CHAPTER 1: INTRODUCTION

1.0 INTRODUCTION

Mental health is defined as a state of well-being in which every individual

realizes his or her own potential, can cope with the normal stresses of life, can work

productively and fruitfully, and is able to make a contribution to her or his community

(World Health Organization, 2001). People with good mental health are able to fully

enjoy day-to-day activities, people, and their environment. Meanwhile mental illness is a

disease of the brain that causes mild to severe disturbances in thought and behaviour,

resulting in an inability to cope with life’s ordinary demands and routines (Mental Health

Association in Forsyth County, 2016). Even though, mental illness can affect the daily

activities of a person but they can still work and function as people with healthy mental if

treated accordingly.

Mental illness touches so many people but a stigma still exists around mental

health. The stigma that continues to surround mental health problem prevents people

from getting the help they need. When you have flu you go to see a doctor for

consultation and medication. The same standards that apply to physical illness should

also be applied to mental illness. Stigma on mental illness has prevented people from

seeking the help that they needed. This research will study the awareness level of

different races in Malaysia and help seeking behaviour. Due to the stigma surrounding

mental health issue people are afraid to come forward about their situation and often

suffer in silence. If society are aware and stop the negative perception towards this

issue, people will not be reluctant to disclose their problems and seek professional helps

as they should.

Globally, an estimated 450 000 000 people of all ages suffer from depression

(World Health Organization, 2014). Although with so many people affected by this

problem however a stigma still surrounds it. Stigma is a negative perception that created

prejudice which leads to stereotype and discrimination among a particular group of

people. Thus making this an important research to investigate the different races in

Malaysia level of knowledge about this issue. Subsequently, study the likelihood to seek

help and express their issues. Malaysia is a multicultural country hence a study

concerning about the different perception and acceptance about this issue need to be

undertaken to decide a method to overcome this stigma.

2.0 ISSUE/PROBLEM STATEMENT

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Stigma is a mark of disgrace that sets a person apart. When a person is

labelled by their illness they are seen as part of a stereotyped group. Negative attitudes

create prejudice which leads to negative actions and discrimination. Stigma is the biggest

barrier to mental health care. It might be caused from lack of adequate knowledge about

mental illness. Majority of people hold negative attitudes and stereotypes towards people

with mental illness. Often the negative stereotypes involve perceptions that people with

mental illness are dangerous. More, people with mental health issues recognize and

internalize this stigma and develop a strong “self-stigma.” This self-stigma will often

undermine self-efficacy. This issue has interest me to conduct a research on how 21st

century society view mental illness and their level of awareness.

These negative attitudes often manifest as social distancing with respect to

people with mental illness. This stigma and social distancing have the potential to worsen

the well-being of people with mental illness in several ways. This bias is not limited to people

who are either uninformed or disconnected from people with mental illness; in fact health

care providers and even some mental health professionals hold these very same

stereotypes. Overall, increased awareness is probably one of the most important things that

can be done to counteract this problem which this research hoped to solve.

There are 450 million people worldwide who suffer from mental health

conditions but the number of people who seeks professional helps and treatment are still

low. This problems has lead me to conduct a study about this problem to see what is it that

holding these people from getting the treatment that they needed. From the 450 million

people that diagnosed with mental health issue majority do not receive any form of care.

This includes people in developing countries receiving no form of care.

3.0 RESEARCH OBJECTIVES

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The main objective of this research is to investigate society view on mental

illness and help seeking behaviours. Besides that, we also identify the specific objectives

which are:

To find out the level of awareness in society regarding mental illness

To determine the number of possible sufferers seeks for mental treatment

To study the different races attitude on this issues

4.0 RESEARCH QUESTION

In fulfilling those all objectives, there were a several research questions that are related

to guide the implementation of this study. The following are the research questions:

What is the level of awareness in society regarding mental illness?

Would the mental illness sufferers seek professional helps?

Do different races have different view on mental illness and help seeking

behaviour?

5.0 RESEARCH SIGNIFICANCE

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This study will benefit government and organizations that had been working to

increase society knowledge about the topic. Organization such as Malaysia Mental Health

Association can use this research to improve their method in awareness campaign.

Improvement in the facilities and treatment can be revised as to improve help seeking

behaviour from mental illnesses. Psychiatric and professionals that dealt with mental illness

will value this study as they can understand what has been keeping them from seeking for

treatment. It is also crucial that those on the front lines of working with people with mental

illness receive the education and support needed to help manage bias. Programs need to

be developed to teach health care professionals to identify and manage their biases toward

mental illness so as not to interfere with clinical care.

CHAPTER 2: LITERATURE REVIEW

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1.0 INTRODUCTION

In this chapter, a more depth explanations about mental illness, help

seeking behaviour and the comparison between differences races will be discussed. This

chapter is a section of what has been published on the research topic by accredited

scholars and previous researchers. This part is an evaluative report of information found in

the literature related to my selected area of study.

2.0 LITERATURE REVIEW

2.1 Mental Health Literacy

A research by Jasvindar Kaur, et al. (2014) revealed that almost one in

five Malaysian adolescents are depressed. This means that someone you know

might be facing this problem right now. There are over 200 classified forms of mental

illness, among them are; depression (the most common), anxiety, eating disorder,

schizophrenia, psychosis, obsessive compulsive disorder (OCD), phobias, bipolar,

panic attack, autism, self-harm, dementias and many more. Mental illness touches

millions of people in the world but it often goes untreated or unrecognized. One

reason for this condition is because the insufficiency of knowledge about psychiatric

illness and treatment options for those illnesses (Swami, Loo & Furnham, 2009).

Mental illness literacy is the knowledge and belief that recognized mental illness

problems. Even in today’s 21st century world, Malaysian citizen are often lacking in

knowledge regarding this issue.

