Mental healthcare amid the Covid-19 pandemic


By Petronella Langita Felix & Aisyah Azzahra Suhiri

KUCHING: Good self-esteem and interpersonal relationship, ability to perform daily routines, sense of satisfaction and gratefulness are some of the many indicators of good mental health, said senior lecturer with Universiti Malaysia Sarawak (Unimas) Faculty of Cognitive Science and Human Development (FCSHD) Nor Hasniah Ibrahim.

Since the beginning of the Covid-19 pandemic, the topic of mental health rolled into the limelight in our country as many were affected by lockdown and movement control orders — losing their jobs, sources of income, family members and friends, and the list goes on.

“As of December 2020, as the country was battling the pandemic, Sarawak was reported as the state with the third-highest mental health issues in Malaysia. This, and the increase in social issues, indicated that the pandemic has left an immense negative impact on people’s welfare,” said Nor Hasniah.

The academician said that mental health affects one’s ability to be productive in their daily life as one contributes to society.

Nor Hasniah Ibrahim

“It affects our emotional, psychological, and social wellbeing, not just our thoughts,” he said.

She also said that poor mental health would often result in functional deterioration, leading to disruption of performance in life, inability to establish or keep up with social lives, and could not practise self-care.

On mental disorders, Nor Hasniah said that it could overwhelm anyone as it alters their thoughts, emotions, and behaviour —sometimes the combination of all three, resulting in disorders in one’s lifestyle and their ability to overcome even the slightest inconvenience in life.

“There are different stages of mental disorders, and it can be classified into two general types; common mental disorders which cause conflicts in daily life, and severe mental disorders that may require one to seek treatment from hospitals or mental institutions,” she explained.

She also quoted the World Health Organisation (WHO) that approximately one in five people in post-conflict settings have mental health issues, and it was very common among children and adolescents, too.

When asked if it was true that every individual has mental health issues, Nor Hasniah said, “I believe so. What differentiates them is the severity as it depends on the factors contributing to those problems and the individual’s ability to overcome the conflict.”

She added that there are several known factors contributing to poor mental health in an individual; take, for instance, traumatising events such as child abuse, sexual misconduct, or substance abuse.

She also said chronic illnesses like stroke, cancer or diabetes also influence one’s mental health, as well as recreational consumption of alcohol and drugs.

“Genetic factors or chemical imbalance in the body are categorised as biological factors and this condition is able to alter the state of one mental health,” she said.

Nor Hasniah said that sociological factors such as lack of social interaction and feeling isolated from the world outside might also be a trigger to poor mental health.

Seek psychological or psychiatric help when battling mental health issues.

She also addressed one of the most common perspectives on mental health, saying, “Yes, there are cases where mental illnesses run in the family, especially if it is left untreated in the long run.”

Speaking on mental illnesses, Nor Hasniah elaborated on two infamous mental health concerns in the country, namely depression and anxiety; as well as the most concerning consequence of prolonged mental struggle: suicide.

She said that people with depression have a different perspective on the world as the mental disorder will find it harder to perform daily routines such as sleeping, eating, or going to work.

She said that depression has no definite cause; it was always the combination of several different factors weighing one’s shoulders and scarring their mental wellbeing.

“We have to understand that depression is not something we can ‘eradicate’ or ‘eliminate’ from someone; depression is like a ticking time bomb living within us, waiting to explode or happen at any time,” said Nor Hasniah.

She said that a proper diagnosis of the symptoms would normally take up to a fortnight before one can be identified as suffering from depression, but this would not mean it is the end of the world for the diagnosed.

“Regardless of the severity of it, depression is curable in numerous ways and the most common treatments are medication prescription and psychotherapy,” she explained.

Nor Hasniah also spoke on the most common yet often overlooked disorder, namely anxiety disorder.

While anxiety was a humane emotion serving as an alert from potential danger or a reaction towards stress that occur occasionally through our daily lives as we make conflicting decisions; that was not the case with anxiety disorder.

