City still faces hurdles to overcome mental health stigma

The Macau SAR has not yet overcome the stigma of mental illness, which has led people with mental health concerns to “save face” and refrain from seeking help.
Recently, five suicides and attempted suicides have occurred within a span 10 days, according to police authorities.
Speaking to the Times, Stella Cheong, president of the Macau Society of Registered Psychotherapists, said that the small size of the community in Macau is one of the most significant reasons why people suffering with mental health issues are afraid to come forward and see therapists.
A study recently conducted by the Fuhong Society of Macau and the University of Macau showed that Chinese culture’s high regard for “saving face” contributes to why people are hesitant to seek help.
Echoing the same sentiments, Cheong said, “upon going to see a therapist, many people are afraid that they will be seen as weak and fragile. They cannot overcome what they perceive as a shameful matter.”
“People are afraid that others will look down on them. It’s all about saving face for the Chinese. You cannot show people that such problems are going on,” she said.
According to the expert, 60% of her clients suffer from both anxiety and depression, while the rest suffer from obsessive-compulsive disorders, dissociative disorders and bipolar disorders.
“The stigma is there and they don’t have the right concept. They don’t know what the therapy can give them. They don’t know how they can start and [will only] seek help when symptoms have become severe,” she explained.
A lecturer from the Faculty of Social Sciences at the University of Saint Joseph, Cynthia Leong believes that being labeled as a sick person is about “more than saving face,” as it not only influences one’s reputation but every aspect of their life.
At the beginning of the year, the suicide prevention and emotional aid hotline Life Hope Caritas recorded more than 10 calls relating to suicide in first 20 days of January.
In an update, the secretary-general of Caritas Macau, Paul Pun, said that the charitable organization’s assistance hotline received 20 calls last month and so far nine calls this month.
“We cannot say we have had more cases, but according to the number who have committed suicide [this year], it seems that it’s more or less the same [as last year],” Pun said.
Most of the callers were women. According to the psychotherapist, it is difficult for men to seek help for cultural reasons.
“Especially for Chinese men, it’s not easy. Only when it’s really very serious, then they seek help. Their symptoms can last for months, sometimes years and I don’t know how they tolerate having insomnia for [such a long period of time],” she said.
Suicidal thoughts come more often when people are suffering from loneliness, helplessness and insomnia, even when taking medication for these problems.
The expert suggested that Macau is a little behind on overcoming the stigma that surrounds mental health issues compared to Guangzhou or other big cities on the mainland.
She added that Macau is still “quite conservative,” although the demand for these services has been increasing.
Meanwhile, Leong says, “the world is becoming more complex nowadays, compared to 10 or 20 years ago. Therefore, you can also see that there are more therapies than before, as there is a market there, people need them.”
The lecturer and psychology expert says there are patients who have needed to wait for over a month for a counselor to become available.
Last year, former Secretary for Social Affairs and Culture Alexis Tam assured that the government was working to prevent suicide. He described that as a challenging task.
Data from 2018 shows that 81 people committed suicide, 20 of which were tourists.
Stress among Cheong’s clients has been worsened due to the pandemic. However, in general, Cheong says that the government has been doing “good work” to strengthen its social community services.
The government also helped these residents acquire medicines that are only available in Hong Kong.
“The government understands that these patients cannot miss their medications, and since these types of high dose medicines are under the government’s control, [they have helped local residents] to acquire them,” said Cheong.
A study conducted in 2017 estimated that between 23,500 and 36,600 people in the Chinese population of Macau were suffering from depression.
Led by Brian Hall, a scholar and an associate professor at UM, the study showed that that there was a larger proportion of residents suffering from depression here than in Hong Kong or the mainland.