The Mental Health Crisis: Did Budget 2021 go far enough?

Tay Yi Thong

Yi Thong is a 1st Year Economics student at University College London (UCL). She is passionate about issues on poverty, inequality, and sustainability.

‘I took up crocheting!’ ‘I learnt how to play the guitar!’ ‘Look at this new banana bread recipe I adapted!’ Have you ever noticed such announcements popping up whilst scrolling through your social media in the midst of the pandemic? Well I certainly did.

Notions like this, seemingly pressure everyone to conform to the norm – to be happy and to make the most out of time at home. But what happens if you just can’t? While many have recognized the coronavirus pandemic as a twin-crisis of both health and economic turmoil, the less apparent calamity, which is the falling mental wellbeing of the citizens, is inordinately overlooked.

A study published by the Malaysian Journal of Psychiatry had projected a rise in various mental health illnesses such as anxiety disorders, post-traumatic stress disorders (PTSD), and obsessive-compulsive disorders (OCD). This is owed to the COVID-19 ordeal that had disrupted many lives – inducing fear, anxiety, and stress among us all with the situation being exacerbated by the adverse social effects of isolation.

According to the parliamentary written response from the Health Ministry, there has been a surge in the number of calls received by national and state helplines set up by the Crisis Preparedness and Response Centre (CRPC). Such number of calls totaled 37,009, with slightly more than half of them being availed by individuals seeking psychological and emotional support (19,729).

While the substantial number of citizens reaching out for help might indicate broadly the impact of COVID-19 on mental health, we should keep in mind that there are many more out there suffering from the alike without seeking proper assistance – possibly due to the social stigmatization associated with mental health or the low health literacy rate in Malaysia (only 6.6% of adults aged 18 years and above has adequate health literacy).

Identifying the Vulnerable Communities around us

The three identified groups that arguably face the greatest mental health impacts of coronavirus are thought to be:

COVID-19 patients: Government mandated isolation might cause these people to feel segregated from society, especially if they hail from lower income groups.
Long-term illness patients: Long-term condition patients might feel pressured or concerned to receive their treatments for fear of contracting COVID-19 via hospitals.
Frontliners: Healthcare personnel and other essential workers might be experiencing prolonged working hours and potential stigmatization due to being exposed to COVID-19. This can cause extreme fatigue, stress, and burnouts.
Individuals who lost their loved ones to COVID–19: Losing someone we love is a traumatic and agonizing experience. The destructive impacts of grief and pain endured by an individual might lead to or begin developing poor mental health conditions.

Source: World Health Organisation (WHO)

The consequences of COVID-19 on mental wellbeing does not end there. In particular, families coming from a lower socioeconomic background are more vulnerable than other households as they are likely to face a deeper and longer-lasting effect due to limited savings, and a lack of insurance coverage to sustain their livelihood during this unprecedented crisis. In Developing Malaysia (DM) Analytics’ report entitled ‘Families on Edge’, 68% of the interviewed households living in low-cost flats have no savings, and among such households who have no savings, approximately 1 in 2 have no SOCSO or EPF coverage as well. Noting that uncertainty and poverty are infamously associated with ill mental health, the amplification of these aspects are particularly concerning amongst B40 families.

Government’s Strategy in Combating the Unseen

Facing the pressure of rising demands for mental health resources in the country, it is sensible that the government will allocate more funding to expand and upgrade current facilities – especially since our country has always been understaffed of psychiatrists, with a psychiatrist to population ratio of 1.27 to 100,000 (the normal ratio being 1 to 10,000).

Budget 2021 showed the government’s commitment towards resolving mental health issues through a special allocation of RM 24 mil for the provisions of mental health, prevention of violence, and substance abuse, with the aims of reducing the severity and mounting cases of mental health conditions among the community.

However, the total budget for Psychiatry and Mental Health (inclusive of the special allocation) approximated to RM 337 mil, which is 2% lesser than the previous allocation, despite knowing the prevalence of rising emotional stress, anxiety, and depression in the country – a massive 61% decrease in fundings for mental health services and infrastructure, the lowest since 2010. Although the reduction is understandably justified as finite resources are expected to be channeled into COVID-19 response funds, it desensitises and threatens to overshadow the positive impacts of such special allocation as well as the 4% increase in emoluments allocation. This drastic shrink of budgets might have a retrospective effect on the maintenance of the operation and quality of mental health services, putting yet again the rising number of vulnerables at the risk of inadequate support.

Mental health in Malaysia will worsen if the rakyat’s plight is purportedly unacknowledged. People, as a result, will feel neglected and powerless to react accordingly. Referring to Code Blue’s article and the WHO report, the median percentage of health budget allocated specifically to mental health by the World Bank for upper-middle income countries such as Malaysia is 2.38%. Yet in Budget 2021, only a mere 0.98% of the health budget is set aside for mental health spending – which is a decrease from the 1.1% in 2020 and considerably lower than the median of upper-middle income countries. This effectively places Malaysia in between low (0.5%) and lower-middle (1.9%) income countries – straying far from our country’s potential.

Concluding thoughts

Statistics released by the Polis Diraja Malaysia (PDRM) revealed that there were 266 suicide cases in Malaysia during the Movement Control Order period (18th March to 30th October), which is an average spike of 30 cases a month. Such disheartening numbers again emphasises the urgency and importance to ensure the mental wellbeing of citizens. The government should formulate appropriate measures to alleviate the current scene – be it by providing counselling trainings, setting up of more helpline centres, or encouraging more students to pursue psychiatry-related courses to heed the need of having sufficient number of professionals available at all times. We must, as a country, realize that we are all living through the crisis together, for what we can all do is to give it our best at staying healthy (both physically and mentally), whilst also giving each other ample support and encouragement throughout this pandemic.

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