By Balkish Awang
KUALA LUMPUR: Mental health problems remain a pressing concern in Malaysia, with projections of a 10 per cent surge in cases by 2025.
The 2015 National Health and Morbidity Survey report by the Institute for Public Health in the Ministry of Health revealed an increase in mental health cases among adults in Malaysia since 2005, rising from 11.5 per cent that year to 29.2 per cent in 2015 – indicating that nearly three out of 10 Malaysian adults experienced mental health issues, according to experts.
Another concerning issue is that Malaysia does not have enough psychiatrists and clinical psychologists to cope with the anticipated rise in demand for their specialised services.
Non-clinical psychologists contend that they can play a bigger role in providing support services to patients with mental health problems but the absence of a law to regulate their industry is preventing them from doing so.
The lack of regulation is also seeing more pseudo-psychologists emerging to offer counselling services and therapy, posing a significant risk as they are not qualified to address mental disorders.
Practitioners of pseudo-psychology use unscientific or fraudulent methods, or biased or false data, to understand or analyse the mind or behaviour of their patients.
Pseudo-psychology
According to Malaysian Psychological Association president Associate Prof Dr Shazli Ezzat Ghazali, currently, services by pseudo-psychologists are “widely available in this country”, stemming from a notable disparity between the number of qualified service providers and the demand.
To prevent people from falling prey to pseudo-psychologists, the association has proposed to the government that a Psychology Act be enacted to regulate the industry and protect the public from being deceived by unqualified practitioners and unethical practices.
Shazli Ezzat, who is also a senior lecturer with the Clinical Psychology and Behavioural Health programme at the Faculty of Health Sciences, Universiti Kebangsaan Malaysia, told Bernama people with mental health issues require literacy and professional support but the number of certified experts that can help them is rather limited.
Currently, patients can seek the help of psychiatrists and clinical psychologists as well as support services provided by professionals such as counsellors and social workers whose services are all regulated by specific laws.
“However, (non-clinical) psychologists are not able to play an active role (in helping such patients) as they are not empowered (by law),” he said.
On how the proposed Psychology Act would differ from the existing Counsellors Act 1998, he said the latter is limited to the counselling profession which focuses more on addressing common issues faced by society. The Psychology Act, on the other hand, is broader as it aims to regulate practitioners and protect patients from being deceived by pseudo-psychological services.
Why proposed Act is important
According to Shazli Ezzat, calls for a Psychology Act by the Malaysian Psychological Association began in 2009 but the proposal was not brought forward by lawmakers probably because mental health was not seen as a significant issue then.
“In 2018, the psychology legislation was almost ready to be taken to Parliament but nothing happened. Our association requires a strong ‘sponsor’ who can help us to realise the creation of this (Psychology) Act,” he said.
He explained the enactment of a specific law related to psychology will safeguard the interests of the community through the containment of behavioural issues and by providing space to enhance training in psychological skills to handle psychological emergency aid, mental health emergencies, coping strategies, and emotional and stress management.
He also believed the implementation of the Psychology Act will enable certified psychologists to provide intervention treatments to patients, which will help in efforts to manage mental health cases better and prevent the situation in the nation from worsening.
Meanwhile, freelance organisational psychologist Dr Alizi Alias opined that Malaysia is somewhat lagging behind other countries in the field of psychology, saying most developed nations have professional bodies to regulate practitioners as well as all aspects of the field of psychology including the academic curriculum.
“In the United Kingdom, they have the British Psychological Society which regulates the titles and practices of psychologists. Practitioner psychologists are also required to register with the government via the Health and Care Professions Council.
“The United States has the American Psychological Association to regulate the (psychology) curriculum and the state law to license practitioners. Australia has the Australian Psychological Society and the Psychology Board of Australia. Indonesia has ‘Himpunan Psikologi Indonesia’, which requires its members to be certified and licensed to practice psychology,” he said.
Supporting the proposal for the enactment of the Psychology Act, Alizi said under this law, it will be mandatory for psychologists to possess the required qualifications and be registered with the professional body concerned.
“We need to have this law as Malaysia already has the Counsellors Act 1998 and is in the process of introducing the Social Work Profession Act to cover the field of social work,” he said.
According to Alizi, initially, there was a proposal to create both the Psychology Act and Counsellors Act simultaneously but priority was given to the Counsellors Act because their numbers were larger. Furthermore, in Malaysia, the counselling field has been in existence since the 1940s compared to psychology, which emerged in the 1970s.
Shortage
Alizi also said since Malaysia has a shortage of psychiatrists and clinical psychologists – professionals who are qualified to diagnose and prescribe treatments to patients with mental health disorders – the proposed Psychology Act can potentially ease their burden as it will empower non-clinical psychologists to assist in terms of primary (prevention), secondary (training) and tertiary (non-clinical rehabilitation) interventions.
“The Psychology Act will enable non-clinical and non-counselling psychologists to help control risk factors, manage early symptoms, and modify policies, cultures and activities for the purpose of rehabilitation in various settings such as workplaces, clinics, hospitals, schools, universities, courts, prisons and so on.
“This can reduce the workload of psychiatrists and clinical psychologists, as well as that of counsellors, in terms of their client and patient numbers,” he said.
The nation’s rising mental health cases also justifies calls for the introduction of the Psychology Act as more certified professionals will be needed to cope with the demand for mental healthcare services.
Citing Ministry of Health (MoH) data, Alizi said 1,142 mental health cases were recorded in 2021 compared to only 631 in 2020.
He said it is worrying that children are also having mental health issues.
“(It has been reported) One in 20 children aged five to nine in Malaysia experience mental disorders. MOH has so far recorded 424,000 cases of children diagnosed with mental problems,” he added.
Alizi also said the stigma against mental health patients still exists, causing people to feel ashamed to seek treatment, or discontinue their treatment, which is making it difficult for the authorities to manage mental health issues.
He said the main factor contributing to this situation is the presence of untrained and uncertified individuals in the fields of psychiatry, psychology, counselling or social work who speak about mental health and mental illnesses through books authored by them; on social media; or via lectures given by them in schools, government departments and private sectors.
“They are doing this because currently there is no law to monitor ethical issues in the practice of psychology,” he said.
“If what they are trying to convey (to the public) adheres to the principles of scientific psychology, then we’ve no issue. However, most of their assertions are based on pop psychology and/or pseudo-psychology.
“Even those trained academically and formally in mental health may inadvertently promote pseudo-psychology by not referencing scientific papers.”
He added in such a situation, the public may develop misconceptions about mental illnesses and how to prevent and manage them, as well as the rehabilitation methods and clinical treatments. – BERNAMA
