Today is a historic day and progressive way forward in mental health reforms with the tabling of the bill to amend Section 309 of the Penal Code to “decriminalise attempted suicide” and strengthening of the Mental Health Act 2021 (Act 615).

Between this Parliamentary session and the next, a moratorium on all prosecutions for suicide attempts is to be declared immediately.

Such fundamental reforms have been championed by mental health experts and activists for decades. Finally, we see this government having the much-needed political will to implement them amidst a growing silent mental health pandemic in Malaysia.

The numbers are not pretty: the government’s 2019 National Health and Morbidity Survey (NHMS) found that almost 500,000 Malaysians experienced symptoms of depression. The NHMS 2019 also found that 424,000 children were experiencing mental health problems. COVID-19 worsened things, with many facing joblessness, isolation, and difficulty in getting mental health aid as various movement control orders (MCOs) curtailed mobility. Existing patients saw psychiatric appointments delayed with wait times of 3 to 6 months.

Even as Malaysia marks 1 year of the endemic phase, there are still people struggling. This is a reminder for the Government: we may relax SOPs, but must pursue reform and resilience for the next major shocks that may come our way.

Relevant arguments for decriminalisation include: reducing the at-risk individuals choosing violent, irreversible means of harming themselves to avoid prosecution should they survive; the need to convert stigma into understanding and providing treatment, and the need to address socio-economic inequalities that aggravate mental health distress.

A new provision will be included in the Mental Health Act to empower first-responders attending to a suicide attempt scene to admit the person into a psychiatric hospital. First responders include the police, fire department, civil defence, maritime department and welfare officers.

In doing so, our system ensures that persons who attempt suicide get the mental health support they need. It also frees first responders from legal liabilities that may arise from making an immediate judgement call, on the spot, on the person’s state of mental health, that may be better assessed by a mental healthcare professional.

Today’s tabling in Parliament is a first step. More has to be done, and thus we propose a few recommendations moving forward.

Short-term recommendations:
– Increase budget for hospital-based psychiatric services to 2.4% of total national health budget in upcoming Budgets

– Amend relevant clinical guidelines to ensure psychotherapy is introduced as a first line of treatment alongside pharmacotherapy

– Develop empathic guidelines and modules to train first responders on handling people with mental illnesses

Long-term recommendations:
– Establish multi-ministerial and multi-sectoral mechanisms on mental health

– Systemically increase the number of MH professionals per capita, and improve distribution to address the urban-rural divide. A 2018 study found that there were a total of 410 registered psychiatrists in Malaysia in private universities, private clin_ ics, public universities and government hospitals. The state with the highest number of psychiatrists is Wilayah Persekutuan Kuala Lumpur with a total of 94 psychiatrists which has a ratio of 5.24 per 100,000 population followed by Wilayah Persekutuan Putrajaya with 3.38 per 100,000 population. The states with the least ratio of psychiatrists were Sabah with 0.54 and Kedah with 0.55 per 100000 population.

– Improve national data and monitoring of mental health disorders

In doing so, we hope to implement reforms that are patient-centric and deliver better health outcomes for all.

YB Dr Kelvin Yii Lee Wuen
MP Bandar Kuching

YB Michelle Ng
ADUN Subang Jaya

YB Lim Yi Wei
ADUN Kg Tunku