KUALA LUMPUR, May 31 – The Circle of Hope, a joint collaborative effort by the Malaysian Psychiatric Association, Ministry of Health (MOH) and Janssen Pharmaceuticals, was launched in conjunction with World Schizophrenia Day 2022 on May 24.
“Managing mental health problems requires a holistic and collaborative effort of multiple parties,” said Dr Salina Abd Aziz, Head of National Psychiatric Services, Ministry of Health Malaysia.
While physicians manage acute care, families, workplaces, mental health non-governmental organisations (NGOs), and society also have roles to play in assisting patients on the long road to recovery.
“Sensitising people around mental health patients is crucial to help them return to functionality,” she said, adding that caregivers also suffer from burnout and stress.
“We need to care for the caregivers too and this is the central concept behind the Circle of Hope.”
The programme was designed as a caregiver support initiative, recognising that every caregiver plays a very important role in caring for their loved ones with mental illness, and that the challenges for both can be overwhelming.
“The aim behind the Circle of Hope is essentially about empowerment through support and information,” said Dr Firdaus Abd Gani, lead for Circle of Hope.
“Modelled along a ‘train the trainer’ concept, it allows caregivers to benefit from a support group to obtain stronger emotional support and the right information from other experts and caregivers who have similar experiences.”
The Circle of Hope comprises a group of trainers who will train caregivers of mental health patients by upgrading their knowledge on mental illness and equipping them to support the patients’ journey towards rehabilitation and recovery.
It also aims to develop caregivers’ basic advocacy skills so they can guide patients back to functionality.
“To date, we have mounted a team of 120 trainers who will train 4,000 caregivers. Within this structure, the Circle of Hope would effectively reach out to some 20,000 family members and mental health patients to make a difference for both the caregiver and the patient,” said Dr Firdaus.
The Circle of Hope trainings are designed to address the primary impacts on families caring for mental health patients, which centre around financial, social, psychological, and physical health issues.
The comprehensive training comprises five modules: understanding mental illness, the treatment of mental illness, handling crisis, caring for caregivers, and recovery in mental illness.
Mental illness refers collectively to all diagnosable mental health disorders involving or associated with significant changes in thinking, emotion and/or behaviour, as well as distress and/or problems functioning in social, work or family activities.
Schizophrenia, a form of mental health illness which triggers hallucinations and delusions, affects 1 in 300 people (0.32 per cent) or 24 million people worldwide and can occur at any age.
Other common mental illnesses include anxiety disorder, bipolar disorder, depression and obsessive compulsive disorder.
The World Health Organization reports that around 20 per cent of the world’s children and adolescents have mental health disorders.
Rising Rate Of Mental Illness in Malaysia
“In Malaysia, incidence of mental illness has risen from 10.7 per cent in 1996 to 29.2 per cent in 2015, while 500,000 adults suffer from depression. It’s becoming more common and it’s likely that every person knows at least one person with mental illness in his or her lifetime,” said Dr Riana Abdul Rahim, psychiatrist in-charge of MENTARI KL, the Community Mental Health Centre under MOH.
“The National Health Morbidity Survey 2015 cites one in three adults or approximately 29 per cent suffer from mental health, with many more potentially under-diagnosed, while 12 per cent of children have also been detected with this illness.”
In addition, Covid-19 has further exacerbated matters. A study conducted from May to September 2020 among 1,163 adults showed that symptoms such as depression (59.2 per cent), anxiety (55.1 per cent) and stress (30.6 per cent) were detected among the group surveyed.
“With such escalating numbers, mental health is expected to be the second most common health problem affecting Malaysians, after heart disease,” said Dr Riana. “It also poses a national burden as it impedes productivity, with economic cost estimated to be about RM 14.5 billion.”
However, mental illness is a treatable medical condition, maintained Dr Hazli Zakaria, president of the Malaysian Psychiatric Association (MPA). “Early detection, diagnosis and treatment by a clinician are important for better prognosis and faster recovery. In addition, the concept of family involvement in helping care and support patients is core to what we seek to achieve.
“The main cause of mental illness is the dysfunction of the brain which could be attributed to imbalances in the secretion of neurotransmitters, meaning the chemical messengers in our nervous system, brain damage as a result of injury, tumour or infection, stress or abnormal hormone secretions,” he explained. “And just like other medical conditions, it can range from mild to severe.”
Risk factors for mental illness can be brought on by social factors such as issues in relationships with family, spouses and friends or feelings of loneliness, isolation, or neglect.
Societal and environmental factors can also trigger the onset while other contributing factors include genetics, trauma, history of abuse, chronic medical conditions, stress, lifestyle, and substance abuse.
“Refer your family or loved ones to a mental health professional at government or private health centres if you detect abnormal patterns in their feelings, behaviour, thinking and changes in their overall physical well-being,” said Dr Hazli.
“And, if you know any caregivers of mental health patients, share with them about the Circle of Hope and the fact that they need not journey alone on this tough road.
“They just need to speak to their healthcare professional or reach out to the nearest Community Mental Health Centre (MENTARI) or any mental health-based NGO to learn how they can be part of the Circle of Hope.”