Latest news with #AndrewMohanraj
The Star
13-07-2025
- Health
- The Star
Making mental care accessible
More must be done to make mental health services more accessible, says Malaysian Mental Health Association president Prof Datuk Dr Andrew Mohanraj. One major barrier, he said, is the out-of-pocket cost of private psychiatric care. 'In Malaysia, private mental health care is generally paid out-of-pocket because insurance companies don't cover the costs adequately,' he said. To ensure everyone who needs it benefits, insurance companies must play their part, he added. 'Insurance companies need to find ways to keep making a profit but also develop policies or premiums that actually cover mental health conditions,' he said, pointing to the urban-rural divide as another deep-rooted challenge. Most mental health professionals are concentrated in urban areas, leaving rural communities underserved, he said. Training local community leaders using the WHO's Problem Management Plus – a manual for basic mental health help that can be delivered by non-professionals – would be a step forward in making such services more accessible, said Sunway University School of Psychology Prof Alvin Ng Lai Oon. He shared that other resources, like the WHO's 'Doing What Matters in Times of Stress' guidebook, can be used in refugee camps and to empower communities with simple stress management strategies. Public psychology officers in the civil service, as well as other frontline health workers like social workers, community nurses and medical officers, can be upskilled with low-intensity cognitive behaviour therapy, Prof Ng added. To make rural mental health work more attractive, Master's in Counselling student Tan Xin Yi urged the government to help set up more non-governmental organisations in underserved areas, especially those offering affordable care. She also called on mental health professionals to take the lead through outreach programmes such as community talks, and free services to local fundraisers that support mental health initiatives. Prof Andrew, however, stressed the importance of checking the credentials of mental health practitioners carefully as there can be confusion caused by unregulated practice. This, he said, is to safeguard the public vulnerable against unscrupulous or unqualified practitioners. 'Many who claim to be psychologists may lack proper clinical training, so the public often doesn't know who to trust. 'Unlike psychiatrists and counsellors, clinical psychologists in Malaysia do not have a formal registration body so whether one is 'qualified' is a grey area. 'But you can always check if they are members of the Malaysian Board of Counsellors or whether they have a National Specialist Registration or Medical Council Registration.' Fight the stigma The stigma against those seeking mental health is another reason why sufferers are not seeking help, said Prof Andrew. 'Studies show that some 80% of people know they have a mental health issue but refuse to seek help because of stigma. 'That silence comes at a huge price,' he said. Scaling up mental health services at primary care can help reduce stigma surrounding mental health, Prof Andrew added. 'Many are reluctant to approach specialist services because of stigma. They, however, may be more amenable to approach their general practitioners.' Citing a 2018 study, Prof Andrew said Malaysia lost RM14.4bil in productivity due to mental health issues at work, a figure expected to soar to RM100bil by 2030. 'We've got to address stigma by also looking into workplace policies or non-discriminatory policies against employees with mental health issues,' he urged. For real progress, Prof Andrew stressed that everyone must get involved. 'We can't just leave it to the government. It's a whole-of-society effort. The public and private sectors both have a role to play. 'That's the real turning point if we want to make mental health services truly accessible,' he said. Danger of 'AI therapy' ARTIFICIAL intelligence (AI) can help people cope with mental health care but relying on it for serious issues could cause serious harm, warns Malaysian Mental Health Association president Prof Datuk Dr Andrew Mohanraj. He said relying on AI chats or virtual self-help tools might cause people to avoid seeing a trained therapist altogether as there might be a perception that AI can give one all the 'right answers' to deal with one's problems. But this, he said, trivialises real mental health care as people might say, 'Why bother seeing a professional if a chatbot can do the job?' While he acknowledged that AI can complement the role of a psychologist in many ways, he said it cannot handle complex or high-risk situations, stressing that mistaking it for real help can be dangerous. 'Nonetheless, AI does have its place. Some may feel more comfortable opening up to a chatbot first, and it can offer some comfort for non-serious issues. 'It has proven useful for offering some relief to people with mental health issues,' he said, while cautioning that it can prove dangerous especially when the individual is suicidal, is having thoughts of self-harm, or is experiencing psychosis. AI has not reached a level where it can offer the right support or direct people to resources and services available, as accurate mental health assessments require far more than just a few prompts on a screen, he said. 'Assessments include non-verbal cues – how a person presents themselves, body language, speech patterns, eye contact, and many more. None of this can be fully picked up by AI,' he said.
