The World Health Organization (WHO) reports that globally, mental illness affects 1

in 4 people. In Malaysia, the Malaysian 2015 National Health Morbidity Survey

revealed 1 in 3 adults has suffered from some form of mental illness at some point
of their lives. The prevalence of mental illness in Malaysia has doubled within 9
years from 2006 (11.2%) to 2015 (29.2%).

Mental illness does not discriminate; it can affect anyone regardless of your age,
gender, geography, income, social status, race, religion, sexual orientation,
background or other aspect of cultural identity.

There is a strong social stigma attached to mental health. As such, people with
mental illnesses can experience discrimination in all aspects of their lives. Such
stigma and discrimination prevents such individuals from seeking professional help
and treatment early. That is why many people who have a mental illness go
untreated.

In PETRONAS, mental illness has been a significant contributor for Prolonged

Illness and Medical Board Out since 2012. As such, we established the Employee
Assistance Program (EAP) for employees to reach out for psychological therapy.
We also introduced our Digital Healthy Lifestyle Coaching (DHLC) to provide
coaching to build mental resilience.

Mental illness is nothing to be ashamed of. It is a medical condition which is

treatable, just like physical illnesses like hypertension, heart disease or diabetes.
The vast majority of individuals with mental illness continue to function in their daily
lives with no problems.

This MIND-A-CARE Handbook was developed by the Occupational Health team of

Group HSSE to promote awareness and destigmatizing of mental health. It is
intended to assist employees in recognizing early signs of mental health issues so
the can be addressed promptly.

Dzafri Sham Ahmad

Vice President
Group HSSE, PETRONAS

2
CHAPTER 1 : INTRODUCTION 4
• Overview of Mental Health 4
• Defining Mental Health 5
• Mental Health Stigma 6
• Myth versus Facts 6
• Risk and Protective Factors 7
• Causes of Mental Illness 7

CHAPTER 2 : STRESS 8
• What is Stress? 8
• Types of Stressors 9
• Body reaction towards Stress 9
• Impact of Distress 10
• Roles of Hormones in Stress

CHAPTER 3 : COMMON MENTAL HEALTH CONDITIONS 11

• Poor Mental Health vs Mental Illness 11
• Depression 12
• Anxiety 14
• Personality Disorders 15
• Self-Harm 16
• Suicide 17

CHAPTER 4 : MIND-A-CARE 18
• First Aid for Mental Health 18
• Before Minding A Care 18
• 4 Steps of C.A.R.E 19
• How to MIND-A-C.A.R.E 20
• Check for signals
• Apply Non-Judgemental Conversation.
• Reassure support with Information
• Ensure Help is Received

CHAPTER 5 : MENTAL HEALTH SERVICES IN MALAYSIA 24

• Support within PETRONAS
• Support by other Organisations

3
Overview of the Mental Health Spectrum

Mental Work-Life Imbalance Poor Mental Health Mental Illness/

Well-Being (Distress) (Unmanaged Stress) Disorder

Life brings our emotions through periods of sadness and happiness,

and everything in between. With experience, nature and nurture, we
learnt from our childhood on how to interpret and manage these
emotions.

The process takes us through adolescence, early adulthood, working

life and continuously thereafter with exposures to either risk and
protectives factors. The good thing is our emotion or mental health
state is not static. We can learn new processes along the way. So with
the trials and tribulations of life, expected or mostly unexpected, our
mental health state will take us, at different times, within the spectrum
from Mental Well Being to a possible state of Mental Illness.

Mental wellbeing is what each and every one of us aspire to achieve.

However, family or relationship issues coupled with poor
communications as well as financial burden can be a trigger to tip off
the balance. This is often referred to as work-life imbalance, which is
arbitrarily a person’s inability to divide the balance between personal
needs, family responsibilities and work demand. These work and
home issues, if not managed early and when persisted for a long time
will inevitably lead to Poor Mental Health. Among the differences
between Poor Mental Health and Mental Illness/Disorder are the
degree of symptoms, the duration of having it and the effect it has on
relationship and performance at work. However, one thing they all
have in common is that they are all treatable and they are all
preventable.

