Reintegration into society: Challenges faced by individuals with mental disorders

SHAH ALAM - People dealing with mental health disorders encounter a plethora of challenges and issues upon their reintegration into the community.

Historically, anyone suspected of having psychotic mental illnesses like schizophrenia would be admitted to mental health facilities such as the Hospital Bahagia in Tanjung Rambutan, Permai Hospital in Johor Bahru, Sentosa Hospital in Kuching, and Bukit Padang Hospital in Kota Kinabalu.

However, the trend towards deinstitutionalisation that started in the 1970s pushed for these individuals, particularly those with mental illnesses, to be introduced to the community, but this was a long process.

There were more psychiatric units throughout the nation for individuals to be treated in clinics, and if necessary, they would be treated in inpatient facilities.

Taylor’s University Impact Lab on Mental Health and Wellbeing Director Professor Datuk Dr Andrew Mohanraj said that hospitals usually adhere to length of stay periods for patients to be stabilised and only kept for specific reasons.

“Hospital units have a length of stay for which they must treat the patient, turn around the patient, stabilise the patient, and reintroduce them to the community and their families, but there’s also some acknowledgement that in some cases they require a longer period of stay.

“The usual recommended period of stay is 14 days, but they would require more treatments if they were found to continue to pose danger to themselves or society, or in some cases, if the conditions were so severe that they did not have anyone to look after them (no family members and such).

“In such cases, they will be sent to the four mental health hospitals in the country,” he said.

Andrew said that the system was not perfect as it required involvement from families in patient care to understand the illness.

“It is not a perfect system; among the setbacks are patients who were seen as not fully recovered, fully well, or stabilised being sent back to their homes.

“We must work towards it, and we must strive to involve the families in patient care from the beginning itself so they understand the nature of the illness, how to detect symptoms when they relapse, and how to prevent relapses from happening,” he said.

There were issues with such systems, particularly when involving methods of simply stabilising patients, as families would often be placed into positions of not being able to fully look after the individual with the mental health illness due to their own responsibilities, such as work.

Andrew said the objective of the system was not to continuously send individuals to mental hospitals, as it was very stigmatising and placed a label that those individuals could not be properly integrated into society.

He added that the government has set up Mentari centres focused on supporting such individuals through the community.

“The government has set up Mentari centres. We have around 20 Mentari Centres, which were community centres under the Health Ministry, around the country.

“The government is also planning to set up more Mentari, or community mental health centres.

“The function of these mental health centres is to give support to persons with these kinds of disabilities who have been discharged from the hospital and who continue to require support from the community,” he said.

The motive behind the development of the centres was to get families and the community to take some responsibility and empower them throughout the treatment and recovery process of the patient.

The advancement of technologies has enabled some patients, with the right medications, to lead a life of recovery.

"Recovery varies for all individuals, but it is hoped that individuals will be able to continue leading productive lives in the community and live like anyone else.

Andrew said the government's shift efforts on improving mental health were improving after the additional allocation in last year’s budget.

“There is a slight shift in how the government is thinking, which was reflected in last year’s budget.

"With the marginal increase in the allocation for mental health in the health budget, an additional RM35 million was allocated to Malaysia's Centre of Excellence in Mental Health, which was set up about two years ago, and among the mandates was to involve NGO and civil society organisations in providing adequate psychosocial support to people with psychosocial disabilities and their families,” he said.