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RECOMENDATION

1.Seek professional help

If support from family and friends, positive lifestyle changes, and emotional skills building aren’t enough, seek help from a mental health professional. There are many effective treatments for depression, including therapy, medication, and alternative treatments. Learning about your options will help you decide what measures are most likely to work best for your particular situation and needs.By seeking professional help, you can have Cognitive Behaviour Theraphy(CBT).

CBT can help you to change how you think ('Cognitive') and what you do ('Behaviour'). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.

CBT has been shown to help with many different types of problems. These include: anxiety, depression, panic, phobias (including agoraphobia and social phobia), stress, bulimia, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder and psychosis. CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue.

CBT has been shown to help with many different types of problems. These include: anxiety, depression, panic, phobias (including agoraphobia and social phobia), stress, bulimia, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder and psychosis. CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue.

BT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These parts are:

A Situation - a problem, event or difficult situation. From this can follow:

1.Thoughts

2.Emotions

3.Physical feelings

4.Actions

Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally.

Student can do CBT individually or with a group of people, or even a self-help book or computer programme.

In England and Wales, two computer-based programmes have been approved for use by the NHS. Fear Fighter is for people with phobias or panic attacks; Beating the Blues is for people with mild to moderate depression.

If student have individual therapy:

Student will usually meet with a therapist for between 5 and 20, weekly, or fortnightly sessions. Each session will last between 30 and 60 minutes. In the first 2-4 sessions, the therapist will check that you can use this sort of treatment and you will check that you feel comfortable with it. The therapist will also ask you questions about your past life and background. Although CBT concentrates on the here and now, at times you may need to talk about the past to understand how it is affecting you now. You decide what you want to deal with in the short, medium and long term. You and the therapist will usually start by agreeing on what to discuss that day.

The work

With the therapist, you break each problem down into its separate parts, as in the example above. To help this process, your therapist may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions. Together you will look at your thoughts, feelings and behaviours to work out: if they are unrealistic or unhelpful how they affect each other, and you.

The therapist will then help you to work out how to change unhelpful thoughts and behaviours. It's easy to talk about doing something, much harder to actually do it. So, after you have identified what you can change, your therapist will recommend 'homework' - you practise these changes in your everyday life. Depending on the situation, you might start to: question a self-critical or upsetting thought and replace it with a more helpful (and more realistic) one that you have developed in CBT recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.

At each meeting you discuss how you've got on since the last session. Your therapist can help with suggestions if any of the tasks seem too hard or don't seem to be helping. They will not ask you to do things you don't want to do - you decide the pace of the treatment and what you will and won't try. The strength of CBT is that you can continue to practise and develop your skills even after the sessions have finished. This makes it less likely that your symptoms or problems will return.

2.Physical activities

Physical activity should be a part of every able bodied person’s daily lives, but especially so for those in stressful situations. For one, exercise improves vigor and decreases depression and anxiety. Acute exercise leads to release of neurotransmitters that promotes adherence to an exercise regimen, which is important for students to continue to reap the benefits of exercise, and activation of cortical areas that improve mood. Regular exercise also promotes mental health through angiogenesis and neurogenesis, showing that there is some actual scientific evidence to back the empirical notions of prescribing exercise as a means for mental illness prevention and health improvement. Neurogenesis is enhanced in animal models, particularly in the hippocampus, which not only gives rise to better mental health in humans, it also gives an added benefit of possible improved memory through exploiting the plasticity of the hippocampus. Exercise improves self esteem and encourages positive self viewing, which is commonly compromised in medical students with or without depressive symptoms. Exercise has been correlated with psychological well being and life satisfaction, whereas physical inactivity is associated with psychological disorder development.10 There is a general consensus that physical activity is beneficial to preventing or treating mental illness, as exercise promotes overall general well being.

Allotted time for exercise in students’ schedules should be implemented into curriculums as a therapeutic preventative measure for mental illness. Exercise is a therapeutic lifestyle change that has been shown to have positive effects on the treatment and prevention of mental illness.Thirty minutes allotted at least three times per week, built into students’ schedules, is more cost effective than eventual counseling, and more pragmatic as it attempts to prevent mental health issues. Mental health problems are easier to deal with before they exist. Thus, prevention is a key component of improving the overall mental health status of this population. We argue that integrating exercise time into the curriculum as a block of time will be more effective than simply encouraging students to stay active. It has been shown that very few adults actually meet minimum exercise time guidelines, and given that medical students are constantly pushed for time, they fall into a vulnerable group to repeat this trend of the general adult population. Placing exercise into the curriculum enforces the concept that exercise is vital to the students’ well being, and it also implies that the students’ studies, while important, cannot be the sole focus and that time for maintenance of health is equally important. Physician heal thyself (Luke 4:23

3.Peer support

Peer Support may be defined as the help and support that people with lived experience of a mental illness or a learning disability are able to give to one another. It may be social, emotional or practical support but importantly this support is mutually offered and reciprocal, allowing peers to benefit from the support whether they are giving or receiving it.