4
Defining the Mental Health Spectrum
Mental Health: Just like physical health, mental health is a
person’s condition with regards to their psychological and
emotional state It is are a range of moods and experiences as
follows:

Mental Work-Life Poor Mental Health Mental

Well-Being Imbalance (Unmanaged Stress) Illness or
(Distress) Disorder

Mental Wellbeing: Is a state of mind in which one realises their

own potential to cope with common stresses in life, can function
productively and meaningfully, and able to contribute to society.

Work-life imbalance: Inability to maintain and divide fair time on

prioritising the demands of one’s personal and professional life.
Excessive multi-tasking and working at unstable pace may cause
distress due work-life imbalance. Hence, the person may feel
overwhelmed and mentally exhausted that later on may leads to
poor mental health if not being managed effectively

Poor Mental Health: Everyone may experience poor mental health

due to unmanaged stressors at any point of their life, presented
with episodes of low mood, restlessness, confusion, short-
temperedness, sadness or being too preoccupied usually for not
more than 2 weeks. If it is prolonged beyond 2 weeks without any
psychological interventions, it could be an early sign of potential
mental illness. Poor mental health does not mean someone is
mentally ill but may end up with mental illness, if not intervened
early.
Mental Illness/Disorder: Mental illnesses are health conditions
involving prolonged changes in emotion, thinking or behavior (or a
combination of these) lasting for more than 2 weeks, commonly
associated with distress and/or problems functioning in social, work
or family activities which can be fairly mild or severe. Mental
illness is treatable. Vast majority of individuals with mental illness
continue to function in their daily lives.

5
Mental Health Stigma
Social stigma: Includes disapproval of, negative attitudes
and discriminatory behaviour that society or particular
individuals hold against those with mental illness.

Self-stigma: Self-stigma is when people with mental

health problems believe what is being said about their
condition is true.

Effects of Stigma Coping with Stigma

• Fear of disclosing about mental health
• Reluctance to seek support
• Victimisation, harassment and physical
violence
• Difficulties connecting with friends and
taking part in activities
• Lack of understanding from close one
• Discrimination/embarrassment from
family and friends
• Obtain reliable information to improve
understanding of mental health
• Seek professional help: don’t let the fear
stop you
• Speak out against stigma
• Join a support group to talk about your
mental illness
• Don’t isolate yourself
• Don’t equate yourself with your illness

MYTH VS FACT
Mental health problems lead to poor They are just as efficient as other
performance in workplace. employees or may have greater work
performance.

People choose to be mentally ill. They
can snap out of it if they try hard
enough.
There are many contributors to mental
health such as biological factors, life
experiences or family history of mental
health.

People with severe mental illnesses are

People with mental health problems
over 10 times more likely to be victims of
are violent and unpredictable.
violent crimes.

Friends and family can be important

I can't do anything for a person with a
influences to help someone get the
mental health problem.
treatment.

Mental health problem do not effect Mental health problems can

physical health. negatively impact physical health.

6
 Risk and Protective Factors for
Mental Illness
Difficult temperament
Low self- esteem
Impaired cognitive development
Poor physical health
Poor language skills
Easy temperament
Good social and emotional skills
Childhood
Well developed cognitive skills
Experience Good physical health
Good language skills

Broken Family or disharmony Stable home environment

History of child abuse or neglected
Lack of positive parental role model
Family with mental illness
Family with substance misuse
Unemployment/underemployment
Poor relationship or peer support
Bullying /Harassment / Violence
Low literacy/Discrimination
Failure in School or at Work
Stressful life events
Death of a close family member
Experienced trauma/witness violence
Homelessness/Poverty
Discrimination/Racism
Social isolation and loneliness
Lack of access to support services
Neighbourhood poverty and
violence
Lack of economic opportunity
Warm and supportive parents
Family Positive parental role models
Relationship
Parental Supervision
Positive family functioning
Secured or stable employment
Sense of belongings and
Education/ connectedness
Work Warm and supportive relationships
Success at School or at Work
Positive self-esteem/attitudes/values
Warm and supportive family members
Good peer group/friends
Life Events Access to Mentor or life Coaches
Healthy Lifestyle Behaviours
Inclusion and caring
neighbourhood
Community Good access to support services
Economic security
Regular Community engagement