Everyone has one of those days where they feel sad and blue; it is part of

human experience. But for normal people this happen only for about a short period of

time and it passed. But in some cases it affects the person so much that they started

to develop a depression. Many researchers has study the factors that affecting

someone to have mental illness. Jasvindar Kaur, et al. (2014) research among

school going in Malaysia find that feeling lonely, Indian ethnicity, using drugs, and

being bullied were significantly associated with depressive symptoms. Lack of

parental supervision, alcohol use, and tobacco use were also significant risk factors.

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2.1.1 Self-perception

Self-stigma or internalizing is a negative thinking or perception that a

person has for themselves. Mental illnesses perceive their illness as a sign of

weakness and incompetence stemming a feel of small and inferior than other normal

people. They often withdraw their self from social interaction because they feel better

off than being socially distance by society. This negative way of thinking that one has

for themselves causing them to feel afraid to come out about their illness and seeks

treatment. By feeling so it will impede their chance to improve their mental health

condition. This has become some sort of a double edged sword battle, because of

the negative perception that both public and themselves has.

Watson, et al. (2007) persons with mental illness may internalize mental

illness stigma and experience diminished self-esteem and self-efficacy. This process

is known as self-stigma. This will resulting in limited prospect of recovery. One

cannot avoid from having a negative perception about their own mental health

condition, but it is up to them to either keep on feeling that way or empower it and

change it. “It is comprised of endorsement of these stereotypes of the self (e.g. “I am

dangerous”), prejudice (e.g. “I am afraid of myself”), and resulting self-discrimination

(e.g. self-imposed isolation)”. Corrigan, & Roa (2012). The key to challenge self-

stigma is empowerment.

In the research by Watson, et al. (2007) they also discussed about self-

concurrence. It is a situation whereby, an individual agrees with the stereotype that

public often endorsed to mental illness. Stereotype agreement happens when an

individual accept the common public stereotypes (eg, people with mental illness are

a burden). The process specifically becomes self-stigmatizing with the addition of

stereotype self-concurrence in which an individual applies the culturally internalized

beliefs to him or herself (I am a burden to my family). Negative perception that an

individual has for themselves affect the quality of daily living and meaning in life.

Subsequently, it will hinder efficient and effective recovery from mental health

problems.

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3.1.1 Public perception

To know the level of society knowledge regarding mental illness, we first

must grasp their perception about this issue. Research done by Swami (2012)

investigates the ability of respondent to recognized mental illness symptom.

Respondents were randomly assigned to receive a vignette either a female or male

that describe individuals with symptoms of major depression, without use of clinical

terminology. Only half of the respondent able to identified the symptom while the

other is unsure or stated that the person in the vignette did not has mental disorder.

This shows that the mental illness literacy among society is still depleted.

Angermeyer, Holzinger, & Matschinger (2009) run a research to examine

the development of mental health literacy and the desire for social distance towards

people with schizophrenia and major depressive disorder in Eastern Germany over a

time period of eight years. It is found that while there was an increase in the mental

health literacy of the public, the desire for social distance from people with major

depression and schizophrenia remained unchanged or even increased. The findings

shown that even they’re aware of the condition of mental illness they still surrounded

with the negative perception that has been associated with mental illness.

Depression is the most prominent and common diseases in mental health

problems. Depression is caused by many factors such as study load, work

environment, physical illness, bullied, and many more. Ariff Fadzil (2013) studies the

level of anxiety and depression during pregnancy among antenatal mothers. There’s

also literature that studies the perception that public will have between mental illness

patients and diabetic patients. Between these two diseases we can estimate which

will get a much more negative feedback. Depression can be associated with many

factors and there are numerous researches about the different causes that might

affect one mental health.

Ainul Hanafiah, & Bortel (2015) discussed about the four main

perpetrators that discriminates against mental illnesses are; family, friends,

employers, and health workers. Some of the mental illness family couldn’t accept the

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fact and feel shameful that their family member is not mentally healthy. They often

avoid disclosing the situation to relatives or neighbours in order to uphold the family’s

dignity and the topic become taboo. For friend perpetrators, the respondent from the

study stated that the minute the friend knows about the mental health condition they

begin to distant themselves. In the employment aspect, mental illnesses are

associated with low workforce productivity and unreliable. This stigma has limit the

job opportunity for the illnesses and lead to them not being able to provide for

themselves. In aspect of mental health worker, despite their role in helping with the

recovery they still has negative perceptions. Health worker would use non-medical

terms such as “crazy” or “nuts”.

Mental illness is a serious topic that needs to be known to all level of

societies. The literacy of this topic could help illnesses or potential patient to seek

treatment and care that they needed. However with the stigma associated with

mental illness it became the biggest barrier that prevents people from getting

treatment or retaining their treatment. Most people think that depression is something

that people choose to have by overthink. To get the fact straight having mental

illness is not an option just like having a flu, cancer, or fever. Besides that, people

don’t think that mental illness serious because unlike physical illness we can see the

wound or injury. Just because you can’t see someone’s illness doesn’t mean it

doesn’t exist.

2.2 Help seeking behaviour

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The level of mental health awareness in society contributes to a better

help seeking behaviour. The recognition of mental illness without anticipating stigma

will encourage adolescents’ help-seeking behaviour. The current hurdle in getting

right care and treatment for mental illness is because of the negative perceptions.

Illnesses feel ashamed to open up about their feeling, emotions, and conditions to

family or friends because fear of being rejected and look down to. Research by

Gearing (2013) finds that personal stigma expressed by the respondent tended to be

lower than the level of stigma the respondent believed others in the community

would hold may indicate that they simply feel freer to share the biases of others than

their own. Personal level stigma may have greater effects on females whereas public

stigma may exert more influence on males.

