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| PERSPECTIVE/VIEWPOINT - COUNTRY/REGIONAL |
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| Year : 2020 | Volume
: 2
| Issue : 2 | Page : 139-141 |
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The Malaysian Perspective of the COVID-19 Outbreak from a Social Psychiatric Lens
Richard Rother1, Hazli Zakaria2, Firdaus Abdul Gani3
1 Alaminda Specialist Clinic, R.01.19, Emira Residence and Urban Retail, Selangor, Malaysia
2 Department of Psychiatry, Faculty of Medicine, Pusat Perubatan UKM, Kuala Lumpur, Malaysia
3 Department of Psychiatry and Mental Health, Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang, Malaysia
| Date of Submission | 18-May-2020 |
| Date of Decision | 29-May-2020 |
| Date of Acceptance | 01-Jun-2020 |
| Date of Web Publication | 14-Aug-2020 |
Correspondence Address:
Dr. Hazli Zakaria
Department of Psychiatry, Faculty of Medicine, Pusat Perubatan UKM, Jalan Yaacob Latif, Bandar Tun Hussein Onn, 56000 Cheras, Kuala Lumpur
Malaysia
 Source of Support: None, Conflict of Interest: None  | 2 |
DOI: 10.4103/WSP.WSP_37_20
The pervasive spread of the novel coronavirus known as COVID-19 has resulted in a global pandemic. The virus arrived in Malaysia in January 2020 but only started to significantly spread in March after the country hosted a large international religious gathering. The government response to the outbreak was effective, resulting in a high recovery rate of the afflicted. This response included the enactment of a “Movement Control Order” (MCO), which saw gradually increasing restrictions on public movement, leading ultimately to a lockdown. The MCO has been a cause of psychological unrest in the population due to social isolation, financial stress, and the limitations placed on cultural practices. This increase in psychological unrest has manifested quantifiably, specifically in the observed 57% spike of domestic violence following the enforcement of the MCO. The initiatives that were implemented to curb the public decline in mental health included a hotline offering psychological first aid, which saw reasonable success. However, it is suspected that a large proportion of those suffering from mental health issues is not coming forward to use the available services due to the prevalent mental health stigma in the country. On May 1, the MCO was drastically relaxed, and public movement was again allowed despite a considerable number of new infections being reported daily. This, in turn, inspired more psychological anxiety in the population, and it is speculated that the feelings of unease and uncertainty due to the coronavirus outbreak and resulting MCO will carry forward into the following months.
Keywords: Coronavirus, COVID-19 Malaysia, mental health stigma, movement control order
How to cite this article:
Rother R, Zakaria H, Gani FA. The Malaysian Perspective of the COVID-19 Outbreak from a Social Psychiatric Lens. World Soc Psychiatry 2020;2:139-41 |
The coronavirus known as COVID-19 has spread rapidly and pervasively throughout the world. Although it is notorious primarily for its dangers to physiological health, more and more attention is now being directed toward its impact on psychological and mental health.
COVID-19 hit Malaysian soil in January 2020 when it was detected on travelers from China arriving through Singapore. Initially, cases remained relatively few and were largely imported until a large cluster of infections emerged in March, which led to a massive spike in local cases. In the following 2 weeks, the virus was reported in every state in the country.
The Malaysian response to the coronavirus outbreak was swift and effective, which resulted in a relatively high recovery rate of the afflicted. However, due to a disruption in the political scene months before the outbreak during our change of government, a temporary lapse of attention by the governing bodies resulted in a massive surge in new infections. On February 27 to March 1, Malaysia played host to an international religious gathering attended by over 17,000 people. In an unusual oversight by the government, the gathering was allowed to proceed without strict precautionary measures against the coronavirus, even though the virus had already infiltrated the country at the time. It was this gathering that acted as a catalyst for the outbreak of COVID-19 in Malaysia and was responsible for over 1700 cases, the largest Malaysian cluster of the virus to date.
However, the government's response following this lapse of attention was effective and commendable. Like many other countries, this response involved the imposition of a lockdown and movement restrictions on the general public to contain the spread of the virus. The term used in Malaysia for this was “Perintah Kawalan Pergerakan,” or “Movement Control Order” (MCO). However, unlike many other countries, the complete implementation of our MCO did not come all at once. Rather, it came in five distinct phases, with each phase introducing new restrictions or relaxations on the former rules of the order.
This allowed Malaysian citizens the unique and nontrivial opportunity to gradually adapt themselves to the increasing levels of the social restrictions being imposed. Despite this, the negative implications of the spread of the coronavirus and introduction of the MCO on mental health in the Malaysian population are existent and consequential.
