Stigma And Suicide
Why we need to break the silence in Asia.
BY Jayme Teoh Jiah Mae | Jun 29, 2018 | Fitness & Health
According to the Centre for Disease Control and Prevention (CDC), suicide is a complex issue, and mental illness, particularly depression, is a major risk factor. Mental illness and suicide are topics that are often misconstrued, and there is still a lot that needs to be done to overcome the accompanying stigma. However, it is apparent that there is an overarching problem regarding mental health that exists within many societies–mental health issues are still highly trivialised today. Whilst many countries are taking progressive strides to address the reality of mental health problems and how we deal with them, it seems to be lacking thereof especially in Asia.
THE FALLACY OF SUCCESS AND HAPPINESS
Conversations about suicide prevention sparked in light of the recent deaths of Kate Spade and Anthony Bourdain, which gave me some hope that perhaps we will begin talking about it more openly and coming up with long-term solutions. But alas, it has been a mere three weeks since the tragic incidents, and the talk about suicide and mental health have once again started to dwindle. Do we really need multiple suicides of those we idolise to open our eyes to an obviously pressing problem that we desperately need to confront? We have this ingrained idea that suicide and depression are issues that are so far removed from us; that these sorts of things only happen in far off places like the U.S. This could not be further from the truth. Just a few days ago [Wednesday, 27 June], a 19-year old male student stole a pistol from a shooting club and is believed to have shot himself in the toilet of a private college in Subang Jaya. ACP Mohammad Azlin stated that “the victim’s father stated that the boy had been suffering from depression since a year ago.” Depression and mental health issues are prevalent everywhere, and that includes right here in Malaysia.
“MENTAL ILLNESS AND MENTAL DISORDERS DO NOT DISCRIMINATE.
THEY CAN AFFECT ANYONE AT ANY TIME.”
I can still remember the various comments my friends in Malaysia had made, such as “Anthony Bourdain seemed like such a happy guy” or “Kate Spade was so successful. Why would she want to kill herself?” Well, that’s exactly the point. It isn’t supposed to be easy to spot someone with suicidal tendencies or personal mental issues. The most common belief is that when reaching that elusive plateau of success, it is synonymous to finding true happiness. That may very well be the case for some, but not necessarily for all.
It is difficult for those who have never been suicidal to grasp how appealing it can seem. Richard Morgan wrote an article on the Washington Post about how we have idealised suicide as a “battle that is lost”, rather than “a kind of fatal exhaustion.” Our understanding of suicide is cut short by what we have been fed by society as being an evil that ultimately takes over. No, not quite. It is far more complex and subtle than that. Sometimes, it is a last resort because you’ve gotten to a point of exhaustion with little hope left, almost like the remedy you need to cure years of pain and feelings of worthlessness.
Though their acts appeared to be impulsive, the likelihood is that Kate Spade and Anthony Bourdain struggled with personal demons for many years, and no one would’ve ever guessed it. In an interview this year, comedian and actor Jim Carrey talked about “getting to the place where you have everything everybody has ever desired and realising you are still unhappy. And that you can still be unhappy is a shock when you have accomplished everything you ever dreamed of and more.” We have been made to believe that success–materials and status–is a clear path. Whilst there is nothing wrong with wanting things, status, or wealth, it is a mistake to assume that they pave the way to happiness.
“PEOPLE ARE AFRAID. THEY ARE HIDING IN THE DARK AND ARE REFUSING TO TALK ABOUT SUCH ISSUES OPENLY OWING TO TABOOS”
The reality is that one in four people will have some kind of mental health problem in their lifetime, according to The World Health Organization. Within Malaysia, 29.2% of Malaysians above the age of 16 years suffer from the same in 2015. Dr. Rabin Gonzaga, a psychiatrist at Gleneagles Hospital, Kuala Lumpur, stated that “mental illness and mental disorders do not discriminate. They can affect anyone at any time.”
