In her first few months of service, Subang Jaya assemblywoman Michelle Ng found herself attending the funerals of people who had committed suicide.
“One big thing I noticed was suicides happening in clusters within my constituency, and that they tended to involve those in their teenage to college years, so that got me really concerned,” Ng shared, when we met for an interview.
So she did her research, spoke to family members, and realised that most of the victims were suffering from some form of mental health problem.
“One response I usually got was how the families often felt helpless and didn’t know what to do. So then the question was, Is knowledge about mental health something that can be learnt?”
After speaking to medical professionals and Health Ministry officials, Ng realised that there are steps we can take to help someone who’s going through mental health issues.
That’s how her idea of the SJ Care Warriors programme came about. Officially launched on Mar 31, 2019, it focuses on empowering a community to self-help as well as help others.
World Mental Health Day falls on Oct 10 annually. The National Health and Morbidity Survey 2015 conducted by the Health Ministry found that the prevalence of mental health problems among Malaysians aged 16 and above stood at 29.2%. This means 1-in-3 Malaysians experience issues related to mental health.
A similar study conducted in 2017, targeting youth health issues, showed that anxiety (39.7%), depression (18.3%) and stress (9.6%) were among the main problems plaguing adolescents.
The SJ Care Warriors programmes adopt a two-pronged approach – a gatekeeper training led by a team of clinical psychologists and psychiatrists for community leaders, on how to identify warning signs of suicide and where to get help (Suicide Prevention); and secondly, a wellness-oriented approach to building resilience among youths (Building Resilience).
With resilience, youths are empowered to better manage their mental state of wellbeing, and are able to impart the wisdom of mindfulness, build resources, and spread loving as well as kindness.
Currently, mental health issues are addressed mainly in hospitals and at the primary care level. But complementary community-based mental health initiatives and advocacy need to be much more integrated into the mental health service ecosystem, said Dr Amer Siddiq Amer Nordin, Assoc Prof with the Department of Psychological Medicine in Universiti Malaya.
“The SJ Care programme gives permission for people to talk about mental health in a more open, non-judgemental platform,” said Dr Amer, a member of the SJ Care Warriors Advisory Council.
“In the past, the issue of mental health might be present but there was a lot of taboo attached to it. But now, with the programme in Subang Jaya, the community is able to talk about it freely, with reduced stigma at least.”
Ng added that collectively, we all have the responsibility to cultivate an environment that helps a person going through a mental health problem. “One thing that feeds into the stigma is the labelling of mental health issues as something unnatural as opposed to other health problems,” she said.
“When you view it as something unnatural, it’s unlikely that a person wants to fall in that category, which means not telling anyone you have a problem or to seek help for it.”
She added, “In Asian culture, traditionally we’re taught to be tough and not bring up our problems. So there’s a lack of emphasis on vulnerability, which is not exhibited. When that happens, you don’t know how to deal with it, so it compounds itself until it becomes a problem.
“We want to show that mental health doesn’t need to reach the stage when it becomes a problem. There’s the earlier part whereby we learn how to deal with stress before it compounds into a problem. When we’re able to look at it as an entire spectrum, it normalises and naturalises mental health issues.”
Dr Amer, a consultant psychiatrist at Universiti Malaya Medical Centre, explained that prior to an individual having a mental health illness, there’s often a stage where change can be made.
“You have a mental health issue at that point, but it’s not a mental health illness yet. However, these people are struggling and it could be due to genetic factors. But there’s another group of people whom when given the right ingredients to become depressed can become depressed.
“You put them in an environment that’s very negative, give them more stress sources, one after the other, and that eventually causes individuals to be clinically depressed. So those who are more vulnerable tend to get it earlier, while those who are resilient, once they lose their coping mechanisms, will also get it.
“We don’t want this to happen because once you’re at the illness stage, function is lost. When function is lost, particularly among young people, countrywide we’re going to have a problem,” he said.
To date, the Suicide Prevention programme has reached 69 community leaders. By the end of 2019, it hopes to reach 80 leaders. The Building Resilience programme, piloted in July with 14 student leaders from Sunway University, was also held on Oct 5 in another college. By the end of the year, they hope to roll out the programme to the first batch of 200 students.
“Our vision is, once the two programmes stabilise, if another community wants it, they can implement it,” said Ng. “The question is, How to get communities interested and how do we have that kind of support system of resources and professionals to facilitate the programmes? That’s the long-term vision.”
Building young warriors
Many of college student Jayashan Chinatamy’s friends have consistently revealed that they feel depressed, and several of them have been diagnosed with depression at some point in their lives.
“Among my peers, there are many who have experienced suicidal ideation in the past, and a few currently experiencing periodical bouts of ideation,” said Jayashan, 21. “As friends, we do our best to support them during these times and always encourage them to seek professional help.”
The first year Bachelor of Science in Psychology student at Sunway University was among 13 students involved in the pilot Build Resilience programme.
“Many students find that transitioning into young adults can be daunting and overwhelming. As such, I believe the skills taught in this programme can be beneficial when applied in one’s personal life,” he said.
He added that the programme is helpful to youths, especially schoolgoers, as it tries to cultivate fundamental aspects of emotional and mental wellbeing.
“I believe that many students are essentially unequipped to cope with the struggles they undergo, as well as the lack of knowledge on how to care for their mental health and wellbeing,” he said.
“Additionally, it’s the feeling of being misunderstood and not having anyone there for you, be it moral or emotional support, or just a listening ear, that leads youths to doubt the validity of their beliefs and choices, leading to an undesirable mental state,” he added.
He also underlined the importance of psychological competencies, such as inner strength and resilience, in coping with life’s struggles and obstacles.
“Aspects such as empathy and appreciation are important in developing quality relationships, maintaining self-compassion and being more positive overall,” Jayashan said, adding that the first step to reducing suicide among youths is to lessen the stigma that surrounds it.