Overview on the Roles of Young Psychiatrists in Mental Health Development. Presented at the 7th National Conference of Indonesian Psychiatric Association, Surabaya, Indonesia. 30 October – 2 November 2013.

1. ‚We are no more caterpillars,
we are butterflies
and we have wings to fly‛:
Roles of Young Psychiatrists in
Mental Health Development
Dr. Umi Adzlin Silim
Psychiatrist, Hospital Putrajaya, Malaysia
Immediate Past President Section on Early Career
Psychiatrist, MPA

2. Background Scenario
With a ratio of 1 : 120 000 psychiatrists per population
compared to the recommended ratio of 1 : 50 000 by
World Health Organization (WHO) and close to 1 in 3
of the psychiatrists are young early career psychiatrists
( ECPs) , we do expect to fly as high and as far as we
can.

3. Assignments
• Near, Far
• Rural, urban
• Part of established teams
• Single one man show

4. Sharing of
Experiences
4 stories of ECPs in Malaysia

5. Malaysia’s First Community
Mental Health Centre (Mentari):
Rebranding of Psychiatric
Services in Malaysia
Sharing of Experience 1 - Dr. Umi Adzlin Silim

6. Task to design the first community
mental health centre
Setting up a new unit also means setting up a new trend and that is how
we could make a difference and significant changes could happen

7. Thinking Rebranding
Besides focusing on compulsory aspects of setting up, she had given her
attention to the details of interior designing and giving a brand new name
to the facility,

8. Interior designing elements
She intensively studied various designs of medical and psychiatric facilities, and
came up with three important elements in the interior designing namely safety
features, therapeutic effects and corporate images to guide her.

9. Trend setting
Every time the renovation contractor showed her “these are what
normally government facilities will use” she would say “can you show me
something that no government facility had used?”.

10. Interior designing as a rebranding
just as how the sights of cells, grills, dark and dull places had defined the image of
psychiatry in the earlier era, the impact of a mindfully thought interior designing
concept will give a new definition and a new image to psychiatry.

11. 11

12. 12

14. Rebranding by the name
So much so that the earlier names of psychiatric institution had been
attached with stigma, the rebranding must give a positive outlook which
lessens the stigma of mental illness

15. MENTARI @ PUTRAJAYA
Contains meaningful terms of
Mental Health & Psychiatry
Translates to the sun in Malay -
symbolizes hope, guidance & a
bright future
Modern & simple & contemporary
Positive image, no stigma
Corporate image
Has commercial values – can be
used as branding for social
enterprise rehabilitation program

16. Success!
As it is now; Mentari, the first
CMHC in Malaysia, launched by
the Health Minister in November
2011, is fully operational; the
tasteful interior designing
concept is naturally admired and
the name Mentari is already
officially approved as the name
for all CMHCs launched later in
other states in Malaysia.

17. A Garden and Bokashi Project;
Success Stories from
Rehabilitation Program in
Hospital Miri
Sharing of Experience 2 – Dr Aida Arif

18. It started with a psychiatric unit
without a psychiatrist
Hospital Miri, a remote place in Sarawak, had no resident
psychiatrist before Dr. Aida, to spearhead the department

19. Identifying resources
Dr Aida had wasted no time; she started to identify her strength and
became very excited knowing that she had bountiful resources in term of
raw materials and her staffs‟ expertise.

20. ‘The best time to plant a tree is 20
years ago, the 2nd best time is now’
Dr. Aida immediately identified an area for a vegetable
garden to start with.

21. Start small
When they started the project, basically they began
with only RM20 to buy the seeds.

22. Sells BIG
A year later, the total income from selling the
vegetables was about RM1500.

23. Outstanding Bokashi Project
Bokashi is a relatively new green and efficient way to
manage food waste by recycling

24. A green way
Using Bokashi‟s bucket, a blend of beneficial micro-organisms is
mixed with food waste to ferment the organic waste as in
traditional composting

25. BOKASHI
Step by Step
25
To get started you need to have:
1. Bokashi Bin 2. Bokashi Powder 3. Kitchen Waste
1
2
3

26. 26
Sprinkle a layer of Bokashi powder at the bottom of
the bin.

27. 27
Break food waste in
smaller pieces (cooked or
uncook). DO NOT add
liquid, rotting and moldy
food, big bones and non
organic matter. Ensure
food waste is drained
well.

28. 28
Throw in the well drained food waste. Preferably at the
last kitchen chore of the night.

29. 29
Sprinkle a handful of
Bokashi Powder over 3-4 cm
of food waste. Add in more
for hard to decompose food
such as meat and small
bones. Press down the food
waste every time you add
into the bin.

30. 30
Repeat the steps until the
bin is full with generous
layer of Bokashi Powder.
Cover the lid tightly Let it
rest for 10-14 days.

