KUALA LUMPUR – The demand for therapy in Malaysia is growing as young adults become more aware of mental health issues, but the costs are often prohibitively high.
As a result, many young adults would rather suffer in silence than seek professional help, as paying for therapy can be a significant financial strain.
Reports by the Institute for Youth Research Malaysia indicate that as of 2022, six in 10 youth experience mild to severe depressive symptoms, and three in 10 have moderate to severe anxiety symptoms.
Additionally, there was a staggering increase of 1,166 youth suicides, from 953 in 2019 to 2,119 in 2020.
Sabby, a 21-year-old student diagnosed with borderline personality disorder when she was 19, shares her experience with seeking professional help.
She initially sought help from a therapist at a public hospital, seeing them once every three months or more.
She now attends private therapy sessions every two weeks, sometimes more frequently, for a fee of RM150 to RM200 per session, as opposed to RM5 per session at public hospitals.
“Although, if I’m not mistaken, some private psychiatrists offer subsidies for students, where they could pay half of the full price.
She uses her allowance and earnings from her part-time job to contribute, as her insurance does not cover mental health issues.
To manage the costs, Sabby and her parents share the therapy expenses.
Despite the high costs, she is grateful that she can afford private therapy without compromising her basic necessities, thanks to her family’s financial stability.
However, Sabby acknowledges the significant financial challenge posed by therapy costs, noting that the RM150 to RM200 per session could cover several days of meals for some people.
She feels grateful to be able to prioritise her mental health without having to choose between therapy and her basic needs.
“I thank God that I can prioritise my mental health while also affording to meet basic needs without having to choose between the two.
“But I can’t help but think about the luck of other families who rely on the public hospital system to care for their mental health.
Sabby believes that the high cost of therapy deters many young people from seeking support.
“Not many would want to spend hundreds on a single session, this does not include the medications for those who need them.”
According to the Malaysia Youth Mental Health Index (MyMHI) 2023, a score of 71.44, which is moderately satisfactory, suggests that many youths are trying to maintain a relatively balanced lifestyle, which benefits their mental health.
Riduan, a young adult with bipolar disorder type 1, who used to attend therapy, shares his perspective on the cost of mental health therapy and the reason he stopped.
Riduan initially attended therapy sessions at a local public hospital, which cost him RM5 per appointment every three to four months.
As a student without family support, the affordability of public hospital therapy was crucial for him.
However, he admits that if he had extra money, he would choose private practices for more frequent and personalised care, but the costs, including necessary medications, would be prohibitively high.
Riduan paid for his therapy sessions out of pocket, as the RM5 per appointment was manageable for him, but he faced significant challenges due to the long intervals between appointments and the potential risks associated with medication.
“For someone with a serious mental health disorder, waiting months and being given a lot of stocks for medications brings more harm to me than benefits.
“I have had so many issues and traumatic incidents that happened to me while I was waiting for my next appointment with medications that I wasn’t aware could lead to an addiction problem.
Financially, Riduan did not have to make any significant sacrifices due to the low cost of public hospital therapy.
However, he felt that the long wait times and infrequent appointments brought more harm than benefit to his overall well-being.
“If therapy were more affordable and public hospital services were better, more young people would prioritise their mental health,
“But, given the high costs, I know many young people, including myself, consider it unnecessary and that they prioritise other issues over their mental health.”
MyMHI’23 reports a score of 66.10, suggesting that youth in Malaysia are at moderate risk of facing emotional disturbances or disruptive feelings, indicating a significant need for mental health support and intervention.
This moderate risk level highlights the importance of addressing mental health issues among Malaysian youth to prevent further emotional distress and promote overall well-being.
Local celebrity Sarimah Ibrahim, spokesperson for the non-governmental organisation Empati, said that the prohibitive costs of mental health services are a significant barrier for many youths.
“Costs (mental health services) are too expensive for people on average income.”
The shortage of mental health professionals exacerbates this issue, creating a mismatch between demand and available services.
She said the financial burden of basic necessities often leaves little room for mental health care, especially in an era where digital interactions and social media increase competition and isolation.
“With the internet booming and people becoming more dependent on gadgets, people are becoming more competitive and more comparative.
“Back in the old days, we had kampungs. After we give birth, the villagers will help take care of the child, so there are fewer cases of postnatal psychosis because the villagers are there to help,” she said.
Befrienders executive director Kenny Lim echoes these concerns, pointing out that financial constraints force many to prioritise essential needs like food and accommodation over mental health treatment.
He suggested that those with financial difficulties seek help from health clinics, the Social Welfare Department, and community mental health centres, which offer more affordable or free counselling services.
“When required, a referral will be made for patients to see a psychiatrist at a public hospital. One can also see counsellors at the Social Welfare Department for free.
“Psychiatric consultation and treatment is also available at community mental health centres set up by the Health Ministry.”
Hasbeemasputra Abu Bakar from the Siuman Collective shared personal stories illustrating the struggles young people face due to the high costs of mental health services.
He highlights the plight of disabled neurodivergent individuals who have to spend significant amounts on private services after being denied proper assessments in public healthcare.
“Among our collective members are disabled neurodivergent persons who have had to spend years and thousands of ringgit accessing private mental health services when proper psychological assessments were denied multiple times in public healthcare,” he said.
He stressed the importance of policies that address these barriers while also incorporating input from those who have lived through these experiences.
“(Currently), our Health White Paper Advisory Council does not include patient and client advocates or human rights defenders. We have no mechanisms for clients to co-design healthcare services.
“Let’s have a policy that meaningfully acknowledges and centres the client and involves us in the design and roll-out of services. That would help make mental health services more accessible.” – July 21, 2024
