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Stigma of mental illness has been identified as a significant barrier to help-seeking and care. Basic knowledge of mental illness - such as its nature, symptoms and impact - are neglected, leaving room for misunderstandings on mental health and stigma.
Individuals with mental illness often struggle a double-edged sword battle. Coping with the symptoms of the condition itself is already difficult enough whilst misperceptions of the condition create further complications such as suffering negative connotations - 'stigma' - and discrimination. Stigma and discrimination are also suggested to be significant barriers to mental health help-seeking, mental health recovery and social inclusion.
This study aims to contribute towards bridging the current gap in research on stigma and discrimination of mental illness in Malaysia. Current literatures lack insight from mental health professionals thus the state of stigma towards people with mental illness was explored from the perspectives of mental health professionals. This was conducted within urban settings in Malaysia.
The study explored the main perpetrators of discrimination experienced by people with mental health problems. Alarmingly, family members garnered the most consensus among mental health professionals as the chief perpetrators. This is followed by friends and then employers.
As the participating mental health professionals elaborated on their patients' plight of being stigmatised and discriminated against, types of mental illness most likely to carry stigma came to light. Full consensus was achieved (15 out of 15) on schizophrenia being the mental health condition carrying most stigma and receiving most discrimination in Malaysia, according to their patients, followed by bipolar disorder and depression.
Half of the participants reported that the general public believes that personal dispositions such as bad genes and psychological weaknesses attribute to their patients' conditions. Moreover, mental health professionals also cited other people's supernatural beliefs as one of the criticisms plaguing patients.
It was found that people living in rural areas are more accepting of mental illnesses, attributing this to their strong collective community lifestyle (social capital) that acts as a protective factor.
Additionally, a third of mental health professionals linked ethnicity to higher or lower stigma of mental illness. Three main ethnic groups - Malay, Chinese and Indian - make up the majority of the Malaysian population. It was reported that the ethnic Malay population is more likely to believe that mental illness stems from supernatural activities and thus are highly likely to reject the condition. Whereas, for reasons yet to be understood, Chinese families were reported to be more accepting of mental illness.
Mental health professionals identified the lack of education and awareness surrounding mental health and illness as the biggest concerns and key areas to address. Mental illness involves a multitude of symptoms: from behavioural to mood changes. As reported, culture and religion play an important role as, on the whole, the general public in Malaysia believes in supernatural or spiritual causes as the aetiology of psychiatric conditions. This leads them to seek alternative healers as primary treatment before reaching out to the officially trained and recognised mental health professionals (both in public and private health services). In this case, traditional or alternative healers in Malaysia are generally without proper knowledge of mental health issues.
Drawing upon the results of this study, stigma of mental illness and of people with mental health problems was found to be a profound phenomenon in Malaysia. Specifically, patients with a diagnosis of schizophrenia, bipolar disorder and depression were highlighted to be the ones receiving most stigma and discrimination and therefore need pressing attention. Family,
friends and workplace staff were mentioned to be the main and most discriminating groups.
The personal and societal implications of stigma found patients to be disempowered, socially excluded and trapped in a vicious cycle of discrimination. Thus, there is a pressing need to address stigma of mental illness in civil society and the health system especially, as stressed by the mental health professionals in this study, through education and awareness raising campaigns taking into consideration the multi-cultural background of Malaysia.
Category(s):Mental Health in Asia
Source material from International Journal of Mental Health Systems