Truth is, mental health issues are still somewhat of a taboo subject in Asia. They are often associated with weakness, guilt, and shame. The stigma around mental health issues is deeply rooted in traditional Asian values–and many studies and reports on mental health in Asian countries have arrived at the same conclusion. A case study on the situation of mental health in China by the academic Veronica Pearson states:
“There is widespread belief that mental illness is a punishment for the ancestors’ misdeeds visited on the present generation, effectively shaming several generations of the family simultaneously. The ‘taint’ associated with mental illness is so strong that it extends beyond the affected person, for instance with regard to the issue of marriage.”
This may be an old study, but the modern-day attitude towards mental health and suicide still remains more or less the same. When I think about it, most of my friends and family in Malaysia seem oblivious to the fact that mental issues are problems that need to be addressed. The stigma of mental illness is often manifested in forms of labelling, rejection, social exclusion, and in employment. In Malaysia, a recent study showed that family and friends are reported to be the main perpetrators of discriminatory conducts. The very people who are supposed to care and support those facing their own mental problems, reject them instead. This amounts to a negative feedback loop, making depressed individuals feel even more of a burden rather than a problem that actually needs to be addressed desperately. Keeping these problems to yourself and not seeking help further exacerbates feelings of isolation, rejection, and despair.
More so, comments about the deaths of Kate Spade and Anthony Bourdain that border on unempathetic show a lack of understanding within certain segments of the Malaysian community. Comments such as “Oh, if only he had turned to God and prayed harder, he wouldn’t have done that” or “Depressed people are such wimps. They should just suck it up like the rest of us” are not uncommon. Like any disease, mental illness, and depression in particular, requires proper intervention, diagnosis treatment, and continuous family support to enable those afflicted to heal.
“WHOLE MINDSETS NEED TO BE CHANGED”
Dr. Shiv Kumar Vats, the ayuverdic doctor of Samkkya center in Kuala Lumpur, shared his own perspective on the matter. He believes that it isn’t enough to rely on modern medicine to solve problems, especially mental health. Rather, whole mindsets need to be changed. “At one point, sex education was banned, but now people are becoming more open to it, and that needs to be the same for mental health. There has to be an open forum to learn about it, understand it, and then improvise upon it.”
Dr. Vats has observed that the modern medical system has just been limited to disease, but the definition of health by the World Health Organization does not just encompass the absolute absence of disease, but also the physical, mental, spiritual, and social well-being of a person. “I don’t deny the fact that modern medicine has done wonders in acute patient management, but we need to educate and have open conversations about physical and mental health so that we don’t have to get to a point where all we can rely on is medicine.” Instead of a pharmaceutical-governed practice of constantly prescribing medicine, a right type of education on wellness and a holistic approach towards mental health prioritising one’s emotions and needs are essential in curtailing this existing stigma.
“THERE HAS TO BE AN OPEN FORUM TO LEARN ABOUT IT, UNDERSTAND IT, AND THEN IMPROVISE UPON IT”
Fortunately, efforts have been made within Asia and Malaysia that are slowly trying to reverse our once obstinate view of mental health issues and suicide. A campaign launched by Dr. Chua Sook Ning entitled #ImNotAshamed, hopes to change the stigma that is preventing many Malaysians from seeking the help and treatment they may need. She states that “people are afraid. They are hiding in the dark and are refusing to talk about such issues openly owing to taboos.” Aside from raising awareness, there are also organizations designed to form outlets for those who need help. Befrienders KL is a 24-hour hotline that seeks to provide free and confidential emotional support for those depressed or suicidal. Slowly but surely, small steps are being taken to reshape the way we approach mental health and suicide.
Ultimately, it doesn’t matter how much money our society pumps into the education and health sectors, how many counselling services you offer, or how many friendly little e-mails and reminders are sent out for you to “not forget to smile”, real change will not happen unless the mindsets of entire populations are moved. Simply presenting services is a passive and ineffective approach.
Mental health must be addressed comprehensively, and not a case-to-case basis. We must change the way we view mental health, the way we talk about it, the way we think about it. I’m not saying that this is going to be easy but being honest with others about our own personal struggles is a good first step. Mental health issues shouldn’t just be personal and private conversations. They should be amplified on a larger scale through public policy, taxes, and civic duty. We can’t just be there for someone if they need help. We need to be there for them all the time. People on the edge have to be constantly assured by a supportive society that there is always a way to get through the roughest of roads.