2.2.1 Facility and treatment

In Malaysia the mental health facility and professional availability is still

low. According to a publication by World Health Organization (2014) for 100, 000

citizens the psychiatric workforce is only 0.8, compared to developed country like

United States that has 12.40. We could only do so much to increase the awareness

of society knowledge but without adequate mental health facility it’s improvident. This

situation may be associated with society in taking traditional way in treating mental

illness. There are numerous studies that investigate about the relationship between

mental health and religious belief (Nurizan Yahaya, 2012; M. S. Nurasikin, 2012).

Mental illnesses often suffer alone and in isolation. In a certain country in

Southeast East Asia found that mental illnesses were physically restrains or under

confinement in a hut or at their home. This medieval method of handling mental

illnesses is disturbing. Violence, concern about the person wandering off or running

away and coming to harm, concern about possibility of suicide, and the unavailability

of a caregiver are among the reasons why these mentally ill person were restrain

(Harry Minas & Hervita Diatri, 2008). Indonesia is the examples of country that apply

this practice although it mostly happened in rural area. Inadequate mental facility and

cost of treatment is among the reasons why they choose such method.

Globally, more than 70% of people with mental illness receive no

treatment from health care staff (Henderson, C., Evans-Lacko, S., & Thornicroft, G.

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(2013). Approaches in equipping society with a better knowledge about mental

illness will make sure that the people with symptoms will get a proper treatment that

they needed. This is because lack of knowledge to identify features of mental

illnesses, ignorance about how to access treatment, prejudice against people who

have mental illness, and expectation of discrimination against people diagnosed with

mental illness. Those are the reasons for treatment avoidance and delays for care.

The biggest hurdle of getting treatment and care is also because of stigma.

Adolescents who were unable to recognize the mental illness in the

vignette, those in the recognition of mental illness group reported they were

significantly more likely to seek help from friends and expressed an increased

likelihood to seek help from professionals. Those in the labelling the vignette as

schizophrenia group reported they were significantly less likely to exhibit help-

seeking behaviour (Yamasaki S, et. al. 2016). It can be concluded that people who

has experience mental disorder will more likely to not seek for professional helps.

The respondent that have knowledge about schizophrenia avoid from seeking help it

would trigger perception of dangerousness and negative stereotype.

2.3 Comparison between different races in Malaysia

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A study about public knowledge and beliefs about depression among

urban and rural society in Malaysia were undertaken. There are three literatures that

focuses on the three most largest race in Malaysia which are Malay, Chinese, and

Indian. Viren Swami, Phik-Wern Loo & Adrian Furnham (2009) study the Malay

knowledge and beliefs about depression. Phik-Wern Loo & Adrian Furnham (2012)

study the Chinese mental health awareness. Afterwards, Viren Swami, Phik-Wern

Loo & Adrian Furnham (2013) also conduct a research about the Indian race mental

illness awareness. The three researches compare the awareness of mental health

between urban and rural population. Findings found that the urban race has shown

higher level of mental health literacy rather than rural area.

Malay population which is the largest race in Malaysia often associated

mental illness with supernatural causes, God punishment, and excessive mental

exertion (Tahir M Khan, Syed A Sulaiman, & Mohamed A Hassali, 2010). It is also

found that Chinese females had a comparatively better knowledge of the symptoms

of depression in comparison with Malays and Indians. The respondents that

participate in the study are non-medical Universiti Sains Malaysia student.

Regardless of race Malaysian still low in mental health literacy and there should be a

proactive campaign that will help to promote better understanding should be done by

the government and other related agencies.

3.0 ANALYSIS REVIEW

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Literatures from previous publications are collected from electronic

bibliographic UiTM database and Goggle Scholar. The following combination of keywords

were used in searching process; mental illness, mental health, mental disorder, help-

seeking, care-seeking, self-stigma, and Malaysia. By using these search terms hundreds of

journal articles were found. Abstracts reading were done to filter the relevant journal article

to be used in literature review. Twenty (20) articles met my criteria and are the focus of my

research. From the 20 articles that I have chosen, a couple of additional article were gain

from the citation and references.

A total of twenty three (23) articles were used as a reference in this literature

review (see appendices). Most of the article use discussed about the mental health literacy

among society. A number of thirteen (13) articles focus on that topic and main themes of

mental health literacy while also discuss other variables. Articles that studies about the level

of awareness towards mental health illness in urban and rural Tan & Yadav (2012); Swami,

Loo & Furnham (2009). Loo & Furnham (2012). I also used articles that examine the

likelihood and trend of help-seeking strategies Yamasaki, et al. (2016); Henderson, Evans-

Lacko, & Thornicroft, (2013); Teh, et al. (2014); Gearing, et al. (2014). Besides that the

literature also discussed about the types of help they prefer.

Koenig, Zaben, & Khalifa (2012); Nurasikin, et al. (2012); Nurizan Yahya

(2012) examined the relationship between religious and spiritual well-being with the better

mental health conditions. Besides that I also used literature about self-stigma to understand

it more Watson, et al. (2007); Corrigan & Rao (2012). There are many literatures that help

me with my information gathering.

4.0 THEORETICAL FRAMEWORKS

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The theoretical framework may give some clear description about the

dependent and independent variables of this study and the relationship between those two

different variables which can give some significant in conducting this research. According to

Kumar (2014), the independent variable is defined as the variable that bringing change in a

situation whereas the dependent variable is been known as the outcome or change brought

by the independent variable. There are three elements of the independent variables that

have relationship between the dependent variables in which can be influence whether in the

positive or negative way in this research as shown in Figure 1.