Causes of Mental Illness

Victims of sexual, Chronic medical Biological factors, Exposure to toxins,

physical, mental or illness or certain such as genetics or toxic chemicals or
emotional abuse infections chemical imbalances substance misuse

x
x
x

Severe psychological Brain trauma/ Early loss or Pregnancy related

trauma/failure defects or injury dysfunctional family factors affecting
in life mother and/or child
7
What is Stress?
Stress is your body's way of responding to any kind of demand or threat.
The human body is made to feel and react to stress. Stress in necessary
in our life as it is the key for survival. There are two types of stress:

EUSTRESS DISTRESS
A positive stress when the stress have A prolonged stress, without taking a
a beneficial effect on health and break in between stressors.
emotional well-being.
Helps us to It is the feeling of being overwhelmed
• Stay alert as the body, mind and emotion are
• Cope effectively unable to fulfil the demands.
• Meet daily challenges As a result of
• Motivations • Negative views of environment,
• Move toward goals others and self
Essential for • Low productivity & quality of work
• Developing resilience • Damaged mental and physical
• Boost brainpower health
• Dodge a cold

Types of Stressors?
Work Related Factors Non-work Related Factors

• High workload/overworking • Family with special needs

• Burnout • Child care
• Imbalance of job demand and control • Separation/ divorce
• Job mismatch • Domestic violence
• Career insecurity • Long distance relationship
• Organisational changes • Weekend spouse
• Conflict with peers/ subordinates • Legal issue
• Conflict with supervisors/manager • Health related condition
• Perceived discrimination • Financial issue
• Workplace bully/violence/harassment • Bereavement
• Workplace sexual harassment • Travel
• Workplace relocation/ movement

8
Body Reactions Towards Stress
Stress triggers the fight or flight response as an adaptation syndrome,
which plays a vital part to alert the body to either tackle the threat or to
run away for safety. When activated, the fight or flight response will
result in the following:

Dilated pupils Pale or flushed skin

Rapid Heartbeat and

Shaking or trembling
breathing

Impact of Distress
Frustrated Overwhelmed
Low self-esteem Lack of concentration

Difficulty making decisions Mentally Anxious/constant worrying

Undereating / overeating
Dizziness
Social withdrawal
Headaches Emotionally
Outbursts of
anger
Nausea
Restlessness
Tiredness
Change in
Chest pain sex drive
Physically Behavioural Unusual habits
Muscle tension of smoking or
consuming alcohol

9
 Role of Hormones in Stress
Stress triggers several hormones which affect how the body reacts during
stress.

Adrenaline: increases heart rate, Cortisol: releases glucose in the

breathing rate ,blood flow to the muscles blood for energy, increase blood
and brain, resulting in increases alertness pressure, suppress immune system,
and sensitive to pain. decrease digestion.

Get your right daily D.O.S.E to prevent Distress

1. What are the Happy Chemicals?
Dopamine Oxytocin Serotonin Endorphin

Reward Hormones Love Hormones Calm Hormones Rush Hormones

Aids Concentration, Anti-Stress by relaxing Feeling significant Release a brief
motivation, learning, muscles, decrease or important among euphoria to mask
pleasures, needs, heart rate, blood peers. Calm form of physical pain
desires, and pressure. Gives feeling accepting yourself Response to pain and
determination to of trust, motivates you with the people stress to alleviate
accomplish goals to build and sustain around you anxiety and
relationship depression
2. How Deficiency Affects You
• Procrastination • Feeling lonely • Low self-esteem • Anxiety
• Low self-esteem • Stressed • Overly sensitive • Depression
• Lack of motivation • Lack of motivation • Anxiety / panic • Mood swings
• Low energy • Low energy / fatigue attacks • Aches and pains
• Inability to focus • Disconnect of • Mood swings • Insomnia
• Feeling anxious relationship • Feeling hopeless • Impulsive behaviour
• Feeling hopeless • Feeling anxious • Social phobia • Emotionally
• Mood swings • Insomnia • Obsession / Sensitive
compulsion • Headache/ migraine
• Insomnia
3. How to Increase Happiness Levels
• Meditate • Physical touch/Hug • Exercise/Sunlight • Laughter / crying
• Daily to do list • Socialising/giving • Cold shower • Creating music / art
• Long terms goals • Massage / • Message/Meditate • Eat dark chocolate
• Exercise regularly Acupuncture • Food rich in • Eat spicy food
• Create something, • Listening to calm Tryptophan (nuts & • Stretching Exercise /
writing, music/art sound/music seed) & magnesium Yoga
• Food rich in • Exercise/Sunlight (dark leafy • Message /
Tyrosine & • Cold shower greens,fish, Accupunture
Phenylamine • Meditate/Deep bananas & bean) • Meditate/Deep
(Egg, meat, milk, Breathing • Vitamin B6 & B12 Breathing
nuts, seeds, • Petting • Reduce Sugar • Regular Sunlight
beans, Lentils, • Kissing intake
Soya & Fish)

