SECURITY FORCE REFORM?

This massacre has happened just ahead of the next election, which is scheduled for the first half of next year. Politicians are starting to get into campaign mode.

In the past, opposition parties have occasionally campaigned on issues around reforming the security forces, and in recent years there have been signs the government wants to be seen to be doing things on this issue.

One such topic has been that of military conscription – all men over 21 years of age in the country must register for the draft, which takes the form of a lottery every April.

This practice is very unpopular, and became a political issue in the last election. The military has floated ways to scale back conscription, but whether changes will actually be implemented is another matter.

My studies of the Thai military over a long period suggest such announcements are often quietly shelved later.

Indeed there’s relatively little oversight of the security forces, because of the country’s governance – in many respects, the military is the government. Other agencies of the government are reluctant to put any pressure on the security forces, as is the country’s anti corruption commission. Military reform is left to the military itself.

Setyawan did not mind helping out and continued to do so while working as a village secretary in Paringan, which is located within Ponorogo regency. He married Lamini in 1998. 

In 2005, Setyawan had to stop volunteering. “I had to stop doing it cos I had tetanus,” he recounted. He almost died but eventually managed to recover. 

He told CNA that the near-death experience made him decide to dedicate his life to helping people with mental health problems. 

In 2007, someone asked Setyawan to pick up two men, aged 37 and 45, who had been discharged from a psychiatric hospital.

As their families did not welcome them back, Setyawan decided to take them home.

Lamini remembers being shocked when Setyawan came home with the strangers.

“To me, it was just strange. Why should we have them at our house? 

“We were still a young family and I wanted attention from my husband but was forced to share it with strangers.”

Eventually, she began to understand why Setyawan wanted to help.

“I realised that people who suffer from mental health problems also need attention, affection and love like us normal people,” Lamini recounted.

Setyawan added: “And now actually it is the other way around. She is the one who takes care of them.”

For the next 10 years, they took in mainly men who suffered from mental health issues.

But in 2017, they decided to house only women as Setywan started to take a step back due to health reasons and Lamini became the main caregiver. 

Setyawan and Lamini do not charge a fee for looking after those with mental health problems. However, most of the families give the couple a small token sum to help out with their expenses. 

When funds run low, the couple would draw from their savings. They have also received donations from the public. 

Margo Widodo can take care of 12 people at once.

Mr Nishida’s new project to set up a separate facility for children exposed to traumatic events became viable after the central government revised the law to step up support for such children until they reach the age of 22.

For a start, Nr Nishida aims to take in six adolescents, mainly from his orphanage, although he is willing to accommodate others who have needs. 

While they provide hot meals, warm beds, and educate the children, orphanages in Japan are not equipped to provide mental health therapy. This is despite orphanages in Japan housing mainly children who are victims of abuse and neglect at home, who often demonstrate signs of traumatic stress. 
Children with a clear need for psychiatric help are admitted to specialised institutes.

Mr Nishida said: “The younger they are, the higher the chances are for them to eventually become self-sufficient. We will try to bring the young hikikomori over here, help them learn how to do chores, then help them go out. It will be hard, but we hope they can mix in society.”

He has enlisted the help of Mr Oshikawa.

But Mr Nishida said without support for families, his new facility may only address the symptoms of the issue.

“I believe the problem is in the family. We should not only care for the children. I believe we need to support each household,” he said. 

According to the Health Ministry, one in 30 people has mental health issues in Japan. One in five will have a mental illness during their lifetime, the Health Ministry added.

In Kitakyushu, Mr Nishida aims to create a network of support with Mr Oshikawa’s expertise.

“Emotional, intellectual, mental disorders tend to run in their parents. I notice a pattern. If the parents have disabilities, illnesses, it’s often the case that their children have them,” he said.

Watch CNA Leadership Summit live on 10 October 2022 from 1.30pm SGT via cna.asia/leadership-summit.

KUALA LUMPUR: May Thay Kyin was just six years old when her family fled Myanmar. 

She’s been living in Malaysia for more than a decade now. But like many other refugees in the country, May still feels like an unwelcome guest. 

“We don’t fit in with anyone here because we are who we are,” said the 21-year-old. 

“I think feeling alienated is one of the very common things that we would have a mental pressure for.” 

She was bullied in school when she was younger, she added. 

“It’s such a common thing. And that was definitely one of the recurrences of my childhood,” she said. 

As May enters adulthood, the issues she faces have become more complex. 

Finding legal employment is a major challenge and many families are vulnerable to poverty, exploitation and health problems. 

Grappling with an unshakeable anxiety about her future as a refugee, May suffers from insomnia. 

As of December 2020, about 178,140 refugees and asylum seekers are registered with the UN High Commission for Refugees (UNHCR) in Malaysia.

