Shocking but very sad and true! There are many patients abandoned by their families at Hospital Mesra, Kota Kinabalu's mental hospital, for as long as 40 years.

The oldest male is 86 years old while the oldest female 79.

mental patient abandoned at hospital mesra in sabah 180609 06 "We have tried to trace their families and next of kin but unfortunately we have been unable to get any leads," said Hospital Mesra Director Dr Mohd Daud Dalip.

"Obviously, there are families out there who have their loved ones here. Why don't they approach us? Perhaps they are too ashamed to deal with the social stigma of accepting a mentally ill family member."

"Many of them have been cured without any signs of mental illness."

Figures from Hospital Mesra show that 738 patients last year were eligible for discharge, while there were 754 in 2007 and 761 in 2006.

The public perception that Mesra, which located in Bukit Padang, is for only "orang gila" (mad people) is the main challenge facing the hospital authorities.

In fact, mention Bukit Padang, and the word conjures up all sorts of negative connotations which the hospital authorities are trying to dispel.

They hope to step up its public awareness programmes, including the holding of seminars in co-operation with NGOs.

"It doesn't mean that you have mental problems if you attend such seminars," said Dr Daud. "These seminars are a way of being better prepared for the pressures in life. Also, the programmes will assist one to help family members, colleagues, relatives and neighbours cope with the ups and downs in life."

"Certainly, those who have mentally ill family members should attend these seminars."

Religious rituals

More importantly, Mesra wants to erase the public notion that those referred to the hospital are all confirmed mental patients.

"Mesra does not only provide care for the mentally ill," said Dr Daud. "We also have a counselling unit to help individuals and families to increase their awareness of themselves in relation to their environment and prepare themselves to overcome problems in a holistic manner."

Dr Daud wants to particularly promote Mesra's Counselling Unit to drive home the point that early treatment can delay or stave off the onset of chronic mental illness.

He deplores the social stigma attached to anyone seeking treatment at Mesra and this tends to discourage many who may be considered "gila" (mad).

Apparently, the desire to avert social stigma attached to mental illness can manifest itself in various ways ranging from denial to seeking out of the ordinary explanations.

For many Sabahans, as with other Malaysians, their first instinct when symptoms begin to manifest themselves or in family members, is to seek a spiritual explanation for the sudden change in behaviour.

Families in denial will often take their loved ones to places of worship, faith healers or bomohs (traditional medicine men).

mental patient abandoned at hospital mesra in sabah 180609 04 Common treatments include inducing the patient into a trance or even physically abusing them.

Age-old religious rituals and superstitions that have been passed on through generations are often relied on and places of worship are regularly packed with devotees looking for ways to rid a family member of "a charm".

In such cases, the mentally ill are referred to a general practitioner only when there is no improvement in the condition and other complications set in

Those seeking outpatient treatment at Hospital Mesra, according to records, show a steady trend in new cases except in 2004 when there was an almost 100 per cent spike.

Last year, 13, 359 outpatients sought treatment including 689 new cases and the remainder being repeat cases.

Dr Daud warned that depression will be the single most burdensome disease in the world by 2020, according to the World Health Organisation.

Oppression leads to depression

Currently, it is ranked number five in the world. This means that if people do not get enough treatment or medication for their sickness, "there will be a lot of depressed people in our community".

"Depression is an illness. It relates to stress and the inability to face everyday challenges in a normal manner," said Dr Daud.

"For example, when a person has high hopes in life and there is a breakdown of those hopes, then they will get depressed because they are unable to handle their stress effectively."

mental patient abandoned at hospital mesra in sabah 180609 03 Research indicates that about 10 percent of men and 20 percent of women will suffer from depressive illness during their lifetime.

It begins between the age of 20 and 40 and can also occur in children and older people.

The cycle of depression can hit other family members as well since depression usually tends to run in families.

"It is, therefore important to go for early counselling and avoid the onset of the inevitable", said Dr Daud.

But, it is estimated that only about half of those with mental illness seek medical help.

"In a clinic day, we see around 40 to 60 patients. We have three clinic days in a week. Our hospital is in-patient based and most of the patients suffer from schizophrenia (split personalities)," said Consultant Psychiatrist Dr Kumaraswami Kannan of Hospital Mesra.

"It is estimated that there are around 25,000 to 30,000 registered psychiatric patients in Sabah."

Hospital Mesra figures tie in with the National Health and Morbidity Study of 2006 which found that 16 percent of Malaysians have been diagnosed with mental illnesses, a startling figure of one in six persons.