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 Poor Mental Health Versus Mental Illness/ Disorder

✓ Constant extreme low energy/

✓ Inability to focus at work
fatigue ✓ Changes in behaviour or
✓ Difficulty sleeping or
too much sleep feelings / mood
✓ Reduce in social ✓ Suicidal thinking
interaction ✓ Social withdrawal or
✓ Agitated self-isolation
✓ Substances ✓ Continuous intense
misuse sadness
✓ Headaches, dry ✓ Extreme mood changes
mouth of highs and lows
✓ Unusual pain &
rapid heartbeat ✓ Major changes in eating
habits / weight gain or
✓ Loss of appetite / loss
over eating
✓ Disturbed sleep/
✓ Negative thinking changes in sleeping
pattern
✓ Feeling unusual
sad or down ✓ Inability to cope with
daily problems or stress
✓ Frequent absence
without reasons ✓ Detachment from reality
(delusions /
✓ Significant tiredness,
hallucinations)
low energy
✓ Engage in self-destructing
✓ Confused thinking behaviour (e.g. cutting,
✓ Loss of interest in biting, hitting)
previously enjoyable ✓ Excessive usage of alcohol &
activities substance misuse

11
Depression
Depression, also called ‘Clinical
Depression’ or ‘Depressive illness’, is
a common mood disorder that causes
severe symptoms of unhappiness that
affect how one feels, thinks, and
functions in daily activities such as
working, eating, sleeping, or enjoying
life.
One must understand that depression
is more than being weak and it is not
something that you can ‘get rid’ or
‘snap out’ of it as it is linked to our
brain-chemistry imbalances.
To be diagnosed with depression,
symptoms must be present for at least
two weeks and there is no single
attributable cause linked to depression.
Even though it is a serious condition, it
is fortunately a treatable illness.
Depression
▪ Mood and/or interest (pleasure)
stay low for most of the two
weeks.
▪ Feelings of worthlessness and
self-loathing are common.
Depression is more than sadness
and grief
All of us will suffer from sadness or
grief at some point in our lives as it is a
part of being human and is a natural
reaction to painful life events. For
example, the death of a loved one,
failing an important examination, losing
a job or the ending of a relationship are
painful experiences for a person to
face.
However, being sad is not the same as
having depression. Grieving processes
and depression may share some of the
same features like involve intense
sadness and withdrawal from usual
activities. Nevertheless, they are also
different in crucial ways.
Individuals who are at risk of mental
illness may suffer from depression
following prolonged excessive grief or
sadness which last beyond 2 weeks
without any psychological support or
interventions.
Grief/Sadness
▪ Painful feelings come in waves,
often intermixed with positive
memories of the deceased.
▪ Self-esteem is usually maintained.
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Signs and Symptoms of Depression
People with depressive illnesses do not necessarily suffer the same
symptoms. Symptoms may also differ depending on the type of the
depressive illness and vary based on the person condition. Some of the
symptoms are:

Lack of motivation and Feeling hopeless and

concentration having low self-esteem
Continuous low mood,
Avoiding contact with
felling upset and tearful
family and friends

Loss of interest in previously Disturbed sleep patterns /

enjoyable activities insomnia

Lack of energy, muscle Changes in appetite or weight

aches and pains gain/loss

Types of Depression
Some other forms of depression under different situations are:
Major Depressive Persistent Bipolar Disorder
Disorder Depressive Disorder
(Dysthymia) A person experiencing
unusual shift of mood
Intense feelings of
May have less severe swings from extreme
sadness for extended
symptoms than Major feelings of low mood
periods of time and
Depressive Disorder but and depression to
occasionally feel life isn’t
symptoms must last for happiness & high
worth living. It impacts
two years to be energy.
mood and behaviour as
well as physical considered persistent
functions. depressive disorder.