The independent variable is the cause supposed to be responsible for

bringing about change in a phenomenon or situation. In this research the independent

variables are mental illness literacy, help-seeking behaviour, and races. This independent

variable can be tested by giving out a method to test it. Meanwhile, dependent variable is a

variable whose outcome or change brought by the independent variable.

13 | P a g eMental illness literacy

-Individual awareness and knowledge about the correct facts regarding mental health problems.

Figure 1: Independent and dependent variables

5.0 CONCLUSION

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Mental Illness literacy and help seeking behaviour: Comparison

between difference races

Mental illness literacy

-Individual awareness and knowledge about the correct facts regarding mental health problems.

Comparison between different races in Malaysia

- Assessing the Malay, Chinese, and Indian that make up the largest race on their perception about mental illness.

Help seeking behaviour

- The likelihood of the mental illnesses to seek for medical treatment or professional helps.

Treatment and facility

This research study the awareness level of different races in Malaysia and

help seeking behaviour. Due to the stigma surrounding mental health issue people are

afraid to come forward about their situation and often suffer in silence. If society are

aware and stop the negative perception towards this issue, people will not be reluctant to

disclose their problems and seek professional helps as they should. Current literature

review mostly focus on the stigma rather than comparisons between cultural differences

between races. Hence, make this research significance. In a nutshell, we can conclude

that better mental illness literacy will enhance the seeking of professional helps in terms

of help seeking behaviour.

CHAPTER 3: RESEARCH METHOD

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1.0 INTRODUCTION

In this chapter the research methodology used in the study is described. The

geographical area where the study was conducted, the study design and the population and

sample are described and the instrument used to collect the data. The purpose of the

methodology chapter is to give an experienced investigator enough information to replicate

the study. Research design is used to structure the research and to show how all of the

major parts of the research project, including the sample, measures, and methods of

assignment, work together to address the central research questions in the study.

2.0 STUDY DESIGN

A traditional research design is a blueprint or detailed plan for how a research

study is to be completed by operationalizing variables so they can be measured, selecting a

sample of interest to study, collecting data to be used as a basis for testing hypotheses, and

analysing the results. The study design is used to describe the type of design that is going to

be adopted to undertake the study. For this research, the study design that has been used is

quantitative study design. According to Nokuthaba (2009), quantitative research focuses on

gathering numerical data and generalizing it across groups of people. Quantitative research

is generally associated with the positivist or post-positivist paradigm. It usually involves

collecting and converting data into numerical form so that statistical calculations can be

made and conclusions drawn (Freitag, 2009). It is also a means for testing objective theories

by examining the relationship among variables.

These variables in turn can be measured, typically on instruments, so that

numbered data can be analysed using statistical procedures. It can allow for greater

objectivity and accuracy of results. Generally, quantitative methods are designed to provide

summaries of data that support generalizations about the phenomenon under study. In order

to accomplish this, quantitative research usually involves few variables and many cases,

and employs prescribed procedures to ensure validity and reliability. Personal bias can be

avoided by researchers keeping a distance from participating subjects and employing

subjects unknown to them.

Quantitative research is used to quantify the problem by way of generating

numerical data or data that can be transformed into useable statistics. It is used to quantify

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attitudes, opinions, behaviours, and other defined variables and generalize results from a

larger sample population. Quantitative research uses measurable data to formulate facts

and uncover patterns in research. Quantitative data collection methods are much more

structured than qualitative data collection methods. Quantitative data collection methods

include various forms of surveys – online surveys, paper surveys, mobile surveys and kiosk

surveys, systematic observations, and etc.

The study design that has been conducted is using number of contacts types

which is cross-sectional studies. The cross-sectional study design is the most commonly

used design in the in the social sciences. This design is best suited to studies aimed at

finding out prevalence of a phenomenon, situation, problem, attitude or issue, by taking a

cross-sectional of the population. The cross-sectional studies also have been chosen

because it requires less time to conduct. This design will be chosen to meet the objectives

of this research, which is mainly to measure the mental health literacy and help seeking

behaviour in Malaysian multiracial races.

3.0 OPERATIONAL VARIABLES

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Variable is some concept that can be measured. As defined by Kerlinger

(1986), a variable is a property that takes on different values. Putting it redundantly, a

variable is something that varies. A variable is a symbol to which numerals or values are

attached. As defined by Black & Champion (1976) variable is a rational units of analysis that

can assume any one of a number of a designated sets of values. As per Ranjit Kumar

(2005), variable is an image, perception or concept that is capable of measurement and

hence capable of taking on different values. Variables need to be understood clearly in order

to measure any concept. These variables are classified into three broad categories which

are dependent variables, independent variables, and extraneous variables.

These are the effect variables whose value depends upon some causal

characteristics. In this research the differences races mental health literacy and help

seeking behaviour is defined as the dependent variable. This mental health literacy and help

seeking behaviour can be measured with the help of independent variables and extraneous

variables.

Meanwhile independent variables are the cause supposed to be responsible

for bringing about change in a phenomenon or situation. These are the variables, which are

responsible for bringing out any changes on the dependent variable. In this research the

differences races mental health literacy and help seeking behaviour is a dependent variable

and is affected by several attributes. Following are the major areas which affects the

dependent variables and so considered independent variable in this study:

Mental illness literacy – The level of society awareness about the

mental health issues.

Help seeking behaviour – The likelihood for society to seek medical

and professional help for their problem.

Comparison between difference races – What is the Malay, Indian,

and Chinese opinion and view about this issue.

