Page 153 - ANUAL REPORT MOH 2017

MENTAL HEALTH SERVICES IN PRIMARY CARE (HEALTH CLINICS)
Mental health services had been integrated into primary health care services since late 1990s. Services
include promotion of well-being, prevention of mental disorders, mental health screening, treatment
and rehabilitation of people affected by mental disorders.

a) Mental Health Screening
Screening for detection of mental health problems is carried out using DASS (Depression Anxiety Stress
Scales). A total of 296,972 have been screened using DASS (Depression Anxiety Stress Scales). Out
of this, 25,402 (8.6 per cent) has risks of stress 29,713 (10.0 per cent) has risks of anxiety, and 18,919
(6.4 per cent) has risks of depression.

b) Treatment of Stable Mental Health Patients in Health Clinics
For the year 2017, a total of 23,058 cases received treatment at health clinics. Out of this, 8.4 per cent
(1936) were new cases. Stable cases that were on follow-up in health clinics were given pharmacological
treatment, counseling and in selected health clinics, psychosocial rehabilitation. Their compliance to
treatment was monitored to prevent relapses and in 2017, the defaulter rate was 2.3 per cent (531
cases) which is within the WHO standard of not more than 10 per cent.

c) Psychosocial Rehabilitation Centre in Health Clinics
There are 15 psychosocial rehabilitation centres in operation in the health clinics from a total of 27 centres
previously. These psychosocial rehabilitation centres will be upgraded into community mental health
centres manned by hospitals which will provide more comprehensive services (screening, intervention,
treatment and rehabilitation) for those with mental health problems. Currently, 11 psychosocial
rehabilitation centres have been upgraded into Community Mental Health Centres (CMHC).

HEMODIALYSIS SERVICE IN HEALTH CLINICS
Hemodialysis services are provided in selected health clinics to make this service accessible for those in
remote areas. In 2017, there were 13 health clinics that provided hemodialysis services (Klinik Kesihatan
Simpang Renggam, Johor; Klinik Kesihatan Kodiang, Kedah; Klinik Kesihatan Song, Sarawak; Klinik
Kesihatan Sungai Lembing, Pahang; Klinik Kesihatan Mahligai, Bachok; Klinik Kesihatan Debak ,
Betong, Sarawak; Klinik Kesihatan Bestari Jaya, Selangor; Klinik Kesihatan Bandar Mas, Johor; Klinik
Kesihatan Chiku 3, Kelantan; Klinik Kesihatan Batu Niah, Miri, Sarawak Klinik Kesihatan Tatau, Bintulu,
Sarawak and Klinik Kesihatan Lenggong, Perak).

PRIMARY HEALTH CARE DIETETIC SERVICES
Primary Health Care Dietetic is in its seventh year of providing services. Initially with 11 posts in health
clinics, it has involved to 66 health clinics. Primary Health Care Dietetics initially offers Medical Nutrition
therapy (MNT) for referred case especially non-communicable diseases such as diabetes, hypertension,
morbid obesity and dyslipidaemia. At present the dietetic scope has extended to cover nutrition support
therapy for bedridden patients in domiciliary health care services and also managing MNT for disable
children in Community Based Rehabilitation Centre. Dietetic workload was increased tremendously
more than 500 per cent in 7 years.

Reduction of HbA1c among diabetes patients receiving MNT within six (6) month was monitor as
dietetics’ indicator. It was start in 2015 and targeting 60 per cent of patients reduced one (1) per cent of

152 ANNUAL REPORT 2017 MINISTRY OF HEALTH MALAYSIA