Treatment of Depression
All types of Depression are treatable through various combinations of
Psychotherapy, medications, lifestyle changes and support to be able to
functions well at work and life.

13
Anxiety

Worried ? Anxious ? Overwhelmed ?......Don’t worry!

Occasional anxiety is expected to be a part of life as a human. However, if
a person continuously and excessively feels intense worry or anxiousness
for no apparent reason that leads to interference in daily activities for more
than 2 weeks, you might want to seek medical advice.
Symptoms and Signs of Anxiety Disorder
Each disorder shows different symptoms and there is no single attributable
cause linked to anxiety, rather, there are multiple factors.

Strong, fast or irregular Feeling tense and unable

heartbeat to relax

Irritability and difficulties

Trembling or shaking
concentrating

Sweating and shortness of

breath Social withdrawal

Dry mouth, feeling sick and

headaches Dizziness and tiredness

Types of Anxiety
Generalised Anxiety Panic Attack Obsessive
Disorder (GAD) Compulsive
Unexpected onset of Disorder
Excessive, exaggerated feelings of intense fear or Unreasonable /
anxiety and intense worry worry with no real danger undesirable fears /
about everyday events and triggers physical worries leading to
with no obvious reasons. reaction such as obsessive thoughts
sweating, chest pain, which result in
irregular heartbeats, and repetitive and
a feeling of choking. compulsive behaviours

Treatment of Anxiety
Anxiety disorders are among the most common mental health issues and
are highly treatable. Once you understand your anxiety disorder, reaching
out early to a psychologist is the best way to reduce the symptoms and
regain control of your life. Cognitive behavioral therapy is the most effective
form of psychotherapy for generalized anxiety disorder.
14
Personality Disorder
Personality is a consistent pattern of thinking, feeling and behaviour.
Meanwhile, personality disorder is when a person has unhealthy
patterns of thinking, feelings and behaviours that deviate from the norms
of generally accepted behaviour, causing trouble perceiving and relating
to situations and people. To them, their thoughts are normal, and they
often blame others for their problems. The symptoms of each personality
disorder is significantly different from each other.
Personality DisordersAffect
Personality disorders usually affect at least two of these areas:
Way of relating to
Way of thinking about other people
oneself and others

Way of responding
emotionally Way of controlling
one’s behaviour

Types of Personality Disorder

Borderline Personality Narcissistic Antisocial
Disorder Personality Disorder Personality Disorder

An ongoing pattern of Associated with excessive A person consistently

shifting moods, self- self-centred belief or
image, and behaviour. personal adequacy, sense
Results in one acting of self-importance,
impulsively and having admiration, vanity, prestige
intense fears of being and power with lack of
abandoned. empathy or ability to
appreciate perspectives of
others.
shows no consideration
for right and wrong of
their actions on others.
Showing no guilt or
remorse for their
behaviour.

Treatment of Personality Disorder

Since personality disorders are so deeply ingrained from genetics and
childhood experienced, they have long been believed to be difficult to treat.
However, Borderline and Narcissistic types are more treatable than others.
Also, different types of treatment work best for different disorders.
15
Self-harm
Self-harm or self-injury is when somebody deliberately hurts or injures
their body without intention of suicide, in order to sense a momentary
calmness. It is not a mental illness and is more common than what people
think. In which it indicates a need for better coping skills and understand
the underlying issue to receive treatment or therapy that could be
beneficial.
Why People Self-harm?
Everyone has different ways of coping with stress, in most cases people
do self-harm to help cope with overwhelming emotional pain. When a
person is not sure how to deal with emotions, or feels like they don’t have
anyone they can talk too, self-harm may feel like a release.