To measure the relationship of dependent variable with independent

variables many times we have to measure some independent variables, which may affect

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the relationship positively or negatively. Such variables are called as intervening or

extraneous variables. Extraneous variables are those variables, which may affect the

dependent variable. Such variables may not cause any change directly to the dependent

variable but if measured can give some effect on the dependent variable. In this study the

extraneous variables are:

Area population (urban or rural)

Educational level

Age (opinion may differ with age)

4.0 SELECTING A SAMPLE

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According to Sekaran and Bougie (2010), the population refers to the entire

group of people, events, or things of interest that the researcher wishes to investigate and

make inferences based on sample statistics. The study population for this research is

multiracial Malaysian from Klang Valley with age range from 20 to 30 years old. A sample

size of 30 participants is going to be given to people in the Klang Valley area using

probability sampling technique in which units of the sample are selected on the basis of

convenience.Quantitative research tends to rely on probability sampling techniques and one

of the famous sampling techniques is simple random sampling, which will be used in this

research.

In simple random sampling, each member of population is equally likely to be

chosen as part of the sample. It has been stated that the logic behind simple random

sampling is that it removes bias from the selection procedure and should result in

representative samples (Gravetter and Forzano, 2011, Dudovski, 2015). Simple random

sampling is the most straightforward probability sampling strategy in quantitative research.

This method was also used in order to obtain a large number of completed questionnaires

quickly and economically due to time and budget constraints.

5.0 DATA COLLECTION METHODS

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Data collection method is a process to gather measuring information on

variables of interest, in an established systematic fashion that enables one to answer stated

research questions, test hypotheses, and evaluate outcomes. This method is important in

research study. There are many ways and instruments to collect data in research. The

instrument that is chosen by the researcher depends on the research question that is being

asked. For examples of data collection instrument includes questionnaire surveys,

interviews, tests, observations and others.

In this research, questionnaire survey has been chosen as a primary

source. It has been developed based on theoretical framework that is proposed by the

researcher. The purpose of using questionnaire survey to collect data is because this

research is more suitable in preparing a standardized data from the questions, without

requiring personal or face-to-face interaction with each respondent. Furthermore, it would be

easier to distribute it among respondents. It is also more convenient for respondents give

their feedback because they are only required to answer straightforward and brief questions.

The questionnaire survey will be strategically prepared using structured question formats,

with some instructions or guidance is given to the respondents. This can be as describe as

close-ended questions because the questions will be short and precise.

The questionnaire consists of three main parts which are personal

information, mental health literacy, and help seeking behaviour. In the personal information

part, a brief information about the participant were asked without disclosing their name. In

the part B section, questions regarding the correct recognition and opinion about mental

illness were asked. Meanwhile, in part C section, question regarding the likelihood of

seeking for help were ask by giving out a particular persons options to choose from. The

comparison between different races opinion or view will be determine by the personal

information that they provided in the race area.

6.0 ANALYSIS METHOD

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Data analysis method is one process that able to help researchers in

summarize the conclusion of the study. In this survey, I will distribute a questionnaire to get

the respondents. The design of the questionnaire was aimed to be user friendly and be

easier for them to answer it thus the questionnaire only contains close-ended questions

because the questions will be short and precise. A five-point Likert scale ranging from very

unsatisfied and very satisfied was used to measure each of indicant.

Data that have been collected then will be edited by ensure that the data

is clean and free from inconsistencies and incompleteness. Editing is consists of scrutinizing

the complete research instrument to identify and minimize, as far as possible, errors and

incompleteness of information. All the answers on the questionnaire will be examined each

questions answered by one respondent at a time.

Then the data will be analysed by using Statistical Package for the Social

Science (SPSS). SPSS is a computer application or software that will be used to measure

the internal consistency or reliability of a score for the data that will be collected later. SPSS

is also a data management and analysis program designed to do statistical data analysis.

The data will be coded for the SPSS software and researcher will conduct a descriptive

frequency analysis including standard deviations, frequencies, and means to better

understand the characteristics of the sample. Then, a correlation matrix table will be

produced to examine the linear associations between the dependent and independent

variables used in the research.

The most appropriate statistical tests used by the researcher were t-tests,

multiple regressions and correlation used for the data analysis to test the relationships

between independent and dependent variable as recommended by Sekaran (2010). SPSS

is a Windows based program that can be used to perform data entry and analysis and to

create tables and graphs. It is capable of handling large amounts of data and can perform all

of the analyses covered in the text and much more. In addition, SPSS is commonly used in

the Social Sciences and in the business world, so familiarity with this program should serve

well in the future.

7.0 EXPECTED OUTCOME

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The main objective of this research is to investigate society view on mental

illness and help seeking behaviours to better understand this issue. Mental health has

been something that people talk to in private without wanting other people to eavesdrop

and the topic often become taboo for family members and friend that associates with

mental illness. With this researched we hoped to changes society perception towards

mental illness. Besides that, a noticeable level of awareness from difference races is

protruded seen. Malay, Chinese, and Indian all has difference opinion and view about

this topic and there is a particular race that has better knowledge than the other. With

this research we hope to close the gap. In addition, I also hoped that this research will

benefit people that work front line with the mental illnesses to better understand them. I

also wished that the current stigma that surrounds this topic will be reduce. Government

and organization campaign towards reducing the stigma can be improved if these parties

learned what makes people view this topic that way, which I hoped this research will

help to uncover.

8.0 CONCLUSION

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In a nutshell, this research will provided a better understanding on society

opinion and view about this issue. The outcome from this research will benefit several

parties that working front line with the mental illnesses, government, organization that

deals with mental health issues, and etc. This research also hoped to reduce the stigma

that are often associated with mental health patient.

