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Affordable ways to invest in mental health

Lim Siew May 
/
Health is a state of complete physical, mental and social well-being and not merely the
absence of disease or in rmity – 123RF

A-  A  A+

The World Health Organisation (WHO) advertisement [x]

constitution states that “health is a state of
complete physical, mental and social well-being
and not merely the absence of disease or in rmity”.

Health is wealth, and without mental health, there is no health, as WHO pointed out. While it
may not be as widely discussed as physical ailments, the struggle is real.

In particular, the WHO reported last year that depression was increasing worldwide, with
more than 300 million people now living with depression, suggesting an increase of more
than 18% between 2005 and 2015. Alarmingly, it was also the leading cause of ill health and
disability worldwide.

Seeking professional help

Anyone can su er mental health issues at any point in their life. Su ce to say, just as it is
important to take care of our physical health, it is important to invest in our mental health.
Leaving aside the stigma of contending with mental health issues, the prohibitive cost could
exacerbate a patient’s dilemma.

/
Even if you have been diligently paying your health insurance premiums, they do not cover
the cost of psychiatric services should you require them, observes Lim Su Lin, a policy
analyst with Penang Institute in Kuala Lumpur who studies the Malaysian mental healthcare
system.

This includes the cost of purchasing medication, consultations with a medical specialist such
as a psychiatrist, and psychological therapy sessions.

Lim adds that charges vary widely, depending on the provider and the type of service
needed. “In most private centres o ering psychological services, rates for a single
psychotherapy session with a psychologist can range anywhere from RM250 to RM800, and
these gures merely represent the cost for one type of treatment.

“Patients with illnesses that require medication will incur even higher costs, since they need
to pay for separate consultation visits to a psychiatrist and make purchases for drugs,” she
wrote in an online media platform.

One way to circumvent the high cost is to opt for e-counselling. Dr Khairi Rahman, a
psychologist at Pantai Hospital Kuala Lumpur who is available on online healthcare-related
platform Teleme, points out that compared with traditional counselling, e-counselling can be
more a ordable, as it doesn’t require the mental health professional to rent a commercial
space and incur overhead or administration costs for face-to-face counselling, he says.

Teleme is an online platform that allows users to access doctors via video consultation, and
have their medication delivered to them.

Patients are able to do online consultation either through messaging, voice call or video call
from the privacy of their home without having to confront the stigma of having mental
health issues. It also breaks down the geographical barrier for those who live far away from
mental health professionals.

Teleme points out that it’s up to their practitioner to set the consultation charges. For
consultation via video call, the charges range from RM10 to RM200, although some
practitioners do not impose a fee. Normally, it would take around 15 minutes for a video
call, but consultation can still continue if both parties need more time.

Meanwhile, for chat messenger with a specialist, the standard price is RM20, although the
specialist can also waive the fee. The chat is unlimited for seven days, and either party can
end the chat once issues are resolved.

These charges, however, do not encompass medical prescription and health lab screening,
which will be prescribed by doctors.

While more accessible and a ordable, Dr Khairi stresses that Teleme’s platform does not
replace physical consultation and examination. Rather, it o ers healthcare professionals
another means to engage and help their patients in good health and illness.
/
Dr Khairi believes that whether or not e-counselling is better for patients will depend on a
case-to-case basis. He points out that an extensive study conducted by the Berkeley Well-
Being Institute suggested that e-counselling is a viable alternative to face-to-face counselling
based on the BetterHelp case study, which is one of the largest e-counselling platforms
worldwide.

Acknowledging that there may be limitations on gauging a patient’s voice tone, facial
expression, body language and eye contact when it comes to online consultation, Dr Khairi
says meeting patients face-to-face for thorough examination or observation at the clinic can
be arranged by the mental health professionals where necessary.

Opting for public healthcare

Associate Professor Dr Muhammad Muhsin Ahmad Zahari, a consultant from Universiti

Malaya’s Department of Psychological Medicine, Faculty of Medicine, says it generally costs
RM15 to see a specialist in a government hospital.