The Star
13-07-2025
- Health
- The Star
Need for more psychologists
MALAYSIA is in dire need of psychologists. The shortage of mental health professionals has been exacerbated by post-Covid-19 issues such as anxiety and stress, as well as a rise in bullying linked to increased social media use. Describing the situation as 'dismal', Malaysian Mental Health Association president Prof Datuk Dr Andrew Mohanraj said the country, with a population of 35 million, only has 400 clinical psychologists. That is a ratio of one clinical psychologist for every 87,500 individuals. Prof Andrew 'Based on the World Health Organization (WHO) recommendation of one clinical psychologist for every 5,000 individuals, Malaysia is far short of the global benchmark,' he told StarEdu. Sunway University School of Psychology Prof Alvin Ng Lai Oon said the shortage means there are fewer opportunities for people to seek mental health services. The problem, however, is not a lack of interest in the career, stakeholders say. They assert that a new generation of psychology students wants to fill that gap, but outdated systems and unfair expectations are stumbling blocks that have caused many to reconsider their options. Tough road Interest in psychology is high among students – but channeling that interest into real careers is not easy, said public health researcher Ellern Eng Hui. He said the challenge starts with the lack of basic protection for those working in the field. 'Despite working to support the mental health of others, we ourselves often lack access to health benefits and job security. 'It's a difficult contradiction, and one that needs to be addressed.' The heavy costs involved are another deterrent. For students like Liong Kah Yan, who is currently pursuing her Master's in Applied Behaviour Analysis, the cost of studying psychology is steep – and the return is not immediate. 'Internship pays little, if at all. And when you finally find a job, the salary is usually low,' she shared, adding that a postgraduate degree is essential for a stable, better-paying role in clinical practice. She pointed out that pursuing a master's degree can cost RM60,000 or more, depending on the course. 'Not many people can afford it, as it is expensive even with scholarships,' she said. The path to becoming a clinical psychologist, said Prof Ng, is also extremely competitive. Prof Ng 'There are only 12 clinical psychology programmes in Malaysia. 'Even if students get in, the lack of qualified clinical supervisors and practicum agencies makes it tough to gain enough hands-on experience,' he noted. He added that trainees often struggle to secure placements for their required internships. 'In Malaysia, postgraduate clinical psychology trainees almost need to beg to be accepted as a clinical intern to receive supervised training, and there's no guarantee that they'll get the experience they need at a public health service if a supervisor is not available, or if psychological tools are not adequate.' This bottleneck, he explained, limits trainees' readiness for real-world practice and narrows their career options. Still considered a young profession, many experienced clinical instructors are under the age of 40 – leaving a gap in mentorship, he added. To make matters worse, Liong said psychology students also have to contend with unfair expectations because of their vocation. 'When I tell people that I study psychology, they would pour their whole life story and expect solutions from me. 'This is very unhealthy. Many psychology students are expected to give 'free' therapy to relatives, friends or just random people we know,' she said. Ellern said many people still do not realise that simply holding a bachelor's degree does not make someone qualified to diagnose mental health conditions. 'Diagnosis is a complex process that should only be done by licensed clinical psychologists. 'It involves detailed assessments, careful observations, and often multiple sessions,' he explained, stressing that it's not something one can figure out from a five-minute chat. Fixing the shortfall Malaysia needs to think beyond traditional methods to close the demand and supply gap for clinical psychologists, Prof Ng said. Calling for reforms to ensure rigorous clinical training and more structured career pathways, he said competitive salaries and clear progression routes are a must. 'Our salary scale is still under the S-job scheme, when there has long been a call to switch it to the U-job scheme, which offers a higher salary and clinical allowances,' he said. The U-salary scheme, Prof Ng explained, is meant for clinicians within the healthcare sector like medical doctors, pharmacists and dietitians. However, clinical psychologists are still categorised under the S-salary scheme, which is meant for social services roles like psychology officers, youth and sports officers, librarians and religious officers. 