Feel good/ energy rush

Cope with negative feeling
Distract and/or purify themselves
To cope with history of trauma
To express feelings
Relieve stress or pressure
Feel in control of the mind and
body

Signs of Self-Harm
If you think someone is self-harming, look out for any of the following signs:
• Unexplained cuts or bruises on their wrists, arms, thigh or chest
• Keeping themselves fully covered at all time, even in hot weather
• Self-loathing and expressing a wish to punish themselves
• Not wanting to go on and wishing to end it all
• Becoming withdrawn and not speaking to others
• Signs of low self-esteem such as blaming themselves for any problems
• Signs they have been pulling out their hair
• Signs of alcohol or drug misuse

Treatment for Self-Harm

Reaching out early to get help from a psychologist is the first step in
managing someone with self-harm behavioral tendency, because the
mainstay treatment are Psychosocial strategies and Psychotherapy based
on the underlying reasons of self-harming behaviours.

16
 Suicide
Suicide is when someone intentionally ends their life. It is a way for people
to escape from pain or suffering. ‘Suicide attempt’ means when someone
has tried to end their life, but did not die. According to the World Health
Organisation (WHO), every year close to 800 000 people take their own
lives and there are many more people who attempt suicide.

Possible Risk Factors for

Suicide • Substance misuse disorder
• Previous suicide attempts • Losing a loved one to suicide
• Mental health problem • Being diagnosed with a serious
• History of being abused medical condition
(physically, sexually, emotionally) • Financial problems or
• Socially isolated or a victim of homelessness
bullying or harassment
• Bereavement or loss of a
significant relationship

Signs of Suicide
Talk Behaviour
• Talking about dying, • Making financial
death, or suicide preparations, updating will
Mood
• Talking about feeling • Self-harm behaviour
• Loss of
hopelessness or having
interest • Engaging in risky
no purpose behaviour / acting
• Humiliation/
• Talking about feeling recklessly
Shame
burdened with life
• Anxiety • Giving things away
• Experiencing unbearable • Increase use of alcohol or
• Depression
pain drugs
• Saying goodbye

Early Intervention Will Save Lives

When someone is having suicidal thoughts or tendency, it is an emergency
situation. Therefore when you experience it or know someone who is
experiencing it, immediate action to reach out for psychological support is
crucial because early intervention will save lives.

17
First Aid for Mental Health
First Aid for mental health is an initial support provided to a person
experiencing distress or poor mental health before reaching out for
professional support. Usually, even when we realised that our colleagues
display certain distress signals, we do not know how to help as compared
to first aid treatment for small cuts or injury. It may be difficult to
recognise the different types of mental health conditions, however MIND-
A-CARE will assist you in recognising early signals of distress or poor
mental health and guide you on how to mind a CARE though a step-by
step-guide in providing first aid support for someone having mental
health conditions.

Before Minding a CARE

1. Be Aware
• Different people heal & accept at
different paces.
2. Be Considerate
• You are not a therapist /
counsellor.
• It’s okay to not have all the
answers for your colleague.
• The most crucial skill is to be a
good listener.
3. Be Prepared
• Allocate ample time and find a
right place to chat.
• Emotionally stable/ ready for any
consequences.
• Open minded & don’t judge.
4. Be Responsiveness
• Demonstrate through your words,
tone, voice, gestures, and actions.

REASSURE
CHECK Reassure support
Check for signals with information

C A R E
APPLY ENSURE
Apply non-judgemental Ensure help
conversation Received
18
 Four Steps of C.A.R.E

Check

Check for LOW

URGENCY
MEDIUM
URGENCY
HIGH
URGENCY /
signals
CRITICAL

Ask “are Ask “are

you Yes you Physical First
okay?” okay?” Aid Required ?

Follow up
No if signals No
persist Yes

Listen Listen
Apply non- Find First
Aid Kit / Call
judgemental Designated
conversation First Aider
Is the situation Reassure No
(DFA)
self- No support with
manageable? information
Reassure Yes No
support with
information Provide psychological Yes
contact numbers and Follow up
follow up later if signal if signals
persist persist

Assist your Escalate:

colleague to reach Immediately Inform
Ensure help is out for support by
the Psychologist
Superior / Local
Emergency No
received

19
 How to MIND-A-C.A.R.E ?
1. Check for Signals based on list of Signs And
Symptoms
• Look for any signals if your colleague requires first aid support.
• Refer to the list of signs & symptoms to determine the level of urgency.

