Better late than never!
On the 20th of April 2021, the National Social Council agreed that the National Counselling Policy will be introduced to address mental health issues in the community by empowering the counselling services in Malaysia. To initiate the move, all ministries and agencies are expected to be involved and play their part so that mental health issues can be addressed in the community and social intervention measures can be taken on the matter.
This move is aligned with other developed countries in addressing mental health issues. In the United States of America, the government integrates mental health policy into public health policy and general society policy. The American government signed the National Mental Health Act in 1946, which called for the establishment of a National Institute of Mental Health (NIMH). The contribution of the NIMH towards battling mental health issues is evidenced when mental health problems are now included in the Patient Protection and Affordable Care Act. This is done to ensure that mental health care is accessible to the community.
Although America had established the National Mental Health Act for over seven decades, it is still battling mental health issues. In 2019, the National Survey on Drug Use and Health reported that 12 million adults aged 18 or older reported having serious thoughts of suicide while 1.4 million adults attempted suicide in 2018.
Suicide should be a major concern
In Malaysia, suicide cases are on the rise. Within the past week, Malaysia has had three suicide cases reported involving the young: a nine-year-old in Kulai, a 15-year-old in Kuala Selangor and a 25-year-old in Kuala Lumpur. This is not surprising when we see the statistics reported by the Health Ministry. Minister Dr Adham Baba said 465 attempted suicide cases were referred to hospitals for treatment between January and July 2020.
Suicide should be a major public health concern in Malaysia. The Malaysian government is seen as responding to this concern wisely when the prime minister announced that the National Counselling Policy will be introduced. The policy will be the strategic mechanism to combat stigma about mental health issues and mental illness and for interventions to be made at an early stage.
National Counselling Policy
Moving forward, components that need to be paid attention to in implementing the policy include the following.
Firstly, there has to be a national component that includes a national strategy to promote mental health and improve the quality of life. The Ministry of Women, Family and Community Development, through the Malaysian Board of Counsellors, is spearheading the establishment of policy links with all ministries in the enacting of specific mental health regulations, for example to set the overall philosophy of approach to the care of people with mental health issues together with precise interventions.
Secondly, there must be a supportive infrastructure component that includes a human resource strategy to involve the community at all levels. Professional counsellors need to equip themselves with the knowledge and competency needed to help individuals with mental health issues. Furthermore, counsellors must have the skills to collaborate with people in other fields that also address mental health issues, such as psychiatrists, psychologists and social workers. This is because mental health issues are complex and interrelated, and require the involvement of many experts.
The Malaysian Board of Counsellors could continue providing refresher courses for all licensed counsellors in Malaysia. The courses must address the recent findings and evidence-based practices in addressing mental health issues. Although cognitive-behavioural therapy (among others) is known to be an evidence-based approach to tackle mental health issues, other approaches are worth exploring by counsellors, for example dialectical-behavioural therapy, mindfulness approach, and solution-focused brief therapy which are also evidence-based practices. Counsellors need to adopt and adapt effective approaches that are suitable for the Malaysian setting and culture so that intervention can be done at the community level.
The International Counselling Association of Malaysia needs to work with other counsellor associations, for example the Association of Educational Counsellors of Malaysia, to move their members and volunteers to address mental health issues in the community. Appropriate programmes with the community need to be targeted and enhanced. With the establishment of the National Counselling Act, mental health issues among Malaysians can be tackled proactively.
Dr Farhana Sabri is a lecturer at the Faculty of Leadership & Management, Universiti Sains Islam Malaysia.