'The U-salary scheme basically acknowledges that the professional provides services within the clinical and health sector, which is what clinical psychologists are trained to do,' he added. The confusion happens, he said, because many people do not realise that clinical psychology focuses on treating patients, while other branches of psychology like organisational psychology, focus on different areas such as workplaces. Moreover, he highlighted a system he thinks Malaysia could learn from the United Kingdom's system – where psychology trainees are automatically employed within the National Health Service, ensuring on-the-job learning while contributing to healthcare services. Beyond placement and training, Prof Ng said equipping trainees with broader knowledge is equally important. 'I'd also like to see more involvement of medico-legal collaborations so that trainees are also savvy about legal issues and the laws of the land in guiding their clinical decision-making,' he added. Additionally, he suggested adopting a stepped-care model inspired by the UK's Improving Access to Psychological Therapies programme. Under this model, low-intensity therapists are trained in a shorter period – compared to traditional mental health professionals – to deliver basic psychological interventions. 'It's creating a new layer of professionals who are trained in low-intensity cognitive behaviour therapy that can be used to reduce symptoms of mental health conditions. They are also easier to access and cheaper than the usual mental health professionals,' he explained. On the other hand, Master's in Counselling student Tan Xin Yi, suggested implementing initiatives at the school level to draw more young Malaysians into the field. 'Schools can invite counsellors or clinical psychologists to share their experiences and show students what the work really looks like. 'It breaks down misconceptions and inspires students to see psychology as a meaningful career,' she said. Ellern agreed, as he said that psychology as a field is still relatively new here, having gained traction only in the last 50 to 60 years. 'Public awareness of mental health is still growing, and until it becomes more widespread and better understood, the demand for mental health services (and by extension, careers) will remain limited,' he explained. Without stronger awareness, Ellern said many people will not seek help, which in turn reduces opportunities for new graduates. 'That lack of demand then feeds into the struggle many psychology graduates face when trying to enter the job market,' he said.
The Star
23-05-2025
- Health
- The Star
Six-month course to help GPs manage mental health cases
KLANG: The Malaysian Society for Academic Psychiatry (MSAP) has developed a six-month training programme for general practitioners (GPs) to help patients with mental health issues. It said there is an urgent need for private GPs to be trained to manage such issues, given the increase in cases among Malaysians. MSAP president Datuk Dr Andrew Mohanraj said the first batch of 49 GPs completed the programme earlier this month. ALSO READ: Experts: It's as vital as physical health He said GPs played an important role in identifying patients who come in with mental health issues and provide them with the first line of treatment. 'Traditionally, GPs have also been family doctors, often treating several generations of the same family. 'Patients are likely to open up their problems to a familiar face they trust," he said on Friday (May 23). According to Dr Andrew, long waiting periods to see a psychiatrist could lead to worsening symptoms, and GPs equipped to diagnose and treat non-complex psychiatric cases can fill the void in such situations. ALSO READ: Many Malaysians at risk of depression, says Dzulkefly 'They can also offer stop-gap treatment while referring difficult cases to psychiatrists. 'Psychiatrists, too, can refer such cases back to the GPs for follow-up treatment," he added. He said this model had worked well in the United Kingdom and Australia, where primary care physicians are scaled up to meet the community's mental health demands. The certificate of completion for the six-month online programme, the only one of its kind in the country so far, is jointly awarded by MSAP, Universiti Kebangsaan Malaysia and a private firm that provides healthcare analytics and consulting services. At the certificate presentation ceremony, Academy of Family Physicians of Malaysia president Assoc Prof Dr Hazian Hamzah said the number of psychiatrists in the country was low, at just 460. ALSO READ: Action plan will help youngsters deal with mental health issues She said the only way to meet the country's needs is to empower primary care doctors to detect and treat common mental health problems while referring complex cases to psychiatrists. 'This will also reduce the bottleneck at specialist services while enabling a conducive therapeutic alliance, since primary care doctors and GPs are familiar with their regular patients," she added. One GP who attended the course said he was interested in participating as he had patients with mental health issues. 'I see quite a number of cases where people come in with depression and anxiety. 'I normally speak to them to try and find out what triggered it and since most of them say they can't sleep, I prescribe something to help them relax," he said. He felt the training programme was timely given the increase in cases.
