Reactions to symptoms of mental disorder and help seeking in Sabah, Malaysia

Abstract

Background: A better understanding is needed about how people make decisions about help seeking. Materials: Focus group and individual interviews with patients, carers, healthcare staff, religious authorities, traditional healers and community members. Discussion: Four stages of help seeking were identified: (1) noticing symptoms and initial labelling, (2) collective decision-making, (3) spiritual diagnoses and treatment and (4) psychiatric diagnosis and treatment. Conclusion: Spiritual diagnoses have the advantage of being less stigmatising, giving meaning to symptoms, and were seen to offer hope of cure rather than just symptom control. Patients and carers need help to integrate different explanatory models into a meaningful whole.

Views of young people in Malaysia on mental health, help‐seeking and unusual psychological experiences

“…Current participants did not suggest that individuals should take sole personal responsibility for mental health problems ("responsible" self) but did endorse support-seeking from friends or family for less severe problems ("resourceful" self). Our findings reflect a clear awareness of societal stigma in keeping with that reported by Shoesmith et al (2017)…”

“…Malaysia is an ethno-culturally diverse southeast Asian country of 32-million people with a high prevalence of mental health problems; estimated at 30%-40% among adults (Institute for Public Health, 2015; Khoo, 2017;Ting & Ng, 2012). Adolescence to young adulthood is associated with elevated mental ill-health worldwide (Kessler et al, 2005) and perhaps especially so in Malaysia, where the youth prevalence of 20% (Ahmad et al, 2015) exceeds the global youth prevalence of 13.4% (Polanczyk, Salum, Sugaya, Caye, & Rohde, 2015) yet access to mental health care is particularly limited by scarce resources and high stigma, especially for severe mental health problems (Hanafiah & Van Bortel, 2011;Institute for Public Health, 2015;Razali & Ismail, 2014;Shoesmith et al, 2017). Accordingly, the mean duration of untreated psychosis (DUP) in Malaysia is greater than 3 years (Chee, Muhammad Dain, Abdul Aziz, & Abdullah, 2010) which exceeds reported UK averages of 2 to 21 months (Cotter, Zabel, French, & Yung, 2017).…”

The Effectiveness of a Depression Literacy Program on Stigma and Mental Help-Seeking Among Adolescents in Malaysia: A Control Group Study With 3-Month Follow-Up

“…26 This could stem from a lack of knowledge and cultural variations such as making a spiritual rather than a medical diagnosis for the mental disorder. 27 There is also evidence of perceived stigma toward mental illness among patients, caregivers and health care providers. [28][29][30][31] In spite of the magnitude of the problem, there is a paucity of intervention studies which focus on improving mental health literacy, stigma, and help-seeking attitudes among mentally ill adolescents in the Southeast Asian region.…”

Moving towards culturally competent health systems for migrants? Applying systems thinking in a qualitative study in Malaysia and Thailand

“…Where guidelines on cultural competence do not exist for domestically diverse populations such as in Malaysia, it is unlikely that they do for migrants. Addressing the needs of a linguistically and ethnically diverse domestic population is already a challenge in the Malaysian health system, where for example, spiritual concerns and family pressure to seek traditional therapies differ by ethnicity [47][48][49][50]. Equally, given previous tensions in Malaysia among the ethnically diverse domestic population, addressing prejudice against migrants and refugees will be challenging (82% of Malaysians wanted to see immigration levels decrease, compared to 49% in Thailand [51]).…”