REFERENCES

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Angermeyer, M., Holzinger, A., & Matschinger, H. (2009). Mental health literacy and attitude

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Gearing, R. E., MacKenzie, M. J., Ibrahim, R. W., Brewer, K. B., Batayneh, J. S., &

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Seeking from Friends in Late Adolescence. PLOS ONE PLoS ONE, 11(3).

doi:10.1371/journal.pone.0151298

28 | P a g e

PERSONAL INFORMATION

1. Age: 20-23 yrs 23-26 yrs 26-28 yrs 28-30 yrs

2. Gender: Male Female

29 | P a g e

APPENDICES

3. Race: Malay Indian Chinese

PART A : MENTAL ILLNESS LITERACY

Please circle the number provided which comes closest to saying how you feel about each statement.

1. Strongly agree2. Agree3. Not sure but probably agree4. Not sure but probably disagree5. Disagree6. Strongly disagree

1. Nervous breakdowns usually result when people work too hard.1 2 3 4 5 6

2. Mental illness is an illness like any other.1 2 3 4 5 6

3. Most patients in mental hospitals are not dangerous.1 2 3 4 5 6

4. Although patients discharged from mental hospitals may seem all right, they should not be allowed to marry.1 2 3 4 5 6

5. If parents loved their children more, there would be less mental illness.1 2 3 4 5 6

6. It is easy to recognise someone who once had a serious mental illness.1 2 3 4 5 6

7. People who are mentally ill let their emotions control them: normal people think things out.1 2 3 4 5 6

30 | P a g e

8. People who were once patients in mental hospitals are no more dangerous than the average citizen is.1 2 3 4 5 6

9. When a person has a problem or a worry, it is best not to think about it, but keep busy with more pleasant things.1 2 3 4 5 6

10. There is something about mental patients that makes it easy to tell them from normal people.1 2 3 4 5 6

11. Even though patients in mental hospitals behave in funny ways, it is wrong to laugh about them.1 2 3 4 5 6

12. People who are successful in their work seldom become mentally ill.1 2 3 4 5 6

13. People would not become mentally ill if they avoided bad thoughts.1 2 3 4 5 6

14. More tax money should be spent in the care and treatment of people with severe mental illness.1 2 3 4 5 6

15. A heart patient has just one thing wrong with him, while a mentally ill person is completely different from other patients.1 2 3 4 5 6

16. Mental patients came from homes where the parents took little interest in their children.1 2 3 4 5 6

17. People with mental illness should never be treated in the same hospital as people with physical illness.1 2 3 4 5 6

31 | P a g e

18. The best way to handle patients in mental hospitals is to keep them behind locked doors.1 2 3 4 5 6

19. To become a patient in a mental hospital is to become a failure in life.1 2 3 4 5 6

20. If the children of normal parents were raised by mentally ill parents, they would probably become mentally ill.1 2 3 4 5 6

21. Every mental hospital should be surrounded by a high fence and guards.1 2 3 4 5 6

22. Mental illness is usually caused by some disease of the nervous system.1 2 3 4 5 6

23. Although some mental patients seem all right, it is dangerous to forget for a moment that they are mentally ill.1 2 3 4 5 6

24. Sometimes mental illness is punishment for bad deeds.1 2 3 4 5 6

25. One of the main causes of mental illness is a lack of moral strength or will power.1 2 3 4 5 6

PART B: HELP SEEKING BEHAVIOUR

If you were having a personal or emotional problem, how likely is it that you would seek help from the

following people? Please circle the number provided which comes closest to describe your intention to

seek help from each help source that is listed.

32 | P a g e

1. Strongly agree

2. Agree

3. Not sure but probably agree

4. Not sure but probably disagree

5. Disagree

6. Strongly disagree

1. Intimate partner (Eg: girlfriend, boyfriend, husband, or wife)

1 2 3 4 5 6

2. Friend (not related to you)

1 2 3 4 5 6

3. Parents

1 2 3 4 5 6

4. Colleague

1 2 3 4 5 6

5. Other relative/family member

1 2 3 4 5 6

6. Mental health professional (Eg: psychologist, counsellor, social worker, and etc)

1 2 3 4 5 6

7. Phone helpline

1 2 3 4 5 6

8. Doctor

1 2 3 4 5 6

9. Religious help (Eg: Priest, Monk, Imam, and etc)

1 2 3 4 5 6

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10. I would not seek help from anyone

1 2 3 4 5 6

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No Author Title Objectives Methods Findings

1 Kok Leong Tan

Hematram Yadav

Depression among the

urban

poor in Peninsular

Malaysia:

A community based

cross-sectional study

To study the factors of

depression associated

with urban poor

Interview

Questionnaire

(The Patient

Health

Questionnaire

(PHQ-9))

37 out of 301 respondents had

depression. The prevalence of

depression among people aged 18

years and above in the urban poor

in Kota Damansara, Selangor was

12.3% and associated with age,

gender, years lived in the area and

exercise.

2 Viren Swami

Adrian Furnham

Public Knowledge and

Beliefs About

Depression Among

Urban and Rural

Malays in Malaysia

This study examined

knowledge and beliefs

about depression among

Malaysian Malays varying

in socioeconomic status

Questionnaire Results showed that urban

participants were more likely to use

psychiatric labels (‘depression’) for

the two vignettes, whereas rural

participants tended to use more

generic terms (‘emotional stress’)

3 Viren Swami Mental Health Literacy

of Depression: Gender

Differences and

Attitudinal

Antecedents in

a Representative

British Sample

To study mental health

literacy and attitudes

towards depression

Interview

Vignette

Respondents were more likely to

indicate that a male vignette did not

suffer from a mental health disorder

compared to a female vignette, and

women were more likely than men

to indicate that the male vignette

suffered from a mental health

35 | P a g e

disorder. Attitudes toward persons

with depression were associated

with attitudes toward seeking

psychological help, psychiatric

skepticism, and anti-scientific

attitudes.

