Secured Livelihoods

Introduction

The development of public and private services for psychotherapy and counseling remains a grey field in Malaysia. While the demand for specialised care in psychotherapy and counseling advances in an increasingly urbanised and industrialised society, it is uncertain if Malaysia has developed a parallel mental and community health infrastructure to match the growing needs of children, youth, women and men in a highly competitive and  automated age.
The changing societal structures and systems under which people live have placed undue pressures on the nuclear family to absorb the stresses of change and transformation. Productivity is stressed upon from the time a child enters a pre-school programme and is encouraged to demonstrate talent and academic competence at a time when it is still learning and discovering a diverse range of interests and skills.. Primary and secondary schooling is based on a series of technical examinations which set hurdles to social maturation rather than facilitate the advancement of talent, confidence and leadership necessary for development of civil society. Tertiary education is the ultimate competitive arena for economic specialisation and determines the future success of youth in economic life which does not necessarily prepare them for the challenges of  modernity. Conflicting interests and values, choices between personal and collective responsibilities, balancing priorities of work and family may place undue stress on individuals, family members and social groups dependent on productive individuals for their survival. Family and social fragmentation  is a result of choices and priorities which are misplaced or misguided in place, situation or time while personal attrition may advance more rapidly without such support systems to buffer the shocks of demanding and competitive work cultures.
  In an automated individualistic and ego-centric society, core values based on tradition and culture may seem unimportant and secondary as modern global work environments impose differential needs and priorities. The importance of family and other social stabilisers through community and support groups may be challenged through engaging discourses of modern work life which may make earlier social values acquired through family and youth socialisation seem outmoded or obsolete. The media facilitates the commoditisation of human life and imposes other uncertainties in individuals who become unable to determine the kinds of values which can ensure well-being and happiness. As a result, states of anxiety and stress, depression, personality disorders, chronic fatigue, insomnia and drug addiction may disrupt work and social performance and in extreme situations promote anti-social and obsessive behaviour which are criminal or unlawful. Crimes relating to child-abuse, domestic violence, marital rape, juvenile rape, incest, drug-addiction, suicide and many other forms of anti-social behaviour are increasing common among the productive middle and upper classes although statistics may highlight the poorer working classes who may be less able to obtain good legal counseling and so are more likely to be convicted.
In view of the growing need for psychotherapeutic and counseling services, it is vital that Malaysia undertakes a comprehensive mapping of services available in the country in both the public and private sector to enable policy makers to evaluate the kinds of resources which need to be further developed to advance the health sector further. It is proposed that such a mapping be undertaken in the form of a national survey to integrate findings relating to training, programme development, accreditation, registration, fitness of practice and codes of conduct and ethics. This will pave the way for a higher level of competence, competitiveness and accountability in the practice of psychotherapeutic and counseling services in the country.