In Malaysia, 1 out of 4 people is experiencing some kind of mental health issue or another. If you are facing any mental health issues, don't face it alone! Help is available.
What Kind of Services Do I Need and Who Should I See
The three main professional mental health service providers are psychiatrists, clinical psychologists, and counsellors. Each plays a distinct role and offer different kinds of services most effective for different mental health issues, with some overlapping of services. Knowing the difference and the services they offer can help you to decide which is the best for you.
Psychiatrists
Psychiatrists are medical doctors - people who have completed first their medical training and continued to receive specialised training and education in treating mental disorders. As they are medical doctors, they can diagnose, prescribe medications, and arrange for hospital admissions. In Malaysia, most of the major hospitals (public and private) have psychiatry service. Psychiatrists help people with mental disorders through medical means, but less focused on psychotherapy.
See a psychiatrist if you are experiencing serious mental and emotional crisis, such as feeling extremely depressed, anxiety, with suicidal thoughts etc.
Clinical Psychologists
Clinical psychologists receive their basic training in psychology and then a graduate or postgraduate training in clinical service (give direct psychotherapy services) for them to understand, treat, and help people in preventing mental, emotional, and behavioural, and psychosocial issues. Clinical psychologists may offer their service in the form of talk therapy (counselling) as part of their treatment. Most clinical psychologists can diagnose mental disorders as well, but they do not prescribe. There are quite some clinical psychologists in Malaysia, mostly working in privately run centres.
See a clinical psychologist if you are having some long standing mental, emotional, behavioural, or psychosocial issues.
Counsellors
Counsellors are trained in psychology and psychotherapy, with major emphasis on helping people to cope with the mental and emotional issues of everyday life. Counsellors almost exclusively focus on providing psychotherapy (talk therapy, art therapy etc.) to individuals, couples, or families. Though they cannot give diagnosis, most counsellors are also trained in recognising more serious mental issues i.e. disorders, and work in tandem with psychiatrists and clinical psychologists for mental disorder cases. In Malaysia, counsellors are governed by the Board of Counsellors Malaysia (Lembaga Kaunseling Malaysia), and are required to register with the board to legally offer counselling services.
See a counsellor if you are having difficulties in coping with the mental, emotional, and behavioural issues in your daily life.
Paraprofessional Services
There are also some paraprofessionals offering supportive care and services in Malaysia. Usually each organisation/centre focuses only on certain specific services and issues, or offer complementary supportive services. The most well known examples are Befrienders (first-line emotional responders for suicidal cases) and services set up by community/religious institutions. Most paraprofessionals are lay-people/volunteers who are not professionally/academically trained, but have undergone some form of training for the provided services.
Paraprofessional services are good in offering immediate and/or supplementary support. But it is encouraged to also seek out professional services for long term help and support.
NOTE: If you are still unsure of who you should see, it is encouraged to start with seeing a counsellor. Counselling services are usually the most accessible, and in many cases are capable of helping one deal with the issues one is facing. Counsellors are also trained to recognise more serious mental health issues, and should you need further mental help e.g. diagnosis and medication, counsellors can provide the most relevant and reliable information for one to seek further mental help.
What Kind of Services You Can Get
- Psychological assessments
- Diagnosis of mental disorders (psychiatrist and clinical psychologist)
- Medication (psychiatrist)
- Talk therapy and counselling
- Specialised therapy i.e. art therapy, play therapy etc.
- Couple counselling, marriage counselling, family counselling
- Group counselling
- Behavioural therapy
- Addiction counselling
- Single parenthood and domestic abuse cases
- Career guidance (counsellor)
- Emotional management, stress management
- Suicide prevention and help
- Psychoeducation
- and etc.
How to Get Help
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It is good to have a general idea on what kind of services you need/who do you want to see (psychiatrist, clinical psychologist, counsellor).
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You need a referral letter only if you are getting the service from a government hospital/clinic. See the section on getting a referral letter on how to get one.
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For private services, and counselling services in general, getting an appointment prior to your visit is adequate. Some services allow walk-ins (without appointment), but look up the centre's walk-in policy to avoid being turned away during your visit.
Getting a Referral Letter for Psychiatric Service
For most government services, a referral letter from a doctor is needed for you to see a specialist. But the procedure is really simple, so don't worry!
Generally, a referral letter from any GP (general practitioner) or medical doctor is accepted - doesn't matter the GP is from government or private practice. You can see your usual doctor to get the referral letter. When you go to the doctor (GP), you can directly inform the doctor that you are requesting for a referral letter to see a psychiatrist, most of the doctors would know what do you need and how to give you the letter. You might need to describe some of your conditions to the doctor, or the doctor might ask you a few questions on your condition (e.g. what are you feeling, how long has the feeling last, your sleep and appetite etc.) and the information will be included in the referral letter.
After obtaining the referral letter, you should then bring the letter to make appointment for your visit and/or your first appointment with your psychiatrist/psychologist.
What to Expect in Therapy
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The first visit is typically used for information gathering, to help your doctor/therapist know what you are facing, so it is useful to come prepared to talk. It may help to spend time before the appointment reflecting, then write something down or print something out and bring it along to your appointment.
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Follow-up visits are general catch-ups on your current status and how the prescribed medication (psychiatrists) is working for you. For psychotherapy and counselling, there may be a fixed cycle (number of sessions) for the whole process.
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To see a psychiatrist / clinical psychologist in government hospitals or clinics, a referral letter from medical doctor is needed. Referral letter can be obtained from doctors in government or private services.
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Here is a very well-written experience sharing and guide from one of our own community members on the experience of getting mental health services.