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Navigating mental health support in South Asia and Southeast Asia
Explore our South and Southeast Asia therapy guide for regulations and resources in India, Pakistan, Philippines, Indonesia, Singapore, Malaysia, and Thailand
Explore our South and Southeast Asia therapy guide for regulations and resources in India, Pakistan, Philippines, Indonesia, Singapore, Malaysia, and Thailand
Accessing therapy can be difficult, but we're here to help you navigate your options
Growing up, men in South Asia and Southeast Asia, as in many parts of the world, are frequently scolded with phrases like “stop crying like a girl”, as if the very human act of experiencing and expressing sadness or fear somehow inherently undermines their masculinity.
From a young age, we are taught that it is our duty to protect our families and to serve as unwavering pillars of strength for others to rely on. Unfortunately, these beliefs foster an environment where seeking support is often wrongly associated with weakness.
For men who grew up in South (India and Pakistan) and Southeast (Philippines, Indonesia, Singapore, Malaysia, and Thailand) Asia, this cultural pressure can lead to basing their worth solely by how much they can provide for others. These rigid structures can weigh heavily on a guy, leaving him feeling responsible for his entire family’s quality of life.
The narrow confines of more traditional and outdated social prescriptions of masculinity leave little room for us to process our emotions, and many of us never learn how to do so in healthy ways.
Across South and Southeast Asia, the need for mental health support remains largely unmet.
For comprehensive global statistics on male suicide, explore our detailed report: Stats on Suicide in Men.
Many men in South and Southeast Asia grapple with mental health challenges, often navigating them without fully understanding the severity of their concerns or the possibility of recovery.
Even among those who acknowledge that they are struggling, the prospect of seeking help can seem daunting. Making the decision to reach out is challenging enough, and finding oneself amidst the sometimes unregulated landscape of mental health services can be confusing and overwhelming. Despite the challenges, resources are available for those seeking mental health care in these regions.
Understanding the local context, regulations, various mental health professionals, and available services is crucial for those seeking therapy in South and Southeast Asia.
In this article, we’ll cover how to access mental health care, including regulations, education, licensing, and finding therapists. We’ll also discuss crisis hotlines, extra resources, and updates in mental health policies.
In India, approximately 1 in 7 individuals struggle with mental health disorders. In 2021, over 73,900 more men died by suicide than women, highlighting a stark gender disparity in suicide rates.
Similarly, Pakistan, home to around 200 million people, faces significant challenges in mental healthcare. With fewer than 500 psychiatrists serving this vast population, a substantial treatment gap exists, leaving over 90% of individuals with common mental disorders untreated.
In such a cultural landscape, many South Asians are raised with the pervasive influence of phrases like “log kya kahenge” or “What will people say?” These societal pressures not only shape every decision they make, but often override their own feelings and desires, prioritizing societal approval over personal well-being. This cultural backdrop is further reinforced by popular media, where characters like Kabir in “Kabir Singh” or Ranvijay Singh in “Animal” embody toxic masculinity, glorifying violence as a response to trauma and insecurity rather than exploring healthier coping skills.
Amidst these challenges, the quest for receiving qualified therapy becomes an uphill battle in a system where psychotherapy lacks proper regulation. Understanding the intricacies of mental health care regulation in South Asia and discerning the credentials that hold significance are essential steps in accessing trustworthy support.
In India
In India, healthcare financing, particularly for mental health services, is primarily paid for through out-of-pocket expenses. Ayushman Bharat aims for universal health coverage, including mental health services, through initiatives like the National Mental Health Program and the National Tele Mental Health Program. By January 2023, about 150,000 Health and Wellness Centres (HWCs) were operational, integrating mental health into primary care. The program offers financial protection to reduce the burden of mental health treatment and combines these services with physical health care to reduce stigma.However, while Ayushman Bharat PM-JAY covers mental disorders, there are limitations and exclusions. Insurers prioritize episodic illnesses over long-term outpatient mental health treatment, resulting in insufficient coverage, especially for therapy sessions.[4]
The three most recognized specialists for treating mental health issues are psychiatrists, clinical psychologists, and counseling psychologists. The Rehabilitation Council of India (RCI) serves as a central authority overseeing rehabilitation and special education services, maintaining the Central Rehabilitation Register.
While you can find mental health professionals like psychiatrists and clinical psychologists in the RCI Registry, counselling psychologists are currently not included. Being listed in the RCI Registry indicates proper qualification, but accessing it can be challenging, and the information may not always be up to date.
Be cautious of ‘therapists’ with degrees in unrelated fields, life coaches, and those offering quick fixes or unrelated solutions. Ensure you seek professionals with appropriate credentials and experience.
In a significant stride toward enhancing regulation, the Indian government introduced The National Commission for Allied and Healthcare Professions Act in 2021. By creating a category for Behavioural Health Sciences Professionals, which includes a range of mental health professionals such as counselling psychologists, behaviour analysts, and mental health support workers, the act sets the stage for increased standardization and accountability in the sector.
In Pakistan
In Pakistani society, mental illnesses like anxiety or depression are often stigmatized and viewed as signs of religious weakness or divine punishment. Consequently, people typically seek help from religious or alternative healers before turning to mainstream healthcare, which often comes later in the illness’s progression.
