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The Mental Health Development In Malaysia - Coggle Diagram
The Mental Health Development In Malaysia
The History of Mental Health Service
Relatively young industry
The number of mental health patients has grown rapidly
The act of taking care for any family member with serious mental illness at home is stressful
Cultural beliefs about mental illness
Living in urban or rural areas
City health care
Largely based on a system created to provide health services to plantation workers
Improved remarkably to imbark provisions and institutions of medical care services
Malaysia Plan (1966-1970)
Rural people started to get benefits of health care
Scores of new medical professionals were trained
Vastly improved the imbalance between health care in the cities and that which was available in the countryside
Development of East and West Malaysia
East Malaysia (Sabah and Sarawak)
Less equipped
Understaffed
Lack of basic infrastructure and medical personnel
Introduced the Rural Health Service
enable them to handle referrals from clinics all over the country
Quality of healthcare in the differences between the rural and city areas had been narrowed immediately albiet not eliminated entirely
Development of Mental Services in Malaysia
The first 'lunatic asylum' in small scale at Penang Hospital (1958)
Revolution of mental health care provision in the country started
The first time mental health service users were treated in a non-psychiatric hospital
The first community-based rehabilitation of mentally ill person was opened in Ipoh, Perak as a day-care center (1967)
There are now 28 general hospitals with 22 equipped with community-based mental health service and over 100 outpatient primary care centers throughout the country
Mental Health Policy
Based on the British and Indian mental health laws in the early 1900s
West and East Malaysia introduced their own laws to govern mental health
Mental Health Disorders Ordinance 1952
Lunatic Ordinance of Sabah 1953
Mental Health Ordinance of Sarawak 1961
The Care Centres Act was introduced as supplement to all previous acts on mental health (1993)
Has brought huge changes to the health professionals, the service users, and all those who are directly or indirectly affected by the mental health system in Malaysia
MOH
Developed the National Mental Health Policy in 1997
Has three aims
To improve mental health services for populations at risk of developing psychosocial problems
To improve the psychiatric services for people with a mental disorder in the provision of care and protection by the family, community and relevant agencies
To provide basis in developing strategies and direction to those involved in any planning and implementation towards improving mental health and well being
Provides comprehensive strategies and guidelines to address issues in mental health
Introduced the National Mental Health Registry
Have five objectives
To evaluate the treatment, control and prevention of mental disorders
To stimulate and facilitate epidemiological research on mental disorders
To identify the potential risk factors involved in mental disorders
To identify subgroups in the population at high risk of mental disorders to whom prevention should be targeted
To determine the disease burden attributable mental disorders by quantifying its morbidity, and its geographic and temporal trends in Malaysia
Concepts of Mental Health In Malaysia
Definition by WHO (2001)
A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community
Definition by MOH (1997)
The capacity of the individual, the group and environment to interact with one another to promote subjective well-being and optimal functioning, and the use of cognitive, affective and relational abilities, towards the achievement of individual and collective goals consistent with justice
Definition by MOH shows more collective nature
Three main ethnic groups
Chinese
Influenced by the traditional Chinese medical belief based on Confucianism and Taoism
Believe that a person with mental illness is because of the imbalanced between
Yin-Yang
as a result of the interaction of the Taoism principles
In the Chinese culture
Illness (both mental and physical) is believed to be caused by the lack of spirit or the weakness of yin and yang
consider the emptions in a person as the integral aspects of the body's basic functions, which are regulated by the circulation of
chi'i
, that is partly innate and partly a product of one's food and drink
Believe that mental illness is caused by problems related to self-worthiness, which is measured by the material achievements that brings the expected honour to the family
Indians
Centralized on the concept of mind-body dichotomy
Summed up in the four aims of life - "Dharma", "Kama", "Artha", and "Moksha"
Aims to provide harmony of life in which dharma appears to be the central axis
In the Indian culture
The strong influence of Hinduism regarding illness and treatment can be found in the Hindu textbook called the
Vedas
Believe that maladies resulting from supernatural causes can be treated using
ayurveda
Malays
Concept of mental health among Malays can be summarized as heredity, periodicity, congenital, brain strain, stress, susceptibility, infection, contagion, delayed onset, conditioning, and resistance
Parallelism between folk and modern concepts suggests certain universal bases and clues in treating the mental health service users in the Malay culture
In the Malay Culture, spiritual and religious factors are viewed as vital parts in mental health
The labelling of mental illness as "sakit jiwa" or literally translated as
illness of the soul
among the Malays is common
Families believe that mental illness is not merely regarded as a medical illness but as a spirit possession or as a social punishment
Concepts of mental illness and mental health in Malaysia can and have been addressed from different perspectives, representing the influence of various races and religious beliefs
Has brought a different definition of "mental health"
The concept of mental illness and mental health continue to be based on mythology, and are socially or culturally unacceptable in Malaysia
Current Issues and Future Development
Community mental health care has become an accepted form of treatment
Can be divided into two categories
Formal community mental health services usually link with primary care services
Informal care provided in community
Malaysia has also moved towards treating psychiatry service users in community-based care
In 2000, MOH launched the psychosocial treatment programmes in community clinics
The National Mental Health Act was amended to include a new strategy promoting community mental health care services
Resulted in many mental health service users being discharged into the community with support available at the community clinics and general hospitals
Has started psychosocial programmes in community clinics to provide the opportunity for people who have mental illness and their relatives to achieve a quality of life through their own environment
Believes that the empowerment of mentally ill persons and their families can be obtained through the process of training and skill developments
Important to make sure that people with mental illness can live efficiently in the community
Faced some difficulties in its attempt to create comprehensive mental health care
Scarcity of funds
Comprehensive community care is unlikely to be a viable option without the support of primary and secondary care service
Internationally
The family caregivers face considerable difficulty due to the lack of coping resources within the community
Appear to be unprepared and untrained as caregivers for their relatives with severe mental illness
Western countries
Many families living with mental illness service users were not well treated by the society or by the health professionals
Eastern countries
Family members report and complain of the burden and distress, anxiety, depression and economic strain while playing a major role in the care of their relatives
In Malaysia
Family caregivers have been regarded as being responsible for looking after their relatives
Malaysian families choose to look after their ill members at home and see the hospital as a last choice
The situation is quite different with mental illness
May pose challenges to the mental health service users and their families as well as service providers
A misunderstanding or lack of knowledge about mental health and illness
Families of severely mentally ill relatives prefer their relatives to be in the institution rather than at home
Devotion to the traditional cultural belief systems among multi-ethnic/religious groups