On 6 November 2020, the 2021 Malaysian Budget was tabled by Finance Minister YB Dato’ Sri Tengku Zafrul bin Tengku Abdul Aziz. Regarding the allocation for mental health, these are the two separate figures we should be taking note of:
- RM 24 million for the Mental Health Program, Prevention of Physical Abuse and Substance Abuse under the COVID-19 fund;
- RM 313 million for Psychiatry and Mental Health under the national health budget.
Special programs
The government allocated RM24 million to address mental health issues through the enhancement of a treatment programme.[1] Tabling the budget proposals, the Minister of Finance said of the RM322.5 billion allocated for 2021’s budget, the RM24 million allocation will be used to address mental health problems, violence prevention and substance abuse.
Though the government’s effort in improving mental health and abuse prevention should be applauded, MMHA president Dr Andrew Mohanraj commented that the setting up of mental health helplines and public awareness campaigns should be considered. He also expressed the need of funding towards mental health initiatives, as many NGOs were in need of “significant and sustainable support”.[2]
Dr Chua Sook Ning did a comparison table that showcases the percentage of funds allocated for mental health in Malaysia, USA, and Australia. It was calculated that generally 0.20% of the pandemic emergency funding is allocated to “mental health issues, violence and abuse prevention; and substance abuse programs.” Comparing to Malaysia, the allocation for the programmes is calculated to be 0.03% of the pandemic package.
2. Mental health budget 2019
Aside from the programmes, RM 313 million was allocated for the psychiatry and mental health budget. Looking at the budget as a whole, psychiatry and mental health makes up 1.13% of the health budget.
It was shared during the budget proposal that the health ministry’s Psychosocial Helpline received more than 35,000 distress calls from March to October, which included callers suffering from depression, stress and anxiety. However, according to the Galen Centre’s report published on CodeBlue, there was a decrease of 9.11% in funding for psychiatry and mental health in comparison to last year’s budget. This report was based on a breakdown of MOH Budget Cuts accessible here. According to the Star, Datuk Seri Dr Adham Baba has denied there was a cut in allocation, focusing instead on the Health Ministry’s efforts in collaborating with other departments to improve the public’s mental health. We should also take note that psychiatry and mental health is not the only category that has suffered cuts.
During the past few months, the World Health Organisation has shed light on the need to increase investment in mental health services and programmes.[3] Hence, the decrease in monetary allocation for psychiatry and mental health services from RM344mil in 2020 to RM313mil in 2021 is detrimental to Malaysia’s health. Bandar Kuching MP Dr Kelvin Yii also voiced his concern regarding the decrease in spending: “On top of that, due to the interventions related to Covid-19 such as the movement control order, the incidences of various NCDs have and are expected to worsen and increase as many patients have missed their appointments and even treatment. All these backlogs are expected to be addressed especially next year and it is a disservice to cut all those allocations that will jeopardise the quality of care given to those patients”.[4]
According to a study in The Lancet Psychiatry, “survivors of COVID-19 appear to be at increased risk of psychiatric sequelae, and a psychiatric diagnosis might be an independent risk factor for COVID-19.” Although it was disclosed that these are preliminary findings, these will still have an impact on the provision of clinical services. The mental health conditions that were pinpointed in this study are insomnia, dementia and anxiety disorders. Given that mental health condition is a risk factor for survivors of the pandemic, there is an urgent need for the execution of effective mental health prevention and treatment programs.
While the allocation and awareness is a step in the right direction, the cut in funding for services and infrastructure does raise concerns. With an increase in demand for services even more so during the pandemic, mental health professionals may face issues in maintaining access and quality of care, resulting in possibly greater rates of burnout, chronic stress and mental strain.
[1] Surin Murugiah. (7 November 2020). Tengku Zafrul refutes allegations of reduction in public health allocation in Budget 2021. The Edge Markets. https://www.theedgemarkets.com/article/tengku-zafrul-refutes-allegations-reduction-public-health-allocation-budget-2021
[2] Faye Kwan. (13 November 2020). Mental health experts laud budget allocation for psychological wellbeing. Free Malaysia Today. https://www.freemalaysiatoday.com/category/nation/2020/11/13/mental-health-experts-laud-budget-allocation-for-psychological-wellbeing/
[3] World Health Organization. (27 August 2020). World Mental Health Day: an opportunity to kick-start a massive scale-up in investment in mental health. https://www.who.int/news/item/27-08-2020-world-mental-health-day-an-opportunity-to-kick-start-a-massive-scale-up-in-investment-in-mental-health
[4] Radzi Razak. (7 November 2020). Despite overall increase for Health Ministry, medical groups and pundits question cuts to funds for frontliners, medicine and suppliers for lifestyle diseases in Budget 2021. Malay Mail. https://www.malaymail.com/news/malaysia/2020/11/07/despite-overall-increase-for-health-ministry-medical-groups-and-pundits-que/1920325
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