Pakistan’s healthcare system prioritizes primary care, but in practice, many families bypass primary-care providers and go directly to specialist hospitals.
The Sehat Sahulat Programme, which strives for Universal Health Coverage in Pakistan, typically excludes mental health services, placing substantial reliance on government funding to ensure affordability.
With Pakistan allocating only 0.04% of its total budget to health, individuals face significant out-of-pocket expenses. While national insurance schemes offer reimbursement for psychosis, bipolar disorder, and depression, they lack funding for other mental health conditions requiring therapy or counselling, such as anxiety and personality disorders.[5]
Healthcare facilities in Islamabad, including psychology clinics, must register with the Islamabad Healthcare Regulatory Authority (IHRA) and comply with quality healthcare service standards to secure licensing for mental health services. Individuals can verify the legitimacy of clinics by consulting the IHRA registry.
Reach out to UMANG at (92) 0311 7786264.
Pakistan is making strides in strengthening mental health rehabilitation. In 2022, the Pakistan Senate passed a bill to decriminalize acts of self-harm and suicide. Additionally, researchers at the University of Manchester have spearheaded the drafting of Pakistan’s first Mental Health Policy, which was initially implemented in Sindh Province.
Various initiatives, including the Psychiatry Registry of Pakistan (PsyRoP) and endeavors facilitated by organizations like the Pakistan Psychiatric Society, are underway to compile comprehensive directories of psychiatrists nationwide. These endeavors are geared towards enhancing access to mental health services throughout the country.
In Southeast Asia, the concept of saving ‘face’ remains prevalent, as openly acknowledging struggles with mental illness can result in a loss of social standing. This stigma stems from traditional values that prioritize honour, pride, and collectivism within families, often leading to the perception of mental illness as a source of shame. These traditional values, coupled with ingrained gender norms, continue to fuel the pervasive stigma surrounding men’s mental health.
In the Philippines
In Filipino culture, mental illness often carries stigma and is sometimes attributed to supernatural causes like God’s will or witchcraft, which can discourage seeking professional help and lead to reliance on traditional healers who lack formal training in providing mental health support.
The Mental Health Act of 2018, or Republic Act 10029, establishes regulatory guidelines for mental healthcare services. While it covers various specialties such as counselling psychology and assessment psychology, there is no differentiation between psychologists based on these specializations.
In line with Universal Health Care objectives, the Philippine Health Insurance Corporation (PhilHealth) now provides an outpatient benefit package for mental health. This package offers funding for both general and specialty mental health services, aiming to enhance accessibility and affordability. Individuals in the Philippines typically directly access psychiatrists or psychologists without requiring a referral from a general practitioner.
In the Philippines, mental health professionals undergo extensive training and certification.
There are two main other types of mental health professionals in the Philippines: psychologists and psychometricians.
Therapists’ credentials can be verified through the Professional Regulation Commission.
Since the passage of the Mental Health Act in 2018, mental health services have expanded, with 362 access sites nationwide serving 124,246 users in 2022. The Philippines Department of Health, in collaboration with WHO, launched the 2024-2028 Philippine Council for Mental Health (PCMH) Strategic Framework to guide mental health policies, programs, and services in the country.
In Indonesia
In Indonesia, mental illness is highly stigmatized, leading to practices like pasung, where individuals with mental health conditions are secluded and restrained by family members. Despite being prohibited due to human rights violations, pasung persists. By 2016, over 57,000 Indonesians had experienced pasung at least once in their lives[6]. This issue is particularly prevalent in regions with limited mental health services and pervasive negative attitudes toward mental illness.
Indonesia’s mental health landscape faces significant challenges due to the absence of a comprehensive mental health policy. While the Mental Health Law focuses on integrating mental health into the medical system, there is still much work to be done.
Currently, most mental health services are provided in tertiary settings, primarily public psychiatric hospitals. The BPJS Kesehatan universal health insurance scheme, introduced in 2014, seeks to improve primary care by designating general practitioners (GPs) in community health centers (puskesmas) as the main gatekeepers to the healthcare system.
Individuals seeking mental health support typically begin with consultations at primary health centers and are then referred to secondary and tertiary levels for psychiatric care, where treatments are covered by BPJS-K.
In 2019, national agencies, including the National Human Rights Commission, signed an agreement to monitor institutions where individuals with mental health issues are shackled or detained. These efforts aim to ensure regular and independent monitoring in places like traditional faith healing centres and mental health facilities.[7] Additionally, initiatives such as the Indonesia Free from Pasung campaign work toward integrating mental health care into community health centres (puskesmas) and providing specialized programs addressing mental health care after natural disasters, depression, suicide prevention, and online mental health care.[8]
In Singapore
Mental health has emerged as the top concern among Singaporeans, surpassing cancer and stress, with 46% of residents prioritizing it, according to Ipsos’ Global Health Service Monitor[9]. The 2016 Singapore Mental Health Study (SMHS) found that one in seven Singaporeans will experience a mood, anxiety, or alcohol use disorder at some point in their lives. Alarmingly, fewer than 25% seek professional help and those who do often face significant delays before receiving treatment.[10]
In Singapore, mental health services are available in both public and private hospitals, with the Institute of Mental Health (IMH) serving as the primary provider.
