Allied Science undergraduate lecture in 2003

1. Perkhidmatan Kesihatan
Mental di Malaysia
Dr Zahiruddin Othman
23/06/2003

3. Definitions of Prevention
Primary prevention
Prevention of disease before it occurs
Secondary prevention
Prevention of recurrence or exacerbation of a
disease that has been diagnosed
Tertiary prevention
Reduction in the amount of disability caused by a
disease to achieve highest level of function

4. IOM (1994) Definitions
Prevention
Prevention to ward off the initial onset of a mental
disorder
Treatment
Identification of an individuals with mental
disorders and the standard treatment for those
disorders
Maintenance
Intervention that are oriented to reduce relapse
and recurrence and to provide rehabilitation

5. Model of Mental Health Services
ModelModel BasicBasic
conceptconcept
TargetTarget
populationpopulation
ComponentsComponents PracticesPractices ExamplesExamples
Institution /
Hospital-based
Mainly
medically
oriented
Mentally ill
person
Custodial
Curative
Whole of life
Minimal outreach /
aftercare
Admission
Diagnosis
Treatment
Discharge
HBUK
De-institutional
community
based
Mainly
psychosocial
Mentally ill
person
In closing of
mental hospital
Treatment in the
community
Arranged social
environment
Train living and
coping skills
Surrogate
parent model
Integrated /
decentralization
Wellness
concept
Healthy
At risk
Mentally ill
Promotive
Preventive
Curative
Rehab
Mental health
promotion
Early detection
Treatment
Psychosocial rehab
As proposed
by WHO
(1990)

6. Mental Institutions
Hospital Bahagia Ulu Kinta, Perak
Hospital Permai, Tampoi, Johor
Hospital Sentosa, Sarawak
@ Sarawak Mental Hospital
Hospital Bukit Padang, Sabah
@ Sabah Mental Hospital

7. Hospital Bahagia Ulu Kinta
1911 – Federal Lunatic Asylum
1928 – Central Mental Hospital
1971 – Hospital Bahagia Ulu Kinta

11. Hospital Permai
Hospital Gila Batu 3 (1922-1929)
Lunatic Assylum Johore Bahru (1929-1937)
Johore New Mental Hospital (1937-1941)
Kichigai Beyoin (1942-1945)
Tampoi Mental Hospital (1952-1959)
Hospital Sakit Otak (1959-1972)
Hospital Permai Johor Bahru (1972- )

12. Hospital Bukit Padang
A 302 bed Psychiatric Hospital situated
in Kota Kinabalu , Sabah, (The Land
Below The Wind) Malaysia.
Commissioned in 1972. It is the center
for psychiatric referrals in Sabah.

13. Community Psychiatry / Mobile Clinic
The Community Mental Health Team
conducts weekly Mobile Clinics to
administer follow-up treatment for
patients around a 30 km radius of Kota
Kinabalu.
Horticulture Rehabilitation
An area within the hospital compound has been
allocated for farming, a form of rehabilitation
activities

14. Occupational Therapy
A unit located within the hospital
compound , led by an Occupational
Therapist, catering for various modes of
rehabilitation for selected inpatients
Day Care Center
This center had begin operations on January
2000

15. Decentralization
Following the deinstitutionalization
policy in 1959
Psychiatric units in general hospitals

16. Aktiviti Pemulihan Pesakit
Projek Cuci Kereta
Program ini telah
dilancarkan oleh Pengarah
Hospital Kangar pada 6
November 1997. Pesakit
yang menjalani aktiviti
pemulihan ini akan diberikan
ganjaran berdasarkan tahap
kemampuan mereka
membuat kerja dan
peningkatan di dalam tahap
kualiti kerja mereka.
Projek Tanaman
Hidroponik
Pelbagai jenis sayuran
seperti bayam, tomato,
kailan, sawi dan lobak
ditanam bersebelahan
dengan jabatan ini. Projek ini
telah mendapat pembiayaan
dari Pejabat Pembangunan
Ekonomi Negeri Perlis
sebanyak RM2,000.00 untuk
tujuan pembelian peralatan.

17. Mental Health Services In Malaysia
Institutionalization
(1911 – HBUK)
Decentralization
(1960s)
Community psychiatry
(1984 – Unit Rawatan
Komuniti, Hospital permai)

18. National MentalNational Mental
Health PolicyHealth Policy
National MentalNational Mental
Health PolicyHealth Policy
National planNational plan
of actionof action
National planNational plan
of actionof action
Training moduleTraining moduleTraining moduleTraining module
Diagnostic and managementDiagnostic and management
guidelines for PHCguidelines for PHC
Diagnostic and managementDiagnostic and management
guidelines for PHCguidelines for PHC
Mental HealthMental Health
promotion materialpromotion material
Mental HealthMental Health
promotion materialpromotion material
State and district levelState and district level
coordinating committeecoordinating committee
State and district levelState and district level
coordinating committeecoordinating committee
MHS inMHS in
existing clinicsexisting clinics
MHS inMHS in
existing clinicsexisting clinics
19971997
CommunityCommunity
Mental HealthMental Health
ProgramProgram

19. to those involved in any planning and
implementation towards improving mental
health and well being of entire population
for population at risks of developing
psychosocial problems
for the mentally disordered in the provision
of care and protection by the family,
community and relevant agencies
To provide aTo provide a
basis in developingbasis in developing
strategiesstrategies
To improve mentalTo improve mental
health serviceshealth services
To improveTo improve
psychiatric servicespsychiatric services
National Mental Health Policy

20. “Mental Health And Mental Health services”
“Life Skills For Mental Health”
“Mental Disorders In Primary Care”
Module 1Module 1
Module 2Module 2
Module 3Module 3
Training Module

21. Mental Health Promotion Materials
32 various topics of mental health
Some 200,000 leaflets covering 13 various
topics e.g. mental health, mental illness, mental
health for children, misunderstanding of mental
illness, stigma and mental illness, stress etc
"Apakah itu Kesihatan Mental" (1997) and
"Tangani Tekanan Mental"(1998)
PostersPosters
LeafletsLeaflets
TelevisionTelevision
documentariesdocumentaries

22. Kempen Cara Hidup Sihat

23. Mental Health Services in
Existing Clinics
By Sept 1999, 129 clinics nationwide have establish:
Health talks on mental health topics
Early detection
Treatment and referral to psychiatrists
Follow up of stable cases
Home visits (defaulter tracing, check drug compliance,
administer injection)
Counseling
Health education for patient, family and community
Training (echo and in-service/attachments)

24. Mental Health Services in
Existing Clinics
Psychosocial-rehabilitation
( vocational, activities of daily living skills, mental health life skills training )
2 clinics-1998 - Klinik Kesihatan (K.K.) Pendang,
Kedah and K.K. Bachok, Kelantan
4 clinics-1999 - K.K. Sri Kembangan, K.K. Pekan
Nenas, Poliklinik Kg. Simee, K.K. Lim King Howe,
Sibu