Medication, however, usually costs more than the

consultation fee. For instance, it can cost RM100 to
more than RM300 for one month’s supply of anti-
depressant medicine, and about RM400-500 for
antipsychotic – a medication required by those with
auditory hallucination and irrational belief.

Compared with the conventional platform, Dr Many of us are only doing what’s
Muhammad Muhsin agrees that the online platform required to survive, we are not taking
enhances the accessibility of mental healthcare care of our emotional state, says Dr
Muhammad Muhsin
providers. “It’s good for screening purpose – if a patient
needs to talk to someone, the online platform makes
getting help more accessible. It is better than having patients think: ‘I don’t want to see a
psychiatrist and I don’t need help.’ You can do screening – if the results turn out to be
positive, you can go and seek help,” he says.

An online platform, he adds, is helpful in picking up patients with a lower level of mental
health disturbances, which may encourage patients to see a doctor for the next level of
medical help.

“In their next interview, the healthcare provider will get a very thorough picture of the
patient, such as taking into consideration the circumstances the patient is living in, his
nancial status, the nature of his job, sensitive information like whether someone is taking
drugs (to cope), which they may not reveal when talking online,” he adds.

/
As to the time it takes to treat mental illnesses, it varies based on the complexity. “If it’s
transient by nature, it takes six months to one year. For example, if you have a clear-cut
problem, such as a relationship problem with your spouse and family, once the issue is
resolved, you follow up with medication for six months to one year,” he explains. At the
other extreme, if your mental illness is related to genetics, it requires lifelong treatment, he
says.

Maintain a healthy lifestyle

Assuming one has not reached a critical stage, there are more cost-e ective (and arguably
more pleasurable) ways to maintain your mental wellbeing on a day-to-day basis.

Our interviewees generally agree that these can be as simple as talking to good friends,
reading self-help books, taking a break, travelling and going for meditation classes.

“People can try di erent ways to see what works for them. It can be as simple as spending
ve minutes with their pets, or taking a short walk around the park,” says Dr Ng Siew Li,
psychology lecturer at HELP University Sdn Bhd.

Just as adequate sleep, regular exercise and a healthy diet is important to our physical
health, mental health would bene t from the same care, too, says Dr Ng. “For example,
there are research studies that found that when people exercise, they are more likely to
have better mental health. Physical and mental health typically go hand in hand.

“In addition, spending some time on ourselves and

doing things that we enjoy are also important. For
instance, it can be in the form of sports, reading, or
doing a relaxing spa. Having enough rest each day
would be good,” she says.

Universiti Malaya’s Dr Muhammad Muhsin concurs

that investing in a healthy lifestyle is good for one’s Physical and mental health typically go
mental health. “Mental health is how you live your life,” hand in hand, says Dr Ng
he sums up.

“Research says physical illness gives you low quality mental health (by impairing the quality
of your life), compared with those with no physical health issues – they are interlinked.
Mental health takes into account many factors.”

Build up good memories

/
Not surprisingly, quality sleep, which is at the core of a healthy lifestyle, has a bearing on
your mental wellbeing. Dr Muhammad Muhsin advises that to cultivate sleep hygiene, one
should not exercise too close to sleeping time, or take ca einated drink before night time,
or do work on the bed or play with your smartphone as the bright light of gadgets disrupts
melatonin, a hormone that regulates sleep.

It also helps to apply positive psychology. “For instance, you should train yourself to build up
good memories. These include sharing good moments on your social media and in real life,
self-congratulating yourself when you do something good – doing so will at least build up a
bu er to make you more resilient towards negative emotions, and makes it harder for you
to develop mental health issues,” Dr Muhammad Muhsin says.

Practising mindfulness is also bene cial. “Some people may think about tomorrow, the day
after tomorrow or look too far into the future – you are only creating more worries for
yourself. To achieve your goal, yes, you should have a plan and work within the time frame –
for example, if you want to have RM1 mil but you only have RM10,000 now, look at what
resources you have, your quali cations and current situation.

