Mental health issues among Malaysians are on the rise. Yet, many still suffer in silence and do not seek help out of fear of repercussions such as ostracisation and being labelled as crazy or problematic. This stigma often stems from a lack of understanding within society and even families, where mental health is still viewed as a taboo subject or a sign of weakness.
Despite efforts to promote awareness, mental health services remain lacking as long waiting times, a shortage of trained professionals and limited access to therapy in public facilities pose challenges. Many young people do not even know where to turn to for help, or they are discouraged from doing so by the very people closest to them.
Poor awareness
Pantai Hospital consultant psychiatrist Dr Ng Yin Ping said this was due to contributing factors such as poor awareness and difficulties with access to much-needed mental health care.
“Young people, especially children who are experiencing mental health issues, often present differently from adults. They are more likely to experience emotional and behavioural changes such as moodiness, temper outbursts, worry and social withdrawal,” she told theSun.
Ng said others may report physical symptoms such as headaches, tummy discomfort, changes in their sleep quality and appetite. While many seek help for physical symptoms, emotional distress often goes unrecognised or overlooked, until it begins to affect daily functioning, such as declining academic performance or refusal to attend school.
“It is important to recognise these symptoms and seek mental health help early before complications arise.”
Ng, who is also vice-chairman of the i-Life Suicide Prevention Association of Penang and a committee member of D’Home Mental Health Association, said while awareness campaigns have improved in recent years, people often do not feel safe expressing their emotional distress.
“The much larger issue here is mental health stigma, which prevents people from even acknowledging their own emotional distress, let alone seeking help. Too often, rather than validating emotional distress as a normal response to overwhelming stress, people have been judged as being weak or thinking too much. As such, many choose to suppress any signs or symptoms related to mental health issues due to fears of being shunned, perceived as crazy or incompetent.”
She said people who acknowledge that they are in distress and need help are more willing to receive help and work on their recovery.
Ng hoped people would come together to speak up against the stigma and urged for better narratives through the media. She pointed out that most conventional stress relief techniques involved shifting focus away from stressors to provide relief or “time-out”.
‘Unspoken’
Earlier this month, a participatory art installation titled “Unspoken” at Hin Bus Depot, Penang, showcased a collaborative effort between artists James Seet and Clay Loo, D’Home Mental Health Association, Penang Art District and Coex to raise awareness against mental health stigma.
Ng commended the efforts of Unspoken for using creative methods to enable conversations and reduce stigma.
“The activity provided an opportunity for participants to intentionally unearth and creatively process their emotions and later let go of the psychological burdens associated with those emotions in a safe space, at their own time.”
She said although the project was not designed as a therapeutic intervention and should not replace therapy, the resultant awareness and emotional processing from the experience can activate their healing process.
Unspoken featured hundreds of handwritten anonymous notes with some expressing despair and anguish, while others pleading for understanding and forgiveness. Such messages captured the unspoken emotions and silent cries many carry in their hearts.
In this art project, participants were invited to pick a piece of ceramic from a display selection. Participants were then gently prompted to connect and reflect on a personal experience or emotion which had deeply impacted them, and to express them via writing or drawing on their chosen ceramic. When they were ready, the participants were invited to intentionally smash the ceramic at a designated safe wall, which served as a symbolic release and “letting go” of their burden. Apart from providing a cathartic experience, the intentional smashing served as a literal “breaking the silent burdens” that they had carried. Finally, the participants exited the room to take a moment to reflect on their experience.
Lee Khai, vice president of D’Home, a passionate art collector, chairman of the Penang State Art Gallery, and adviser to the Penang Art District, provided financial support for Unspoken and described Seet as a thinking artist with depth and a strong sense of social responsibility.
Ng highlighted that the art installation was not just about stress relief but about dealing with distress. Instead of moving away from the distress, creative art projects such as Unspoken can be therapeutic as an intervention to gently prompt and facilitate acknowledgement, introspection and meaning.
She added that participatory public art projects have been used to raise awareness and combat suicide-related stigma within the community.
“Creative art is often viewed as fun and non-threatening, while conferring freedom for one to express themselves.”
Ng said Unspoken hopes to convey that “it is okay not to be okay” to further encourage open, non-judgemental conversations on mental health, coping and help-seeking. The smashed ceramic pieces will later be used by Seet and Loo to co-create new artworks with the participants of the art installation.
“It is a symbolic way of turning the unspoken brokenness or distress into something meaningful,” she said.
The co-created art pieces will be on display in an exhibition at Coex @ Kilang Besi from Nov 1 to 16.
She said from a psychological point of view, this transformative act represents “post-traumatic growth” (PTG), such as the experience of positive change that occurs after the struggle with highly challenging life circumstances.
“It is important to note that PTG does not deny the negative effects but acknowledges that growth can occur alongside pain and suffering. In this case, transforming broken pieces, conveying hurt into new art, is an artistic expression of PTG in that it may encourage healing and growth for the participants,” she said.
According to the Health Ministry’s National Health and Morbidity Survey (NHMS), mental health concerns are highest among adolescents and young adults.
The number of people affected by depression has doubled from 2019 to 2023, with nearly half having thoughts of self-harm or suicide.
The latest 2023 NHMS reports that 4.6% of Malaysians, aged 15 and above, suffer from depression, but it is noticeably higher among young adults, aged 16 to 19 (7.9%), and 20 to 29 (7.6%). The same survey revealed that mental health problems were found in 16.5% of children, aged between five and 15, mostly involving peer, conduct and emotional problems.