One such implication of the spread of COVID-19 in Malaysia is the rise of anxiety-related symptoms in the general population. From studies of previous similar pandemics in Malaysia, we can expect to see a surge in the fear, panic, and emotional distress experienced by society due to the outbreak.[1]
The implementation of the MCO has also been a cause for much psychological unrest. This is not due to the act of restricting the autonomous movements of individuals per se, but more so, the consequences of these restrictions, which include social isolation and financial distress. To illustrate, many Malaysians who have emigrated domestically to the capital for work or study have found themselves stranded far from home during this time of exceptionally high stress. Because these individuals are without the social support of their families and friends, they are understandably more vulnerable to the negative psychological effects brought on by the pandemic. Furthermore, employees and business owners are finding themselves under considerable pressure during this time as layoffs and forced closures are becoming increasingly common as a result of the MCO. The businesses still in operation are also strained by supply issues as most local businesses are primarily sourced by Chinese suppliers, who themselves had to cease operations during their own bout with the coronavirus outbreak.
In addition, because of the timing of the MCO, some cultural implications were also observed as a consequence of its implementation. Malaysia is predominantly a Muslim country and celebrates Ramadhan, a month of daily fasting leading up to Eid Mubarak (the eventual breaking of the fasting cycle). During Ramadhan in Malaysia, bazaars are often held, which offer a wide variety of food and delicacies for breaking fast after sunset every day. This breaking of fast is usually done in large groups and is followed by the performance of special prayers held in a mosque. The enforcement of the MCO, unfortunately, overlapped with Ramadhan, leading to mosques being closed and the Ramadhan bazaars being banned from the operation. Malaysians were also not permitted to return to their hometowns for Eid, a cultural practice common during this festive time. These inadvertent restrictions to the Muslim cultural practices have no doubt contributed further to the psychological stress in the population.
This psychological unrest inspired by the spread of the coronavirus and subsequent implementation of the MCO described in the preceding paragraphs has been reflected by some startling statistics. For instance, we have seen a 57% spike in the number of domestic violence cases following the enforcement of the MCO.[2] In the first 2 weeks, the Women Aid Organization has also reported a 14% increase in calls to their helpline.
As a result of this dip in the psychological well-being of the Malaysian population, both the government and private organizations alike have responded with various efforts to curb the decline. For instance, the Health Ministry's Crisis Preparedness and Response Centre and Mercy Malaysia have set up a hotline, which offers psychological first aid (PFA) to individuals impacted by the pandemic through telecounseling. This effort, in particular, has seen some amount of success, as it has been noted the hotline encounters anywhere from 200 to 800 calls per day, with a third of the callers citing emotional and/or psychological distress as the reason for their call.[3] However, due to the presence of a strong stigma against individuals suffering from mental health issues in the country, it is suspected that a large proportion of sufferers have yet to come forward and utilize the services provided.
Other official efforts to promote psychological well-being included the publication and popularization of guidelines on how to best maintain a healthy mental state, targeted at the general public. PFA was also made available to frontline health-care workers, although its efficacy would understandably be reduced due to the narrow time constraints placed on the frontliners engaged in PFA.
At a higher level, an economic stimulus plan was unveiled totaling RM250 billion (approx 57 billion USD) to aid struggling businesses, employees, and low-income individuals affected by the crisis. This would serve to reduce but not eliminate the psychological impact of the financial struggles brought on by the MCO.
Months later, on May 1, the government unveiled the fifth phase of the MCO, dubbed the conditional MCO (CMCO). The CMCO saw relaxations in many of the restrictions enforced in the earlier phases of the MCO. For instance, many businesses were allowed once again to operate in full. In addition, the previous restrictions on movement were also essentially lifted, allowing the public to travel freely within states, with the exception of barring travel into highly infectious areas. Although arguably well-intentioned, this drastic relaxation of the restrictions previously applied seemed premature and overzealous in the eyes of the general public. This was because a considerable number of new infections were still being reported daily. As a result, it inspired much anxiety in the local population.
We can only wait to see how the CMCO and any possible future phases will affect the mental health of the Malaysian public. At the time of writing this article, the CMCO has been extended until June 9. Not much more information is readily available due to the topical nature of the subject. However, it would be safe to speculate that the feelings of psychological unease and uncertainty due to the coronavirus outbreak and MCO will carry forward into at least the following months until a new and stable status quo is reached.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Abdullah JM, Wan Ismail WF, Mohamad I, Ab Razak A, Harun A, Musa KI, et al. A critical appraisal of COVID-19 in Malaysia and Beyond. Malays J Med Sci 2020;27:1-9.  |
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