LOW URGENCY MEDIUM URGENCY HIGH URGENCY/CRITICAL

• Difficulty sleeping • Disturbed sleep (insomnia) • Aggressive/abusive
• Undereating/ overeating • Undereating/overeating in a • Act of violence
• Lost interest in enjoyable few days • Reckless / risky behaviour
activities • Avoid joining activities like • Talking, writing on
• Reduce in social usual worthlessness of life
interaction/ isolation • Withdrawal from family and • Express or engage in self-
• Unusually sad friends harm behaviour/potential
• Easily agitated • Continuous intense sadness suicide
• Inability to focus in doing • Feeling hopelessness • Observable physical injury
task • Persistent irritable mood • Expression of anger or
• Constant worrying • Excessive worrying seeking revenge
• Negative thinking • Continuous negative • Hear/see things that are not
• Low energy thoughts there
• Headaches • Constant low energy/fatigue • Repeatedly talking to self
• Chest pain & rapid • Persistent headaches • Expressing beliefs that are
heartbeat • Alcohol & substance misuse not real without evidence
• Unusual habits of trying • Inability to take care of self • Sudden jerky movement of
to smoke, drink alcohol or performing/ taking limbs/convulsions
or substance use responsibilities • Unconscious/fainted
• Unusual late to work • Frequent absenteeism • Weak pulse / short breath
• HIGH URGENCY/CRITICAL require immediate escalation for emergency
response
• LOW or MEDIUM URGENCY, approach them to ask specific questions
that have made you concerned for them, like “Are you Okay? Or ……
“You don’t seem to be energetic as
“It seems that you are
usual. Anything you want to share?”
not in a good mood.
Are you okay?”

“You look upset

today. What’s been
happening?”

• Wait for the answer from your colleague, either I’M FINE or I’M OKAY! or
the answer is NO, I’M NOT OKAY or any response seem that he/she is
NOT OKAY
20
When they answer, I’M FINE/I’M
OKAY, do the followings :- “I’M FINE /
i. Respect their decision but say “It’s I’M OKAY”
just that you don’t seem like your old “But I’m really
self lately” and upset today…..

ii. Give them time to think “Take your

time. Tell me whenever you want to
talk about it, okay?” or

iii. Suggest talking to trusted people

“Is there someone else you’d rather
talk to?” and

iii. Follow-up, check in a few days

whether they are doing fine “How are
you feeling now? Have you consulted
anyone to talk to ?”

“NO. I’M
NOT OKAY”

When the answer is NO, I’M NOT

OKAY or any response seems
that it’s NOT OKAY,
Go to No 2
Apply Non-Judgemental
Conversation

21
 2. Apply Non-Judgemental Conversation
DO’S
• Speak calmly and clearly using
soft tones and short sentences
• Listen without judgement
• Face them with open hand gestures
and nod your head to show
understanding
• Say encouraging things to give
hope & reassurance:
“You matter. And your
“You’re not alone” feelings are valid”
• Discourage negative behaviours
or intention.
“Please don’t hurt yourself, there are
people who love and care for you”
• Rephrase to show understanding
and clarify when you don’t
understand.
“So I understand that you need a break
from work, is that right?”
• If they break down with tears, offer
them tissue and say; “It’s okay
to cry”
• If their words reflect any potential
harm (e.g. suicidal/self-harm
ideation), ask to confirm.
“Did you really mean what you said? I’m
very concerned for you.”
• Clarify whether the situation is
under control or help is required
“Are you able to handle this or need
assistance? It’s good to reach out coz it does
not make you weak ”
• For ‘Life Threatening/Suicidal
Tendency’ situations, remove
potentially harmful objects away
from them & don’t compromise your
safety.
DON’TS
• Don’t interrupt them - let them
finish their story first
• Don’t be offended due to negative
behaviour; e.g. If they shout or slam
objects, remain calm
• Don’t leave them alone when you
sense danger
• Avoid negative body language &
facial expression such as crossing
your hands or being distracted with
your phones.
• Don’t undermine /look down on
them “This is all in
your head”
“You’re overthinking”
“This is normal coz everyone experiences
stress sometimes”
• Don’t promise to keep secrets on
life threatening situation e.g. Self-
injury or suicide attempts where
escalation is necessary
• Don’t make assumptions about
the situation faced.
• Don’t use stigmatising or
insensitive words:
“Psycho”
“Abnormal”
“Crazy” “Mentally ill”
• Don’t take over to solve their
problems: If a 3rd party is involved,
don’t confront that person (3rd party)
on their behalf. You might make the
situation worse
• Don’t disclose any confidential
information to unauthorised
individual
22
3. Reassure support with Information
During distress, you may need to reassure that assistance is readily
available and accessible then provide them with information on contact
numbers.
Ask them to Reassure them that help and support are available.
get help and • “You don’t have to carry the burden alone. What can I do to help
provide the you?”
information 1 • “Have you thought about seeing professionals psychologist?”
• “I really hope you can contact the psychologist (Employees
Assistance
Program or Personal Health Coach in Digital Healthy Lifestyle
Coaching (DHLC) immediately before your condition gets worse”

