PLHIVs and Mental Health Problems Diverse range of mental health issues. Differ according to various groups of PLHIV community Needs clinical and psychosocial intervention
AIDS Spending in MalaysiaFor the period 2006 – 2010, Malaysiareceived approximately USD 3.6millionfrom UN Development partnersFor 2008 and 2009, the majority of publicfunding was used in preventionprogrammes, followed by the provision ofcare and treatment ( UNAIDS Country Progress Report- Malaysia, 2010)
AIDS Spending in Malaysia 2008 % 2009 % RM RMPrevention 38 855 000 44.85 45 761 000 47.76Care & 34 741 000 40.10 35 819 000 37.39Treatment ( UNAIDS Country Progress Report- Malaysia, 2010)
PLHIVs and Mental Health ProblemsVoluntary HIV testing in Malaysia: 17349 out of 17641 persons knew results of HIV test in within the year 2009 98% of the people were in the range of 15- 49 years age group. ( UNAIDS Country Progress Report-Malaysia, 2010)
PLHIVs and Mental Health ProblemsMandatory HIVtesting Needs proper pre-test and post-test counseling
Intervention StageBeginning stage of statusidentification is crucial forintervention
Study on Mental Health among HIV Patients in Malaysia Psychiatric Morbidity among HIV patients in Tuanku Jaafar hospital in Seremban, Malaysia (2009) (Shane, V., James Koh, Cheah,K.S., Nikram, S., Ting, Y.L & Tong, W.T) Prevalence of psychiatric morbidity among 41 patients interviewed was close to 51% of which 21% suffered from depressive illness
Study on Mental Health among HIV Patients in Malaysia 31.7% of patients had suicidal thoughts 8% of the study samples had made a suicide attempt within one week of learning of their HIV seropositivity. 29.3% patients with CD4 count lesser than 200 had the ideation of suicide.
Effects on PLHIV communityneuro-psychiatric disordersserious mental illnesscommon mental disorders: depression, anxiety, substance use disorderspsychosocial disorders: Social isolation, suicidal ideation, crime intention
Effect on the infected and the affected communitymen Family memberswomen Relativesdiscordant couples Friendschildren Colleaguesmarginalized groups
Implication on PLHIVs CommunitySignificant prevalence of mental healthillness among PLHIVs affects: quality of life of PLHIVs and family harmony of family institution job performance and work force
Effect on the Care-givers and Social WorkersNGOs work with minimum staffsHigh turn over of staffsLack of professional staffsIncreasing number of casesIncreasing work load and officemanagement duties
HIV/AIDS in MalaysiaThe first community response forHIV/AIDS came from NGOs.Aimed at: reducing psychosocial impact improving mental health condition sustaining positive living
HIV/AIDS NGOs in MalaysiaUnder the umbrella body of MalaysianAIDS CouncilApproximately 44 partner organizations Coordinate HIV/AIDS prevention, care and support programmes Carry out capacity building initiatives Assist in advocacy initiatives
Main Role of HIV/AIDS NGOs in Malaysia couselors mediators service providers
MediatorNGOs have the resources and networks tolink the PLHIVs to obtain services andfacilitiesMediate with other agencies to assist infinancial assistance and referral services.Play an important role in minimizing thestigma and discrimination faced by PLHIV empower the PLHIVs community educate and sensitize the general public
CounselorsThe NGO personnel takes up the roleof a counselor and involve in ahelping relationship.Individual and group counseling arecarried out with the PLHIVsPrevilage of having more time tospend with the PLHIVs compared toclinical staffs
Service ProvidersOccassionallyaccomplish task forPLHIVs Making arrangements for treatment procedures Dispatching medication for PLHIVs who live far from the hospital
LimitationsLack of expertiseLack of skills trainingLack manpowerLimited outreach to hard to reachpopulation - senior citizens, physically andmentally challenged groups, children,immigrants & refugees
NeedsCorrect information on HIV/AIDS issues tocope with their condition.Social support to lead a positive lifeMotivation to assume responsibilities tochangeIncrease their self-efficacy to face thesociety and disperse discriminatory andstigmatization situations
NeedsSupplement Mentalhealth programmesfor PLHIVs: sustain adherence to treatment and care have a quality life build up self esteem reduce undue suffering
NeedsTraining on Mental Health Facilitation Counseling skills Peer to peer training
Local ResponseThe National Board of Certified CounselorsInternational (NBCC-I) has collaboratedwith WHO to develop a response throughMental Health Fasilitation (MFH) inMalaysia.
Local ResponseAims of Collaboration: To meet the need for effective and equitable mental health care and promote sustainable health. Bridge the gap between formal and informal resources of mental health care.
Outcome Universiti Sains Malaysia (USM) is the first institution fo higher learning in Malaysia to complete a Mental Health Fasilitation (MHF) training.
Outcome18 USM staffs weretrained as MHFtrainers. attended a 45-hourssession in thetraining.
OutcomeNBCC Malaysia NBCC Malaysia is formed in USM under the umbrella of USAINS Holdings Sdn.Bhd. since 2010 to promote MHF trainings in Asia Pacific
OutcomeNetwork and Linkages The USM Mentor Program and NBCC-Malaysia act as the points of reference for MHF train- the-trainers and MHF trainings. All MHF will be registered under Youth Council Malaysia, NBCC Malaysia and NBCC- International Registry The MHF training team will provide the training upon request
Future NeedsInterventioninitiatives mustintegrate mentalhealth facilitationin order to help thePLHIVs community.
The way forwardIntegrate MHF into HIV/AIDS educationand awareness programmesPropose for a MHF training for care giversand social workers of HIV/AIDSorganisations to acquire necessary skillsfor mental health intervention initiatives
Conclusion and Policy ImplicationThere is an increasing interest to instillmental health concerns in building ahealthy community in MalaysiaWe need a nationwide study in the area ofmental health and HIV/AIDS in order toformulate a programme which will be cost-effective for the needs of the localcommunity.
RecommendationNationwide survey to assess the varioustypes of mental health problem in thecountryAssess the psychosocial needs inaddressing the problem
Recommendationidentify the intervention strategy that willbe cost-effective in addressing the mentalhealth problems among the PLHIVs inMalaysiainclude and promote holistic mental healthapproach in HIV/AIDS programmes carriedout in Malaysia by training the frontlineworkers in the NGOs
RecommendationAdvocacy and smart partnership must bedeveloped among the HIV/AIDS partnerorganizations as well as the civil society sothat mental health initiatives will includeboth clinical care as well as communitycare in order to promote positive livingamongst the PLHIVs community