“Anxiety disorder is nothing like occasional anxiety; it causes constant, overwhelming uneasiness and fear that may cause one to avoid social gatherings or activities, or anything that may trigger or worsen their symptoms,” she explained.

On the bright side, Nor Hasniah clarified that most mental illnesses can be treated, especially with the accessible and advanced modern medication nowadays.

She said that presently, medicines are becoming more effective in treating mental disorders than compared to decades ago, although it may be time-consuming for the effects to take place.

“However, it must be noted that almost all medications for mental disorder treatment require consistent consumption for effects to take place, on top of attending regular screening as scheduled,” she said.

She stated that a non-medicinal approach such as counselling, psychotherapy and group therapy can also be employed to treat people with mental issues, and it was proven that psychosocial treatment had been important in the healing process.

On the time taken for treatment, Nor Hasniah explained that the span of time would vary depending on three conditions, namely the type of mental illness, the duration of each treatment session, and the type of treatment received.

Nobody should be sad for too long. It’s a mental state that is emotionally draining on the mind, body and soul.

In the exclusive interview, Nor Hasniah also brought about the topic of suicide as she opined that it was a desperate attempt to escape unbearable suffering inflicted by prolonged mental health issues.

“Here is a hard pill to swallow: people who commit are most likely blinded by self-loathing, hopelessness, and isolation; they do not have the ability to think straight or to see any other way to find relief except through death,” Nor Hasniah said.

According to Nor Hasniah, there were 46 suicide cases reported in Sarawak in 2020 and as of mid-2021, a total of 37 cases of suicide was recorded which means there was a possibility that it would breach the cases recorded last year.

“The number of suicide cases recorded on the first half of this year is catching up to total cases recorded last year, and I believe the pandemic might have contributed to this inclining statistic.”

On the available help for people who are struggling with mental illness, she mentioned that it was best to seek professional assistance from a qualified medical practitioner.

“While tests like Depression Anxiety Stress Scale (DASS) may help in identifying major questions, such test do not prove that one is suffering mentally because proper diagnosis would be needed to confirm the type of illness,” she added.

The senior lecturer said that another alternative to cope with mental struggles, namely Befrienders, a non-governmental organisation (NGO) providing around-the-clock service for those struggling with suicidal thoughts or entering depressive episodes.

“Befrienders provide assistance through trained volunteers, and it is their policy is to keep callers’ information confidential, so one can opt-out to remain anonymous during a consultation,” she explained.

She said that the Sarawak government also offered a tele-counselling service, namely Counselling Help at Any Time (CHAT) where members of the public will be given counselling, guidance, support, and education on mental health.

The community service with Sarawak Social Welfare Department employed psychologists, counsellors, and assistant psychologists for consultation via phone calls or social media applications.

Most hospitals and clinics in Malaysia also employed trained professional that can be trusted in treating those diagnosed with mental illnesses, and Nor Hasniah added that some higher education institutions were also equipped with counselling services.

“Unimas FCSHD, for example, offer psychological and emotional assistance to those in need. Regardless of whether they are Unimas students or members of the public, we are always available for consultation,” she added.

She said that the first step in seeking help was that one need to acknowledge that they were struggling mentally; only then would they be able to move forward and seek professional help.

“The first professional counsellors you can approach are those stationed at your school, university, or workplace; they are trained to listen to your concerns and guide you on what to do next,” said Nor Hasniah.

She said that another option would be to visit nearby health institutions for psychological screening before scheduling for consultation with a psychiatrist or therapist.

The counselling programme lecturer also advised the public to not be afraid to seek help, because all information shared between a patient and a certified or trained medical practitioner would remain confidential.

She also added that the public should be more aware and open to discussion on these issues and disorders in order to eliminate the social stigma towards mental health and stop disregarding the topic.

“Seeking help means you are aware that your mental health is your responsibility,” said Nor Hasniah, and on people’s responsibilities to care for their mental health, she advised them to be kind to themselves physically, emotionally and mentally.

As a long-term effort to keep their mental health thriving, she also encouraged people to keep educating themselves on mental health and to actively manage their emotional and mental wellbeing.

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