KUALA LUMPUR - Having been diagnosed with depression since she was a teenager, online retailer Nina Razif, 35, had learnt to cope with it over the years - or so she thought.
Being under Malaysia's first two lockdowns after the pandemic started last year did not affect her mental health, but by the time the third one was imposed last month, Madam Nina's feelings of stress and depression began to overwhelm her.
"I started feeling really depressed and helpless when I saw more and more people, including some I know, suffering," she told The Straits Times.
During the lockdown, a friend attempted to take his life but she managed to reach him in time.
"This shook me to the core because years ago, I lost a close friend to suicide and it also brought me back to the time when I tried to take my own life," she said.
"I'm burnt out, and it's almost impossible to juggle parenting, work, school and taking care of my differently-abled child. And for the first time in my life, I'm tired of staying at home. I've been a good citizen but why are cases still increasing?"
Madam Nina is not alone.
The police recorded 468 suicides in the first five months of 2021, compared to 631 in 2020, and 609 in 2019. The three main causes cited were family problems, emotional pressure and finances.
Emotional support help centre Befrienders Kuala Lumpur recorded 20,575 calls from January to June this year, compared to 32,710 for the whole of last year, its publicity director Ardy Ayadali told ST.
When the first lockdown began in March last year, lasting until June, some 9,754 calls were received. This year, a total of 14,136 calls were made to the Befrienders during the same period, marking a 45 per cent surge.
Amid the mental health crisis, several groups are calling for the decriminalisation of attempted suicides, a crime under Malaysian law.
A parent whose teenage child had attempted to overdose on medication earlier this year told ST that she was shocked when the hospital told her to make a police report immediately about the incident, as this was a procedure.
"The police immediately wanted to come and interview my child, but I managed to convince them it was not an attempted suicide but merely a cry for help," said the parent, who declined to be named.
Earlier, she had rushed her child to a private hospital, but was told to go to a government hospital because they could not admit attempted suicide cases.
Datuk Dr Venugopal Balchand, chair of the National Coalition of Mental Wellbeing's Decriminalisation Focus Group, was quoted as saying by The Star daily on July 7: "It is not an issue of crime; victims should not be hauled up to the police or remanded. They should be sent to a medical institution."
"But our laws treat these individuals like criminals and deny them the psychological treatment that they need."
Malaysia has recorded over 836,000 coronavirus cases since the pandemic began, with daily new infections hitting a record high of 9,353 cases on Saturday (July 10).
The country is under a nationwide lockdown until the number of daily cases dips below 4,000.
While six states have had some restrictions eased this week, much of Klang Valley has been placed under the strictest form of lockdown due to a persistently high number of infections.
Dr Ng Yin Ping, a consultant psychiatrist from Pantai Hospital, Penang, said that she is seeing more patients with symptoms of increased stress, such as insomnia, anxiety, irritability and low mood, which may affect their daily functioning.
"Contributing factors include work stress or academic stress. Many are required to work from home so some may have difficulties focusing at home due to an unsuitable or noisy home environment."
Economic uncertainty, loneliness, fear of visiting health facilities due to the risk of infection, and the loss of one's usual coping mechanisms such as socialising, group sports and travelling also contribute to mental health problems, said Dr Ng.
The government needs to incorporate suicide prevention in its lockdown plans, the Consumers' Association of Penang (CAP) said.
"Never have Malaysians witnessed the despair of so many jobless, hungry and homeless people, having to depend on soup kitchens for their meals," CAP president Mohideen Abdul Kader was quoted as saying by The New Straits Times on July 1.
"Such a situation causes despair and hopelessness, besides the feeling of loneliness during the pandemic."
Government aid was insufficient as some may have already depleted their life savings and were jobless, he said.
While the number of people with mental health issues is rising, Malaysia is also grappling with a shortage of psychiatrists.
Health Minister Adham Baba on Tuesday (July 6) revealed that Malaysia's psychiatrist-to-patient ratio was only a tenth of the one per 10,000 recommended by the World Health Organisation (WHO).
There are a total of 400 psychiatrists in Malaysia, when there should be 3,100.
Dr Ng's advice for those who find it difficult to cope during the pandemic is to reach out to family and friends, or to call helplines or see mental health professionals for help.
"Stay connected with people, via video or phone calls. Remember to eat balanced meals, exercise and have adequate rest and sleep. Exercise caution when it comes to receiving or sharing information on social media as some news may be triggering or even harmful to your mental health.
"Finally, be kind to yourself. It's okay to not be okay, and to seek help from mental health professionals," she said.
Samaritans Of Singapore: 1800-221-4444
Singapore Association For Mental Health: 1800-283-7019
Institute Of Mental Health: 6389-2222
Care Corner Counselling Centre (Mandarin): 1800-353-5800
Tinkle Friend: 1800-274-4788