There is an increasing fear that the second wave of job retrenchments will cause more urban poor in Malaysia to fall into mental illness.
This can be seen in the cities of Kuala Lumpur, Selangor and Kota Kinabalu – the heads of households (HoH) have to pretend to go out for work even though they lost their source of income, people commit suicide due to job losses and people might even commit crimes to survive.
According to the Department of Statistics (DoSM), there were 764,400 unemployed persons in November, which result in a rise in unemployment rate by 0.1 percentage point month-on-month to 4.8% in November 2020.
The recent EMIR Research third quarterly poll (3Q’20) also revealed a worrying figure of the National Worry Index (NWI) at 0.79, which is just one notch below the unhealthy level of 0.80 of maximum worry.
In addition, the Health Ministry (MoH) recorded 465 attempted suicide cases between January to July.
The National Health and Morbidity Survey 2019 (NHMS 2019) also revealed that close to half a million of the population in Malaysia have had their mental health affected by the Covid-19 pandemic.
As the economy is yet to recover to pre-pandemic levels, The Befrienders Kuala Lumpur revealed there are more people suffering in distress and feeling suicidal between July to September compared with April, May and June.
This is especially apparent among the urban poor households with family obligations.
According to the latest United Nations Children’s Fund (Unicef) “Families on the Edge” survey released on Oct 30, there are increased tensions between spouses and cares of children in some households where almost one in five HoH and roughly one in three of female-headed households (FHH) in low-cost flats around the Klang Valley felt depressed and experienced unstable emotions.
Their emotional distress along with their worry of being able to put food on the table for their family and meeting the children’s education-related expenses, and having insufficient savings and now, the loss of jobs, have heightened the pressure further.
The long isolation arising from the health crisis also causes more Malaysian youths and children to suffer from mental illness.
Even before the pandemic, the NHMS 2019 survey also recorded 424,000 youths and children suffering from mental health related problems, including one in 10 children aged between 10 and 15 years.
Another study also revealed there were secondary school students as young as 13 years old attempting to commit suicide.
The latest Unicef survey also showed there was a significant proportion of families reporting difficulties in meeting the costs associated with school attendance, especially among FHH.
About four in 10 of all HoH and one in two of FHH reported difficulties providing face masks for their children.
With inadequate access to education, children who were originally from urban poor families will find it challenging to make ends meet when growing up and their self-esteem will remain low.
The rising unemployment among Malaysian youths is also another factor that could result in mental illness, especially among youths who come from poor urban families.
The Higher Education Ministry (MoHE) estimated 25% or 75,000 potential graduates will have their employment opportunities disrupted, six months after they graduated.
This poses a greater financial burden among vulnerable urban youths who are trying to cope with the continuous rise in living costs.
With the rising mental distress among the urban poor, it has indirectly contributed to a high number of psychosocial hotline calls received by the MoH since lockdown measures were imposed in Malaysia – 37,009 calls as of Nov 11.
To date, the helpline received 53.3% of requests for emotional support related to psychology, 12.6% on Covid-19 related enquiries, 4.6% on domestic issues, 4.98% on financial assistance, 2.7% on domestic violence.
As the number of psychiatrists in Malaysia (410 psychiatrists in 2018) is much lower than the World Health Organisation (WHO)’s recommended ratio of one psychiatrist per 10,000 population, the government should increase the funding allocation of mental healthcare by training more mental health professionals, with the provision of free consultancy services to urban poor who can’t afford to pay for mental illness related treatment.
As mental illness is expected to be the second biggest health problem affecting Malaysians after heart disease in 2020, now is the time for the government to work closely with mental health practitioners, schools and community groups – expanding mental health infrastructure to support urban poor in managing the mental illness problem.
Mental health practitioners therefore, can organise door-to-door visits to understand inner needs and problems among the urban poor, in addition to providing psychological first aid-based helplines for urban poor to express their psychosocial concerns.
Schools and community groups could create a supportive and enabling environment for the urban poor to have a greater sense of belonging in the community.
In turn, schools may help students from poor urban families cope with stress better by adapting teaching styles, offering safe emotional spaces within classrooms and improved services for diagnosis and referrals.
Moreover, community groups involving social workers can play a preventive role by working together with counsellors, psychiatrists and clinical psychologists, improving mental health literacy through parenting workshops and peer assistance groups focusing on urban poor.
Although the current administration acknowledges the mental illness issue by allocating RM24 million under Budget 2021, greater emphasis on mental healthcare among the urban poor is required, continuing the spirit of providing universal healthcare for the benefits of all Malaysians.
Amanda Yeo is research analyst at EMIR Research, an independent think tank focused on strategic policy recommendations based on rigorous research. Comments: firstname.lastname@example.org