Mental health challenges can affect anyone, regardless of ethnicity, socio-economic status or gender.

Like other health challenges, prevention is better than cure. Also, like other health challenges, mental disorders can be treated successfully, provided the sufferers and their families understand the factors that contribute to the challenge and take the necessary steps to seek treatment from qualified and experienced healthcare professionals and stay with the treatment prescribed.

Mental disorders comprise a large group of mental health challenges that include mental illness (e.g. psychoses, mood disorders, anxiety disorders), developmental disorders (e.g. autism, ADHD), addictions and personality disorders (e.g. borderline personality disorder, anti-social personality disorder). A person may suffer from more than one type of disorder (e.g. alcohol abuse – an addiction, and major depression – a mental illness).

The prognosis for a person with mental disorders depends on how successful one tackles all aspects (bio-psycho-social) of the disorders. This holistic approach involves biological treatments (e.g. medications), psychological treatments (e.g. counselling) and social support.

Club HEAL, since its formation in 2012, has seen an increasing number of referrals for Malay/Muslim clients, not only from healthcare professionals but also from members of the public, be they the sufferers themselves or their family members. This indicates that awareness of mental health issues is improving and that more people are coming forward to seek help.

SOCIAL IMPACT OF MENTAL HEALTH CHALLENGES
Mental disorders have their impact on potentially many social institutions – families, schools, workplaces and neighbourhoods. Issues of domestic violence, divorce, unemployment and even terrorism can be linked to mental health issues. For example, in families – if one parent has a mental illness that is not treated, this can result in a lot of stress on the family. Someone with bipolar disorder, when in a state of mania may exhibit undesirable behaviours such as excessive spending or becoming disinhibited. If the ‘normal’ spouse does not understand and does not encourage his or her partner to seek treatment, this could cause a huge strain on their relationship that could end up in divorce.

Another example is a person with Obsessive Compulsive Disorder who takes a very long time to get ready for work, because when unwell, he will spend long hours in the bathroom just to get a shower. This could cause him to be terminated from employment if he consistently turns up late for work.

UNHELPFUL ATTITUDES AND MYTHS
Many still believe that certain mental disorders are the work of black magic or evil spirits and hence, treatment is usually initially sought from traditional healers. When that fails, they go to the psychiatrist as a last resort. Delays in diagnosis and early treatment make it difficult for people with mental health issues to recover.

Many are still ashamed to talk about a member of their family as having a mental disorder because of negative perceptions society has of the sufferers. They are deemed to be violent, emotionally ‘weak’, lacking in faith in Islam, or worse, choosing to be ‘mad’. Hence, many mental disorder sufferers or their family members are reluctant to come forward to seek treatment. Many of them are belittled and viewed as being a ‘burden’ to society. Very few employers are willing to employ people with a history of a mental illness and this means there are many sufferers who remain unemployed. Without meaningful employment, their sense of worth is likely to decline, making them depressed and more likely to suffer relapses.

RECOVERY PROSPECTS
In terms of recovery, many still think that there is little hope for people with mental disorders, and tend not to seek help. On the other hand, some think that their loved ones will recover simply by going for ‘counselling’. They then approach organisations that offer counselling but which may not necessarily be equipped to deal with people with serious mental health conditions. When results of their efforts to seek help do not match their expectations of recovery, they may give up. It is very important therefore that organisations serving those suffering from mental disorders, such as Club HEAL, work closely with other community organisations to ensure they get appropriate help. In cases where the problem is mainly ‘social’ in nature, perhaps social service organisations such as AMP or PPIS would be better equipped to handle the case, while for those where there is mental illness afflicting a family member that is having a social impact on the family, then Club HEAL would be the appropriate organisation to refer the client to.

Organisations like Club HEAL should also work with qualified practitioners of Islamic medicine in cases where the illness may be triggered by first encounter with ‘evil spirits’, as a combined approach may work better for some individuals.

PREVENTION IS BETTER THAN CURE
There is much that can be done to help prevent people from developing mental disorders. By understanding the risk factors leading to mental health issues, we can easily prevent them from developing. Like other illnesses, mental health disorders are a combination of inherited tendencies (genes) and the environment. A person with a parent or a sibling suffering from schizophrenia for example, is ten times more likely to develop the illness. The environmental triggers for schizophrenia include stress, trauma and losses.

It is therefore important for those with family histories of mental illness to be more vigilant in taking steps to prevent the illness from developing, and to look for early signs so that early treatment can be sought.

Healthy lifestyles help prevent not only physical illnesses like diabetes and cancer but also mental illnesses.

THE LINK BETWEEN MENTAL AND PHYSICAL HEALTH
It is also important to remember that physical and mental illnesses are linked, in the way that a person who is physically unhealthy is also more likely to be depressed and anxious for various reasons (e.g. loss of self-esteem, financial stress due to loss of income from having a physical illness or huge medical bills). On the other hand, a person with mental illness like anxiety, depression or schizophrenia is more likely to also suffer from physical illnesses such as diabetes for reasons such as lacking motivation to adopt healthy lifestyles or to stay with treatment. This is why in the war against diabetes and other chronic physical health conditions, the emotional and mental aspects of the person need to be taken into consideration.

MAXIMISING POTENTIAL, MINIMISING SETBACKS
It is important to erase all negative attitudes towards mental health issues. The benefits of early diagnosis and treatment cannot be overemphasised. Important too is continuity of treatment, so that relapses can be minimised because frequent relapses can undermine the confidence of persons with mental illnesses (PMI) and their families.

In this, the media plays a crucial role. Instead of focusing on the negative aspects of mental illness such as tragic stories of PMI who did not seek treatment and the harmful consequences of inaction, it would be more helpful to spread the good news that PMI do recover, do well and are able to contribute to the community. Club HEAL encourages its clients and their caregivers to be open and share their experiences with the public. Their stories are not only positive but also realistic, making the public realise that while it is possible to recover and do well, for some, the journey can be rather long. Advocacy work is crucial in combating stigma and dispelling myths surrounding mental disorders.

OUTREACH TO THE COMMUNITY
Club HEAL has been reaching out to the public through its publications, traditional media, social media, talks, forums and workshops. It welcomes invitations from institutions such as schools, mosques and madrasahs as well as community, religious, and other organisations, to collaborate and help in the prevention and treatment of mental disorders. Club HEAL’s participation in public platforms such as forums, talks and booth participation enables it to reach out to more groups in the community, including these organisations’ staff, volunteers and clients, on mental health matters.

Without community support, it would take Club HEAL that much longer to remove stigma – the biggest barrier to people seeking help – and for others to show their support to people with mental health issues and their families. ⬛

Dr Radiah Salim is the Founder and President of Club HEAL, an Institution of a Public Character formed in 2012 to help people with mental illness regain confidence in themselves and others in their journey towards community reintegration. Her past experience as a resident medical officer at the Institute of Mental Health (IMH) in 2008 and her personal experience as a caregiver inspired her to form Club HEAL.