FOCUS ON MENTAL HEALTH ISSUES

Mental health issues have become a focus for non-profit organisation Refuge for the Refugees in recent years. 

The organisation was set up to help refugees with emergency relief and aid, as well as educational programmes, but founder Heidy Quah saw a pressing need to help refugees deal with mental health issues. 

“A lot of times, the refugees tell me that they struggle to sleep at night, because they don’t know when authorities are going to be knocking their doors, waiting to arrest them,” said Ms Quah. 

“They also struggle to get through the day because already they are barely earning minimum wage,” she added. “What more having to support your families, putting food on the table, sending kids to school? Living in limbo causes extreme stress.”

Studies have found that the prevalence of mental disorders among refugees is high. About 43 per cent of them suffer from at least one mental disorder. This includes depression, anxiety, post-traumatic stress disorder, and complicated grief. 

In August, a tragic murder -suicide involving a Burmese man and his two children in Kepong, Kuala Lumpur shocked the nation. 

It was later reported that the father had been suffering from depression, which deteriorated after he lost his job during the pandemic. 

The incident cast the spotlight on the refugee and migrant group’s state of mental health in Malaysia.

President of the Alliance of Chin Refugees (ACR) Salai Maung Maung Lat, said he’s personally heard of at least 19 suicide cases among the burmese migrant community in the last two years. 

“Just like everyone in Malaysia, the refugees also could not go to work because of the movement control orders. Some don’t have food to eat, and they are also scared of being infected with covid-19,” Salai expained.  

He added that many undocumented migrants who are still waiting to be registered by UNHCR, are afraid of getting arrested and deported back to their country of origin. 

“We are worried like every day here because of being refugees. It’s not easy,” he said.

“Frequency and extremity of flood events (in Malaysia) have increased in recent decades with projections they could increase with continued global warming,” said the report which was released in 2021. 

There is concern among mental health experts in Malaysia that there will be more flood victims, who will in turn show symptoms of post-traumatic stress. Such cases could start with depression and anxiety. Eventually, there may be more suicides. 

Mental health expert Andrew Mohanraj, who is president of the Malaysian Mental Health Association (MMHA), told CNA that those with PTSD from floods are likely to report intense feelings of anxiety, depression and paranoia.

“A person having PTSD will exhibit symptoms like being highly irritable, sometimes even violence towards others, having poor sleep, as well as feeling guilty and having a great deal of shame over what happened,” said Mohanraj.

“And then of course, unfortunately, in trying to cope with this then the person might tend to resort to maladaptive coping strategies, like abusing substances such as sleeping medication and alcohol. And, sadly, in some cases, this results in suicide as well,” he added. 

In Abdul Rahman’s case, he was referred to counsellors from the Ministry of Health and underwent weekly tests to monitor his trauma level. 

“When the sky gets dark and I hear thunder, my stomach would sink. I have never been afraid of heavy rain like how I feel now,” he told CNA. 

Rohini Krishnan, a counsellor from Meraky Counselling Services who has treated flood victims in Kedah, suggested that Abdul Rahman’s trauma level is likely to be high given the magnitude of grief and bereavement from the incident. 

“The loss of loved ones will definitely exacerbate the impact of the trauma on the individual … because it’s something much, much more than loss of property and valuables,” she said. 

“For such cases, the person might be at level eight or nine or even 10 (out of a scale of 10). Counsellors need to sit down (with him) and do a lot of processing and uncovering to help in recovery,” she added. 

Last month, Health Minister Khairy Jamaluddin said that Malaysia saw an 81 per cent increase in suicide cases overall in 2021, with 1,142 cases reported last year as compared to 631 cases in 2020. He noted that a main cause for this was mental health issues exacerbated by the COVID-19 pandemic.

Such a move was also reported in other campuses as part of the country’s strict zero-COVID policy, which it has maintained since the pandemic began more than two-and-a-half years ago. 

Mr Huang said he felt frustrated at times. The uncertainty behind the ban meant that “we could not see how long before it will end, and we’re just stuck in that cycle”, he added. 

China’s strict measures also meant that many schools had closed with lessons moved online, depriving students of in-person interaction with their peers.

“A child’s feelings of anxiety or loneliness can be especially strong,” said Ms Victoria Yang, founder of Resoul Psychological Counselling Center in Shanghai.

The 38-year-old, who has been a therapist for over a decade, has seen an increase in adolescent specific issues such as internet addiction since the pandemic began.

The harsh lockdowns and quarantines have also taken a toll on parents, as China’s economy and livelihoods have suffered.

Some of them are under greater pressure, said Ms Yang, adding that their children may end up suffering because of this.

Citing an example, she said: “A couple may go from seeing each other before and after they go to work in the past, but now they are together every day and all the time, which will magnify some of the potential problems in the relationship.”