“It’s not like you don’t think or do anything about it. About 60-70% of your thinking will shape
your present, and your present a ects your future. If you want to know your future one year
from now, taking the right actions within the next 12 months will keep things in order,” he
says, adding that nurturing a good relationship with one’s family and friends is also
imperative to one’s mental wellbeing.

It also works wonders for your mental health to engage in hobbies. “The keyword is to do
more of what gives you pleasure. Some people go for music therapy as they like to relieve
their stress through karaoke.

“Some go for pet therapy – where they learn to calm down by playing with their pets. Many
of us are too busy – we are only doing what’s required of us to survive, we are not taking
care of our emotional state. We focus on what we need to do, not what we like to do. We
should have a balance,” says Dr Muhammad Muhsin.

/
 

Maintaining good ties with family and friends is crucial to one’s mental health – 123RF

Mental health and you

What are the signs that say a person needs the help of a mental health professional?
After all, it is only human nature to feel unhappy, anxious or depressed sometimes.

Dr Khairi Rahman, a psychologist at Pantai Hospital

Kuala Lumpur, acknowledges this but points out
much of those experiences should be temporary in
nature, and are often associated with certain causal
or de nitive factors.

“Once those causal factors have been identi ed and

Dr Khairi says common signs and addressed appropriately, this temporary negative
symptoms, like heightened irrational mental state of health would fade away,” he says.
behaviour, require the help of a mental
health professional  This, however, may not be the case with prolonged
unhappiness or being in a depressed state where
there are no apparent reasons or external factors causing one to be in such a state of
mind, he observes.

/
Dr Khairi points out some common signs and symptoms that require the help of a mental
health professional. They include heightened irrational behaviour, such as increased
drinking, smoking or sleeping a lot more than usual, inability to focus well at work or even
carrying out simple tasks, crying for no apparent reason, prolonged loss of appetite,
shying away from friends and others, and not enjoying the activities they used to love.

HELP University psychology lecturer Dr Ng Siew Li says based on her experience, people
seek mental health services for various reasons – stress or time management issues,
anger or relationship issues, depression, anxiety and beyond.

“Sometimes, people who seek the services may not necessarily present with obvious
signs. For instance, you may not see obvious signs if someone has a depressed mood
because he may appear to function as usual.

“In general, prolonged changes in one’s mood or behaviour, such as being unusually
aggressive or isolated, that result in signi cant distress or dysfunction like missing work
or frequent arguments with others may be possible signs,” Dr Ng says. She adds it also
depends on the duration, frequency, and intensity of those changes in mood or
behaviour as well.

Who to ask for help

Mental health professionals come in various forms. Assuming you have established the
need to seek help, should you choose a counsellor, therapist, psychologist or psychiatrist?

Dr Ng points out that people in di erent helping professions have slightly di erent
functions, and the way they treat patients is also di erent. “For example, although
counsellors and clinical psychologists both provide psychotherapy, clinical psychologists
are also trained to do assessments and testing. For example, we (clinical psychologists)
do testing to assess for attention de cit hyperactivity disorder (ADHD), learning
di culties and giftedness, among others.”

Dr Khairi adds that this would depend on the background of a patient’s case. According to
him, the majority of other mental health cases may bene t from the help of
psychologists, therapists, counsellors or even experienced pastors, and they are fairly
dependent on the nature and background of the cases.

Meanwhile, most cases that fall under the scope of mental illness bene t from psychiatric
intervention, he says.

Dr Ng adds that psychiatrists are medical doctors who have specialised training in
treating people with mental health concerns. “In Malaysia, psychiatrists typically prescribe
medication when treating patients. Counsellors or clinical psychologists cannot prescribe
medication; they typically provide psychotherapy,” she says.
/
This article rst appeared in Focus Malaysia Issue 272.

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