Subsidies of up to 80% are offered for mental healthcare at public institutions[11], supported by Singapore’s universal healthcare system and its “three M’s” (Medisave, Medishield, and Medifund). Programs like the Chronic Disease Management Programme (CDMP) cover conditions such as schizophrenia, major depression, bipolar disorder, and anxiety.
Coverage rates and caps depend on treatment type and diagnosis.[12]
The Ministry of Health serves as the central authority for locating healthcare professionals and clinics. While patients often require a referral from their General Practitioner (GP) for subsidized care, they have the option to directly book appointments with psychiatrists at their own expense.[13]
In Singapore, a referral is not required to schedule an appointment with a clinical psychologist, facilitating quicker and easier appointment bookings.
In 2023, Singapore unveiled a National Mental Health and Well-being Strategy aimed at establishing a comprehensive mental health ecosystem. This strategy encompasses expanding services, enhancing capabilities, promoting mental well-being, and improving workplace mental health. The strategy involves collaboration across multiple sectors and includes proposals for legislation on workplace fairness. To ensure a holistic approach to mental health, a National Mental Health Office will oversee the implementation of this strategy.
Currently, over 450 GPs in GP clinics are trained to support individuals with mental health needs under the Mental Health GP Partnership Programme. The goal is to make mental health services available at 1,350 Healthier GP clinics by 2030.[14}
In Malaysia
In Malaysia, terms like sakit mental (mental illness) and gila (madness) carry strong negative connotations. Malays often attribute various forms of madness to different causes and frequently seek treatment from traditional healers (bomoh).
For instance, Dirasuk, a term for someone experiencing emotional outbursts, hallucinations, or a trance-like state, is believed to involve possession by ghosts or spirits and is treated by traditional or religious healers. The acceptance of a mental health diagnosis and treatment remains low among Malays due to concerns about side effects and stigma, leading many to prefer spiritual remedies. Health beliefs among Malay Muslims often link psychiatric issues to fate and religion, prompting them to confide in family members rather than seek medical help, a trend observed even among professionals.[15}
The journey to seeking therapy often begins with consulting a family doctor or GP, who may refer individuals to a psychiatrist if medication is required, or to a clinical psychologist or counsellor for therapy.
Alternatively, private treatment offers the option to schedule appointments directly with psychiatrists or psychologists without needing a GP referral. However, it’s advisable to keep your family doctor informed throughout your treatment process.
To ensure therapists’ qualifications, it is crucial to verify their registration through the provided links below:
For Immediate Support
Additional Resources
Updates and Improvements:
The Malaysian Mental Health Association continues to advocate for the review of private psychiatric nursing homes and centers by the Health Ministry in Malaysia, emphasizing the importance of ensuring compliance with global standards and provisions of the Mental Health Act.[16}
In Thailand
In Thailand, there is a cultural belief that when someone’s kwan (soul) is lost, it can lead to illness and signal weakness. Ceremonies are often performed to preserve or retrieve lost kwan. Some people attribute mental illness to ghosts or spirits, seen as consequences of past misdeeds, and seek remedies like holy water, while others believe it is due to bad karma. These cultural beliefs can stigmatize mental health issues and deter individuals from seeking professional help[17]
Thai citizens can access mental health services through the Universal Health Coverage (UHC) system, administered by the Ministry of Public Health and its Department of Mental Health. This system provides essential mental healthcare services through psychiatric departments in both general and specialized hospitals.
Under UHC, most mental health services, including consultations and related medications, are either free or heavily subsidized. However, accessing these services typically requires a referral from a doctor and booking an appointment with the relevant specialist. Unfortunately, due to a shortage of mental health professionals, particularly psychologists and psychiatrists, the public healthcare system often faces long waiting times, sometimes up to six months.
Alternatively, many individuals, including Thai nationals and expatriates, opt for private healthcare options, which offer shorter waiting times, multilingual practitioners, and better facilities. However, these services come with associated costs that may or may not be covered by health insurance.
English line: 02 113 6789, press 2
Psychiatric care in Thailand has undergone continuous development, fueled by collaborative efforts among various organizations. Recent changes include the integration of Eastern and Western treatment approaches, the enhancement of academic training programs, and a growing recognition of the importance of gender in mental health care.
These advancements are positioning Thailand to provide more effective and integrated care for its citizens.[19]
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The pervasive stigma surrounding men’s mental health continues to have lasting effects, especially among younger generations, who often associate mental illnesses with derogatory terms and may feel (wrongfully) embarrassed about seeking help.[20]
Finding a therapist in South and Southeast Asia can be challenging. Thankfully, awareness about mental health issues is steadily rising. Organizations like the World Health Organization (WHO) are actively advocating for change, and initiatives aimed at destigmatizing mental illness are gaining traction.[21]
Governments and healthcare systems are beginning to acknowledge the importance of implementing comprehensive mental health policies and integrating these services into primary care.
References: