How Southeast Asian Countries Deal with Mental Health Issues


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The discourse on mental health issues might not be very popular in Southeast Asia. Whereas, the region that makes up a quarter of the global population possesses quite significant mental illness problems to be discussed.

People in this region tend to be ashamed to admit and recognize mental issues around them, most of them are afraid to be judged as abnormal and potentially end up being isolated. Or else, if they admit their illness, they do not receive proper treatment to follow up.

With the number that keeps on staggering, what are the issues faced by Southeast Asian countries that caused the whole region to seemingly underrate mental health concerns?

As the first and foremost issue, policy and legislation regarding mental health should be more strengthened in Southeast Asia.

Based on the data by the World Health Organization (WHO) in 2014, at least eight out of eleven Southeast East countries own a separate national policy that puts concern on mental health, yet these policies are still very limited and restricted in terms of the implementation and enforcement, especially in the low and middle-income countries.

The same source also reveals the fact that five Southeast Asian countries have not yet established their separate mental health policies, even among those which have ones, the documents are quite outdated with some principles that do not fulfil the international standards and values.

To make the matter even worse, many suicidal actions took place in many countries in this region has contributed to more than one-third of the global suicide rate—reported in 2014.

Suicide Rate in Southeast Asia (WHO, 2016)

As part of the strategy, the WHO has suggested to link and combine programs of mental health with other healthcare services so that the policies regarding mental health can be more fostered.

The next challenge is the financing issues. Singapore, for instance, has announced that the 2017 budget allocation also covered mental treatments for those who suffer mental illness in the country where it also supported the caregivers who accompany disabled Singaporeans.

In coming up with the budget allocation for mental health in Singapore, the government’s concern did not just evolve around financial concerns alone. In the same occasion, the Ministry of Health attempted to provide dementia-friendly communities to facilitate the care situation for older Singaporeans.

Joining Singapore in expanding the national budget allocation for mental health issues is Thailand that was reported to allocate its health budget for as much as 4%.

The second issue that is seen as the obstacles is regarding the resources. By resource here, it means both human and capital resources, as well as the facilities that follow to complete the resources. Skilled mental health staffs are very limited in number.

ASEAN presented the causes behind this challenge in its ASEAN Mental Health Systems report published in 2016, claiming the trends of social workers, clinical psychologists and occupational therapists in Brunei who want to be trained more professionally must independently seek further specialized training overseas as they are only introduced with general or common skills in their home country, to begin with.

As in the case of Indonesia, the report points out the ratio of the available psychiatrist in the country. In Indonesia, the ratio is 0.3 per 100,000 population in 2016 with the total of 800 psychiatrists, not to mention the uneven distribution across the country.

In terms of healthcare facilities, Singapore as one of the most advanced countries in the region makes the best record. The report shows, Singapore recognizes each subject of mental health care recipients as the country has set up the National Mental Health Blueprint of 2007 that covers policies, strategies, and initiatives based on different groups—be it for children, adults, and the elderly.

Following the blueprint, until 2016 Singapore had invested around US$131 million in its mental health care systems. Singapore also has its own psychiatric hospital namely the Institute of Mental Health (IMH) that provides sufficient psychological and psychiatric-related examinations and treatments.

Mental Health-related Services in Singapore in 2013

mental healt table singapore

Source: Mental Health Atlas 2014 Questionnaire – Singapore input (Ministry of Health Singapore, 2014), as shown on the 2016 ASEAN Mental Health Systems report

 

What remains as tasks for Southeast Asian countries are further assessment and standards in developing more instruments needed to observe mental health issues in the region, such as screening for depression in primary care, information systems on mental health to familiarize public to be aware of the issue, and the well-defined treatment guideline to set the standard for assessment and treatment towards mental illness.


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Nadya Yolanda Moeda
A former travel blogger who is now a full time consultant & loves to write about everything under the sun

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