But the country has made some progress, said Ms Yang. “10 years ago, many in China were not able to receive psychological counselling. They thought it was very strange.”

Even as more people accept the idea of seeking professional help for mental health issues, Ms Yang said this may be limited to China’s bigger cities like Shanghai.

People in lower tier cities, particularly seniors, may still ignore the importance of mental well-being.

“They may not want to expose some parts of their life too much, because they feel that we should not wash our dirty linen in public,” said Ms Yang.

Watch CNA Leadership Summit live on 10 October 2022 from 1.30pm SGT via cna.asia/leadership-summit.

In Bekasi on the outskirts of Jakarta are several known private institutes for people with mental illness. These include Al Fajar Berseri. 

Founder Marsan Susanto, 51, said that he realised his calling was to take care of people with mental health disorders when he one day saw a mentally ill person eating rice from a garbage dump full of flies.  

A former coachman without any psychiatric education background, Susanto set up the institution in 2005 and relies on donors for funding.

The institution is now home to about 500 people with mental health problems. 

Those who are deemed harmless are free to move around in the 8,000 sqm facility, but some who are diagnosed as severely disturbed are housed in a building with bars.

Susanto said that two of the patients were chained because they have been aggressive since their admission.  

When CNA visited in early September, a man was seen with his right wrist chained to a bar. He used his left hand to throw orange peel at Susanto as the latter stood in front of him.

“Authorities brought him here a few days ago after they found him on the streets. 

“We don’t know his name nor anything about him as he barely speaks. But he has been aggressive since he arrived,” Susanto explained.

When they start to calm down, they will be freed from their shackles, he said. 

Susanto said that local authorities would often bring in people wandering the streets to his institution. 

At the start of the pandemic though, he did not dare to take in new people as he was afraid they may have COVID-19.

While Al Fajar Berseri is privately run, he does get some support from local authorities.

The head of Bekasi’s social agency visits the institution once in two months, and officials from the local health centre visit quite regularly to monitor the condition of the patients, Susanto said. 

As the COVID-19 caseload has now declined, the Indonesian government hopes it can pick up where it left off in terms of ending shackling cases. 

“We will increase mental health services and access to it, and work on cross-sectoral programmes,” said Jaya of the health ministry. 

For now, Yasa in Karangasem continues to be confined while his mother Seken prays for him regularly. 

“I pray so that Yasa is healed and given salvation,” she said.  

The full names of those with mental illnesses and their family members have been withheld in order to protect their identity.

Watch CNA Leadership Summit live on 10 October 2022 from 1.30pm SGT via cna.asia/leadership-summit. 

 

In March, de facto law minister Wan Junaidi Tuanku Jaafar said a study on proposed amendments to the law to decriminalise suicide attempts was almost finished and would be submitted to the Cabinet for approval. 

He said the government had, via the AGC, taken the initiative to study laws related to attempted suicide and abetment of such attempts, due to statistics showing the growing number of attempted suicides across all ages. 

“Based on the findings of the study, the AGC has examined the available legal options as well as the legal implications if the offence of attempted suicide is removed from the criminal justice system,” said Dr Wan Junaidi in a written parliamentary reply. 

“In addition, the AGC has also examined the need to amend other related laws in order to avoid loopholes if the offence of attempted suicide is removed from the criminal justice system,” he added. 

“The study covering the proposed amendments to the law has almost been finalised and will be submitted to the Cabinet for approval,” he said. 

SUICIDE STATISTIC SHOWING WORRYING TREND: KHAIRY 

In the same event on Wednesday, Mr Khairy outlined that Malaysia saw an 81 per cent increase in suicide cases in 2021, with 1,142 cases reported last year as compared to the 631 cases in 2020. 

“Trend of suicides, according to police data, showed an 81 per cent increase in 2021 from 2020,” said Mr Khairy. 

“This is a worrying statistic that requires attention and quick action by authorities,” he added. 

The health minister also pointed out that mental health issues have been exacerbated by the COVID-19 pandemic, evident by data from the Ministry’s psychosocial helpline.

He noted that since March 2020, the Ministry has received more than 307,000 calls of which 74.3 per cent were made by individuals who needed emotional support and counselling due to chronic stress, depression as well as anxiety due to the COVID-19 pandemic.

“Contributing factors include financial issues such as loss of income or employment, crisis in household finances, issues relating to family relationships, death of loved ones as well as domestic abuse,” said Mr Khairy.

During the height of the pandemic, prolonged lockdowns and financial issues led to an average of four suicide cases reported each day. 

The situation prompted the Health Ministry to warn the public to watch out for symptoms of depression such as any change in behaviour among friends, colleagues and relatives.