4 Tahir M Khan

Syed A Sulaiman

Mohamed A Hassali

Mental health literacy

towards depression

among non-medical

students at a

Malaysian University

To evaluate the

knowledge and perception

of depression among

students of University

Sains Malaysia (USM), in

Penang.

Interview

Questionnaire

A moderate level of knowledge

about the symptoms of depression

and a cursory knowledge of its

therapy were observed.

5 Jasvindar Kaur

Siew Man Cheong

Balkish Mahadir Naidu

et al.

Prevalence and

Correlates of

Depression Among

Adolescents in

Malaysia

To determine the

prevalence and correlates

of depression among

school-going

adolescents in Malaysia

Questionnaire The study revealed that almost 1 in

5 Malaysian adolescents are

depressed. Feeling lonely, Indian

ethnicity, using drugs, and being

bullied were significantly

associated with depressive

symptoms. Lack of parental

supervision, alcohol use, and

tobacco use were also significant

risk factors.

36 | P a g e

6 Phik-Wern Loo

Adrian Furnham

Public knowledge and

beliefs about

depression among

urban and rural

Chinese in Malaysia

The study compared

knowledge and beliefs

about depression among

urban and rural Chinese

in a Malaysian sample

Questionnaire

Vignette

The urban Chinese were more

likely to identify depression as the

problem in the vignette.

The results indicated that the

causes most strongly endorsed

were stress and pressure, and

standard treatments rated the

highest as treatments for

depression. Overall, depression

literacy was moderate for Chinese

Malaysians. The results are

discussed in relation to Chinese

cultural beliefs about depression.

7 Amy C. Watson

Patrick Corrigan

Jonathon E.

et al.

Self-Stigma in People

With Mental Illness

To examine stereotype

agreement as a mediator

of GI and PL on stigma

self-concurrence (SSC);

SSC as a mediator of GI

and PL on self-efficacy;

and SSC as a mediator of

GI and PL on self-esteem.

Questionnaire Findings provide partial support for

the proposed meditational

processes and point to GI, PL, and

stereotype agreement as areas to

be considered for intervention. Our

study of self-stigma clearly

indicates that the self-stigma

process varies between individuals

and points to GI, PL, and

stereotype agreement as important

37 | P a g e

points of intervention.

8 Harold G. Koenig

Faten Al Zaben

Doaa Ahmed Khalifa

Religion, spirituality

and mental health in

the West and the

Middle East

To investigate whether

content’ of religious

beliefs may influence

mental health outcomes.

Quantitative Greater religious involvement in

these faith traditions is associated

with better mental health.

9 M. S. Nurasikin

L. A. Khatijah

A. Aini

et al.

Religiousness,

religious coping

methods and distress

level among

psychiatric patients in

Malaysia

To determine the level of

religious commitment and

coping methods in

psychiatric patients and

its relationship with

distress level

Cross-

sectional

Psychiatric patients were religiously

committed and used more positive

religious coping methods. Practices

of negative religious coping, severe

psychiatric symptoms and

anxiety/depression were

associated with higher distress.

10 Ariff Fadzil

Kartini Balakrishnan

Rosdinom Razali

et al.

Risk factors for

depression and

anxiety among

pregnant women in

Hospital Tuanku

Bainun, Ipoh,

Malaysia

To determine the level of

anxiety and depression

during pregnancy.

Cross-

sectional

The prevalence of anxiety and

depression disorders among

antenatal mothers using diagnostic

clinical interview was 9.1% and

8.6%, respectively. Factors

associated with antenatal anxiety

were marital status (being

unmarried), positive history of

mental illness, gestational age (<20

weeks), unplanned pregnancy and

depressive comorbidity.

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11 Nurizan Yahaya

Yadollah Momtaz

Mumtazah Othman

et al.

Spiritual Well-Being

and Mental Health

among Malaysian

Adolescents

To examine impact of

spirituality on adolescents’

mental health problems,

after controlling for

possible

sociodemographic factors.

Questionnaire The prevalence rate of possible

mental health problems was

calculated 54.6%. The findings

from hierarchical multivariate

logistic regression showed

existential well-being and religious

well-being were statistically

associated with 58% and 37%

lower odds of mental health

problem, respectively, over and

above sex, living arrangements of

adolescents, parental education

and household income.

12 Robin E. Gearing

Michael J. MacKenzie

Rawan W. Ibrahim

et al.

Stigma and Mental

Health Treatment of

Adolescents with

Depression in Jordan

To examines stigma

perceptions of mental

health treatment for Arab

adolescents managing

depression

Vignette Personal level stigma may have

greater effects on females whereas

public stigma may exert more

influence on males. Community

seems to appreciate the need for

treatment and the likelihood of

benefiting from formal mental

health services.

39 | P a g e

13 Patrick W. Corrigan

Deepa Rao

On the Self-Stigma of

Mental Illness: Stages,

Disclosure, and

Strategies for Change

To more fully define self-

stigma, describe the

negative consequences of

self-stigma for people with

mental illness, and the

advantages and

disadvantages of

disclosure in reducing the

impact of stigma.

Many others are unaware or

unmotivated by the phenomenon

altogether. There are those,

however, who seem to apply the

prejudice to themselves and suffer

lessened self-esteem and self-

efficacy. These people might

benefit from structured programs to

learn to challenge the

14 Syudo Yamasaki

Shuntaro Ando

Shinji Shimodera

The Recognition of

Mental Illness,

Schizophrenia

Identification, and

Help-Seeking from

Friends in Late

Adolescence

The recognition of mental

illness without anticipating

stigma might encourage

adolescents’ help-seeking

behaviour. We aimed to

identify the relationship

between mental illness

identification and

adolescents’ intention to

seek help if faced with

mental illness.