31. 31
Appearances of
white growth on
the surface and
the presence of a
sweet and sour
pickle-smell are
good indicators
that fermentation
is in progress.
When the full bin
fermentation
period is
completed, the
contents is ready
to be buried into
your garden.

32. 32
For vegetables as fertilizer.

33. 33
Drain liquid (Bokashi Tea)
2-3 times a week, dilute in
water (1:1000) as natural
fertilizer or pour pure
Bokashi Tea in kitchen
sinks as bio-sewege
solution. Can be store up
to 3 days.

34. 34
Bokashi Tea: as fertilizer and to avoid unwanted fungi
and bugs…

35. 35

36. 36

37. 37

38. 38

39. 39
Bokashi Tea can also be use with flowers…

40. Tuesday, October 29,
2013
40

41. 41

42. 42

43. 43

44. Tuesday, October 29,
2013
44

45. 45
Mango: Free of fungi after using Bokashi Tea and the
fruits become healthier…

46. Media attention
Using Bokashi‟s method, psychiatric patients had transformed food waste
from the hospital‟s kitchen into organic fertilizers for their vegetables
garden

47. Recognition
Impressed the hospital director and recognized by the
Miri Municipal Council

48. Success!
Dr. Aida had been invited to deliver her success
stories in many local conferences. She single-
handedly as a psychiatrist has set up a good example
to ECPs, especially those being sent to remote areas
and being given responsibilities to lead, that the post
you occupy is an opportunity for you to be innovative
when the sky is your only limit.

49. Outreaching Public When A
Celebrity Told Her Story
Sharing of Experience – Dr. Hazli Zakaria

50. Targeting the Media
Lots of media news on mental health are stigmatizing. Changes will
happen when media people are well informed and educated.

51. When A Celebrity Talks
TV personality and actress Wardina Safiyyah might be the first Malaysian
celebrity to come forward with the story of her journey through
postpartum depression, when she shared her ordeal in 2011.

52. Positive Outcomes
The outcomes: her stories became headlines in major newspapers; her
stories were mainly reported positively and were well received by the
public.

53. Behind the scene

54. For Positive Images of Psychiatry
Psychiatrists should play big roles in guiding the media to
paint the images.

55. Success!
To date, Dr. Hazli has been the key person in
conducting media skills workshops for ECPs and
other psychiatrists. With the aim to produce media-
savvy psychiatrists to promote positive images of
mental health, he had conducted workshop on
skills for writing in media and appearing in TV

56. Mindful-Gym, the Pioneer for a
Mindfulness-based Stress
Management Program in
Malaysia
Sharing of Experience 4

57. MBSR
Mindfulness-based stress reduction programs are already very popular in
the West, but become „phenomenal‟ in Malaysia by the work of Dr.
Phang Cheng Kar

58. Mindful-Gym
Initiated and „branded‟ by Dr Phang, Mindful-Gym® is a mindfulness-based
stress management program specially designed for stress reduction and
wellness

59. Grant Award
Dr. Phang had managed to secure a grant support from the Malaysian
Health Promotion Board (MySihat) for Mindful-Gym. This enables the
program to be conducted free to benefit the public,

60. Evidenced-Based
The effectiveness of the Mindful-Gym program has been supported by several studies by
Dr. Phang and his research team. The most recent, he presented the positive outcomes of
Mindful-Gym at the International Mindfulness Conference, Rome in May, 2013

61. Phenomenal
Mindful-Gym was first piloted among caregivers and volunteers at Kasih
Hospice Foundation in 2010. Now available in more than 10 centres.

62. Success!
The remarkable success of Mindful-Gym is a result
of Dr. Phang’s unfailing dedication to what he
believed he wanted to do – as proven by his
commitment to program development, education,
training, and research on local mindfulness-based
interventions. He plans to further develop Mindful-
Gym program for children, adolescents, and women.

63. ‘Give me a fish and I will
eat for a day, teach me to
fish and I will eat a lifetime’
‟.

64. Making Changes
‘What type of changes’ that ECPs want to make is
for each ECP to decide, it is ‘knowing how’ ECPs
should play the roles to make such changes that is
more crucial.

65. Knowing How
Start with either a vision or a passion
Think like a leader and not a follower
Grab the opportunity to make a difference if it is available
or look for challenges and change one to an opportunity if it is hidden
Proactively and consciously think differently
Always work in harmony with people around you,
build networking and respect your seniors.

66. Acknowledgement
• Dr Aida Arif
• Dr Hazli Zakaria
• Dr Phang Cheng Kar
• Dr Abdul Kadir Abdul Razak
• Dr Azizul Awaluddin

67. Terima Kasih
umiadzlin@gmail.com