Military Mental Health Care in East Malaysia – An Innovative Approach

Abstract

INTRODUCTION. To describe the military psychiatry out- reach program in East Malaysia and review the referrals to the psychiatric service over a 20 months’ period by looking at the referral pattern from the primary care centres within East Malaysia and the attitudes toward mental illness among unit leaders. A comparison was made between the first 10 months and the subsequent 10 months after the outreach program was introduced. RESULTS. It showed that the outreach program has increased the numbers of referrals, enthused medical officers for early referrals and developed more positive attitudes toward mental health among unit leaders. Referrals from 4 visited primary care centres tremendously increase from 5 to 36 within 10 months whereas the referrals from other non-visited centers, however remained low in the same period. The program was also found to encourage early referrals reflected by shorter mean DUI (5 to 2.67 years) and less severe illness reflected by lower arbitration rate (60.0% to 10.7 %). CONCLUSION. An outreach program provides access to specialist expertise, increases awareness among unit leaders and the primary medical officers. It has not only increased the number of referrals but has also increased early referral which reduces premature arbitration rate among military personnel. Similar outreach program in other areas may enhance the clinical care of patients who are currently not being referred to the psychiatric services.