Monday, October 31, 2016

Brunei - Breaking down barriers and understanding mental health illness

WORLD Mental Health Day is celebrated on October 10 every year worldwide, including in Brunei Darussalam. It is a day for global mental health education, awareness and advocacy. This year’s theme, ‘Dignity in Mental Health – Psychological & Mental Health First Aid for All’, is apt and relevant as it encourages a culture of openness and cooperation.

In Brunei Darussalam, the launch of the Mental Health Order and its Code of Practice in 2014 has to a certain extent, contributed to more people coming forward to seek professional help.

This marks a significant milestone in the development of mental healthcare in Brunei Darussalam, particularly in its aims on addressing the care, rehabilitation, welfare and protection of people with mental health disorders.

This aim can be further achieved by empowering the public to help through the World Health Organization (WHO) recommended ‘Look, Listen and Link’ action steps of Psychological First Aid (PFA), which guides everyone on how to engage and support individuals with mental health disorders.

Stigma is defined as a sign of disgrace or discredit, which sets a person apart from other people. A culture where there is stigma and shame associated with mental illness discourages help-seeking behaviour and this will delay the help that persons affected by mental health disorders need.

On-going prejudices and discrimination are just a few examples that a person may live through. Throughout the world, many people with mental health illnesses are often left stigmatised either by others or by themselves.

This can bring numerous negative expectations toward our own mental health and in turn stops many people from seeking help and may even try hiding it from others, especially their love ones. When they do seek help at a very late stage, they have become so unwell that they need urgent medical attention.

The impact of non-early intervention may have a huge effect not only to the individual but also to the family and their next generation. The negative effects of this can include from a loss of financial income, stress on family relationships, impairment in caring for his/her own children, not to mention the strain on the carer having to care for someone suffering with mental health illness. Thus, this stigma and all that it implies needs to be rectified.

PFA describes a humane, supportive response to a fellow human being who is suffering and who need support (WHO, 2011). It is an approach aimed at helping people who have been very recently affected by an emergency, disaster or a traumatic event.

The WHO PFA Guide is built around the following action steps: Look, Listen and Link. The main principles are to address basic needs such as food and water, and to protect people from further harm by providing a caring and comforting presence, connections to information and social supports as well as referrals to professional services whenever necessary.

The helper or responder can be supported also by sitting quietly with someone in distress or who does not want to talk; by offering practical comfort, such as a glass of water or a blanket, if possible. PFA is designed to be delivered by a wide variety of people in the community, from emergency personnel to neighbours and volunteers, in addition to trained PFA responders.

Therefore, PFA is often offered in community settings wherever it is safe enough to do so such as at the scene of accident, or places where people who are affected by the crisis are served, such as health centres, shelters or camps, and schools.

Aside from this, believe that religious efforts are beneficial for a better state of mental health. There is a well-known Hadith from Prophet Muhammad (pbuh), “Verily, in the body there is a piece of flesh, if it is sound then the entire body will be sound, and if it is corrupt then the entire body will be corrupt, indeed it is the heart.” (Bukhari & Muslim).

By having a sound heart, not only do our mental health improves but so does our physical health. Bear in mind a verse from the Al-Quran, “Verily, in the remembrance of Allah the Almighty do hearts find rest” (Surah Ar-Ra’d: Verse 28). Perform our responsibilities and good deeds and make effort to refuse any ill-doings to find peace.

In a similar vein, the Ministry of Health strives to provide ‘Person-Centred Care’ which emphasises a recovery-oriented approach to maximise quality of life and help to de-stigmatise the people affected by the illness and their families.

Healthcare under this perspective is the responsibility of all involved – patients, families, health professionals, non-governmental organisations, communities, as well as governmental agencies and policy makers.

A “Health is Everyone’s Business” approach is required to tackle this goal effectively.

As much as possible, treatment should start in the community with the cooperation of the patients, families, health professionals, and welfare and community agencies. Hospitalisation may be necessary, but only in more serious cases.

In support of breaking down the social barriers and changing people’s perspectives on mental illness, the ministry has consistently worked closely with schools, community partners, government agencies as well as non-governmental organisations in raising awareness of mental health.

In the past, the ministry conducted a series of mental health awareness campaigns and programmes in the community such as the ‘Mind Your Mind – Jaga Mind Kita’ campaign and the ‘Illness Management Programmes’ across the country.

This great effort has been part of our constant goal of not only improving the lives of people affected by mental health illnesses and their families, but also making sure the community understands the struggle these people face and what support can be given to them.

With an active involvement in promoting and in increasing concerns of mental health also, this can result in increasing the public’s knowledge and their acceptance about mental health in general. By this, they can play an important role just by further understanding and appreciating of those who are suffering with mental health disorders.

It is by working together with all members of the society and through extensive participation and promoting that we can maintain good mental health together.

Such a collective effort, from all walks of life, will have a positive impact in eradicating the social stigma associated with mental health for the betterment of our society.

The Ministry of Health also strives to continue in strengthening the efforts to improve the quality of mental health service to be more accessible, comprehensive, holistic and systematic, to meet the requirements of treatment and care of patients who suffer from psychological and mental health conditions in this country.

The ministry believes that such collective efforts will enable this country to contribute to the worldwide aspiration of taking mental health out of the shadows, so that public in general feel more confident in tackling the stigma, isolation and discrimination that continues to afflict people with psychological and mental health conditions.

Message by Dato Seri Setia Dr Awang Haji Zulkarnain bin Haji Hanafi, Minister of Health, In conjunction with World Mental Health Day

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