Vignette When compared with adolescents

who were unable to recognize the

mental illness in the vignette, those

in the RMI group reported they

were significantly more likely to

seek help from and expressed an

increased likelihood to seek help

from professionals Those in the

LSC group reported they were

significantly less likely to exhibit

help-seeking behavior and

expressed an increased likelihood

of helpseeking from health

professionals than the UMI group

40 | P a g e

15 Matthias Angermeyer

Herbert Matschinger

Georg Schomerus

Attitudes towards

psychiatric treatment

and people with

mental illness:

changes

over two decades

To examine whether

these changes are

reflected in changes in the

public’s conceptualisation

of mental disorders, the

acceptance of mental

health treatment and

attitudes towards people

with mental illness.

Survey

Interview

Although the public has become

more inclined to endorse a

biological causation of

schizophrenia, the opposite trend

was observed with the other two

disorders. The public’s readiness to

recommend help seeking from

mental health professionals and

using psychotherapy and

psychotropic medication has

increased considerably. Attitudes

towards people with schizophrenia

worsened, whereas for depression

and alcohol dependence no or

inconsistent changes were found.

16 Angela M. Parcesepe

Leopoldo J. Cabassa

Public Stigma of

Mental Illness in the

United States: A

Systematic Literature

Review

1)Evaluate methods used

to study

the public’s stigma toward

mental disorders

2) Summarize stigma

findings focused on the

public’s stigmatizing

beliefs and actions and

Literature

review

Public stigma of mental illness in

the U.S. continues to be

widespread among children and

adults. Our literature review

summarizes population-based

studies’ findings on the public’s

stigmatizing beliefs and actions and

attitudes toward mental health

41 | P a g e

attitudes toward mental

health treatment for

children and adults with

mental illness

3) Draw

recommendations for

reducing stigma towards

individuals with mental

disorders and advance

research in this area

treatments for children and adults

with mental illness, highlights

avenues for future research in this

area, and can serve as a point of

departure to inform future anti-

stigma interventions.

17 Siobhan Parle How does stigma

affect people with

mental illness?

To study how does stigma

affect

people with mental illness

Literature

review

The literature confirms the public

hold negative beliefs about those

with mental health problems.

Despite national campaigns, there

has not been a significant change

in the way the public perceive

mental illness.

18 Nicola J. Reavley

Anthony F. Jorm

Stigmatizing attitudes

towards people with

mental disorders:

findings from an

This paper reports

findings from a national

survey on stigmatizing

attitudes towards people

Telephone

interview

Chronic schizophrenia was most

likely to be associated with

dangerousness, unpredictability

and a preference for not employing

42 | P a g e

Australian National

Survey of Mental

Health Literacy and

Stigma

with depression, anxiety

disorders and

schizophrenia or

psychosis.

someone with the problem, while

social phobia was most likely to be

seen as due to personal weakness.

Attitudes concerning

dangerousness and social distance

were greater in relation to men with

mental disorders compared to

women. Other people were

perceived as more likely to hold

stigmatizing attitudes than the

respondents reported for

themselves.

19 M.C. Angermeyer

A. Holzinger

H. Matschinger

Mental health literacy

and attitude towards

people with mental

illness: A trend

analysis based on

population surveys in

the eastern part of

Germany

To examine the

development of mental

health literacy and the

desire for social distance

towards people with

schizophrenia and major

depressive disorder in

Eastern Germany over a

time period of eight years

Trend analysis

Interview

While there was an increase in the

mental health literacy of the public,

the desire for social distance from

people with major depression and

schizophrenia remained

unchanged or even increased.

43 | P a g e

20 Harry Minas

Hervita Diatri

Pasung: Physical

restraint and

confinement of the

mentally ill in the

community

To identify the cases of

mental illness physical

restrain in North Sumatra,

Indonesia.

Cross-

sectional

Observational

research

Fifteen cases of pasung,

approximately even numbers of

males and females and almost all

with a diagnosis of schizophrenia

were identified. Duration of restraint

ranged from two to 21 years.

21 Claire Henderson

Sara Evans-Lacko

Graham Thornicroft

Mental Illness Stigma,

Help Seeking, and

Public Health

Programs

In this article, we

reviewed the evidence on

whether large-scale

antistigma campaigns

could lead to increased

levels of help seeking.

Survey This suggested that even if Time to

Change were to increase initial

treatment seeking, that is, if public

knowledge, attitudes, and

behaviors improved, a lack of

reduction in the risk of negative

experiences with health

professionals would continue to

deter people from seeking further

help.

22 Jen Lee The

David King

Bernadette Watson

et al.

Self-Stigma,

Anticipated Stigma,

and Help-Seeking

Communication in

People with Mental

Illness

To determine the effect

that different types of

stigma have on help-

seeking decisions

Online survey Respondents believed that others

viewed them more negatively than

they viewed themselves.

44 | P a g e

23 Ainul Nadhirah Hanafiah

Tine Van Bortel

A qualitative

exploration of the

perspectives of mental

health professionals

on stigma and

discrimination of

mental illness in

Malaysia

The state of stigma and

discrimination of people

with mental illness was

investigated from the

perspectives of mental

health professionals in

Malaysia.

Interview

Cross-

sectional

Seven principal themes, each with

their own sub-themes, emerged

from the analysis of ‘stigma of

mental illness’ from mental health

professionals’ point of view,

including: (1) main perpetrators, (2)

types of mental illness carrying

stigma, (3) demography and

geography of stigma, (4)

manifestations of stigma, (5)

impacts of stigma, (6) causes of

stigma and (7) proposed initiatives

to tackle stigma. Stigma manifests

itself most often in forms of

labelling, rejection, social exclusion

and in employment. Family, friends

and workplace staff are reported to

be the main perpetrators of

discriminatory conducts.

45 | P a g e