills.
Stigmatization of a vulnerable group of people can affect not just that population, but also the whole society in general. Stigma in general population can cause people to be prejudiced, fearful and develop mistrust towards the vulnerable group. In extreme cases, they may even be violent towards this stigmatized group of people.
Stigma on those with mental health issues can be especially debilitating. Many will endure the discrimination and self-stigmatize whereby they internalize the negative stereotypes and perception of society. This will affect their sense of self-worth, self-esteem, their dignity and also may reduce their quality of life. The most serious impact is that they will not seek the help or treatment that they need, which will lead to more severe symptoms and affect their daily functioning, and may cause them to be stigmatized even more. This is a vicious cycle that must be stopped.
While there isn’t a simple solution to stopping the stigma, there are some ways to cope with it. These are some useful ways that can be applied by individuals who struggle with mental health issues:
- Focus on other positive aspects of you – you are not your illness.
- Do not keep to yourself and do not isolate yourself. Talk to friends, family. Join a support group.
- Use humour.
- Talk about the stigma that you have experienced, or are experiencing. This can help you to work through those difficult emotions.
- Know that there will be people who are not ok with you and that’s ok. Do not waste your energy on them. Walk away if you must.
- Be in the know. Get information from the right sources.
Take things you see or read with a pinch of salt. Not all may appear as it is.
- Get treatment. Do not let fear stop you from getting the help you need.
Mass media could also be one of the best medium to overcome stigma in Malaysia. Responsible reporting involves conveying accurate and balanced information about mental health and mental illness. By doing so, they are taking the responsibility of helping the community to have better understanding of mental health and mental illness. Emphasizing that mental illness is common and may be treatable; offering information of psychological, psychiatric and other related services; and encouraging people to seek help are just some examples of how media could help in overcoming stigma. We have to agree to the fact that media has powerful capacity to reach people and thus able to sway their perception and understanding of certain issues. Hence when used responsibly, mass media can help society to be more aware of the reality of mental illness and promote mental health on a bigger scale.
As for individuals in the society, we have to work harder to be more empathetic and kind to one another. Let’s support people with mental illness instead of judging them, because a healthy mind does not speak ill of others.
“At the root of this dilemma is the way we view mental health. Whether an illness affects your heart, your leg or your brain, it’s still an illness, and there should be no distinction” -Michelle Obama