Give them “Because by talking to the psychologist, it will help to …………”

reasons why • Comfort you • Reduce emotional & negative impact
• Getting back on track • Being a coach to be more resilient
they should
get help. 2 • Speedy recovery • Prevent worsening of situation

Share with
them your • Share your positive experience with EAP or Psychologist in
personal Digital Healthy Lifestyle Coaching (DHLC), if any.
experiences 3 • Share your experience in managing similar situations, if any.

Offer Offer your moral support in helping to call on behalf to reach out…..
assistance to
call a
4 • “I can help you contact them, if you want. I’ll be right beside you.”
• “Getting help takes strength & courage. I believe you have both,
Psychologist just let me help you to contact the psychologist”

4. Ensure Help is Received

If they are ready to consult the Psychologist and agree for you to contact on
their behalf, immediately assist them in contacting the professional:
“I will help you contact your Health
“The health coach or psychologist in
Coach. He/ she may help lessen
DHLC/ EAP can help you deal with
your workload and refer you to a
professional for help” your situation”

Ask for consent before assisting to contact. If they prefer to contact on their
own, give them EAP/ DHLC Health Coach’s contact number and request to
contact immediately in your presence.

For life threatening/suicidal/critical situation, you won’t need their consent but
immediately contact his/her supervisor/HR (if available) or local emergency
contact no for immediate assistance before get professional help.

23
PETRONAS
Employee Assistance Overwhelmed ? +03 8063 5019 / +6016 262 1675
Program (EAP) Stress ? Need consult@turningpoint.org.my
someone to talk 9am - 9pm (Mon to Fri)
to?

Digital Healthy Lifestyle Online support Download the Naluri app from the
Coaching (DHLC) by and coaching for Apple App Store or Google Play Store
Naluri mental health and Hotline 24 hrs (03-84081748)
building resilience Click here https://dhlc.naluri.net/

OTHER ORGANISATIONS
Befrienders +03 7956 8145 / +03 7627 2929
In need of
emotional sam@befrienders.org.my
support? Feeling 24 hours everyday
suicidal? befrienders.org.my/

Malaysian Mental Need guidance in 03-2780 6803

Health Association managing mental admin@mmha.org.my
health? 9am – 5pm (Mon to Sat)
mmha.org.my/

Mental Illness 03-7732 2412

Looking for a
Awareness and Support support group and miasa.malaysia@gmail.com
Association Islamic spiritual 9.30pm-6.30pm (Mon to Fri) / 9.30pm -
therapy? 1.30pm (Sat)
miasa.org.my

SOLS Health Looking for +6018 664 0247

affordable and solshealth@sols247.org
life-changing
mental health 9am – 6 pm (Tues to Sat)
services? sols247.org/

Relate Malaysia Prefer to have info@relate.com.my

an online relate.com.my/
psychotherapy?

Centre For Looking for other 03-20961212

Psychological And options for online 9am – 5.30pm (Mon to Fri) / 9am –
Counselling Services counselling ? 1pm (Sat)
cpcs-helpuni.com/

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