Key elements of Peer Support in mental health include that it is built on shared personal experience and empathy, it focuses on an individual'�s strengths not weaknesses, and works towards the individual'�s wellbeing and recovery. Though the language of peer support is relatively new in the UK, in practice self-help groups and mutual support has been around for many years. In Canada and the USA, Peer Support in its various forms has been a widely recognised and utilised resource that has been developing since the 1960s. In recent years there has been an increasing emphasis on the value of peer support in the UK. Research has shown that peer-run self-help groups yield improvement in psychiatric symptoms resulting in decreased hospitalisation, larger social support networks and enhanced self-esteem and social functioning.

The benefits of Peer Support are wide ranging for those receiving the support, peer-support workers themselves, and for the mental health system as a whole. One of the key benefits of Peer Support is the greater perceived empathy and respect that peer supporters are seen to have for the individuals they support. Peer Support also has benefits for peer support student themselves, increasing levels of self-esteem, confidence and positive feelings that they are doing good. Peer-support workers often experience an increase in their own ability to cope mental health problems.

Peer Support also benefits the health system as a whole as it can lead to decrease in hospital admissions for those taking part.

REFERENCE

Akbaraly TN, Brunner EJ, Ferrie JE, Marmot MG, Kivimaki M, Singh-Manoux A. Dietary pattern and depressive symptoms in middle age. Br J Psychiatry. 2009;195:408-413.

Anglin R, Samaan Z, Walter S et al. Vitamin D deficiency and depression in adults: systematic review and meta-analysis. British Journal of Psychiatry, 2013.

Dinatul Akmal Bt Abdul Kadir ,Personal Communication,Disember 6,2018,UKM Health Center

Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-Hydroxyvitamin D and Risk of Myocardial Infarction in Men: A Prospective Study. Arch Intern Med. 2008;168(11):1174-1180. doi:10.1001/archinte.168.11.1174.

Hilwa Abdullah @Mohd Nor ,Personal Communication,December 7,2018 ,FSSK,UKM.

Nardi AE, Valenca AM, Nascimento I, Freire RC, Veras AB, de-Melo-Neto VL, et al. A caffeine challenge test in panic disorder patients, their healthy first-degree relatives, and healthy controls. Depress Anxiety. 2008;25(10):847-53

Nauert, R. (2012). Dehydration Influences Mood, Cognition. Psych Central. Retrieved on March 12, 2014, from http://psychcentral.com/news/2012/02/20/dehydration-influences-mood-cognition/35037.html

University of Eastern Finland. (2013, September 16). Diet is associated with risk of depression. ScienceDaily. Retrieved March 5, 2014 from www.sciencedaily.com/releases/2013/09/130916103530.htm

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Finding problems:

1)Environment
Based on the questionnaires we did it before, 28%
of the respondents said that studies is the most factor of mental health
problems in UKM. It is because UKM is one of the research university in
Malaysia. Besides that, mostly the respondents who answered that are degree
students who are faced the life stage transitions such as starting university, feeling
overwhelming exam stress can become overwhelming and stressful. It is important that young people learn how to cope and adapt to change to maintain optimal physical health and mental wellbeing.

2) Health Problems

68% of the respondents said that mental health problems are one of the serious problems in UKM.

3) Biological factors

Based on the interview, Dr Ehsan said that lack of sleep or sleeping disorder is on of the affect the students faced cause by stress and depressed. Not getting enough sleep can have major biological consequences. Lack of sleep can negatively impact mood, concentration and work or school performance. It can also make a person more likely to crave junk food, therefore not getting proper nutrients in their diet. It can make a person feel tired and lethargic, therefore not getting the exercise that they need for proper mental health. Adequate sleep (which ranges from seven to nine hours for adults) is a biological necessity, and a lack of it can lead to a slew of mental health disorders.

Finding Solutions:

1) Qualification

The group support is running by students which can cause a trustworthy issue among other students.

2) Evironment

Mental health promotion by the group support through emotional support is involves actions that can improve psychological well-being.  This may involve creating an environment that supports mental health. Promoting the social-emotional well-being leads to higher overall productivity, better educational outcomes, lower crime rates, improved quality of life, increased lifespan and improved family life.

3) Health problems

Based on the interview, Dr Dinatul said the youths are more awareness about their physical health and disconnected between the mental health and physical health. Poor physical health can lead to an increased risk of developing mental health problems. Similarly, poor mental health can negatively impact on physical health, leading to an increased risk of some conditions.

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Mental health problems are one of the serious problems that happened among people in the world included Malaysian. This problem also happened among students in the National University of Malaysia (UKM) which is one of research university, in the country. Its  caused by family history and some people will be at increase genetic factors. Stress with examination and worry of coping with serious illness can lead to depression which is apart of mental health problem. Suicide case happened in UKM  due to serious stress show that the mental health problems had been developed for a long time ago. Individuals with mental illness are at greater risk for decreased quality of life, educational difficulties, lowered productivity and  social problems. So if mental illness among UKM student cannot be prevented, the productivity of UKM’s student will be decrease and it is of course can effect university and student’s achievement.

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The methodologies that we use for collecting the datas on solution are from questionnaires, interviews and library researches. The type of questionnaires we use for the solution are multiple choices. There are about 10 questions that we asked the respondents which are from  UKM students. The total of respondents are 25 students only and we choosed them to answer the questionnaires randomly. We distribute the questionnaires by google drive through whatsapp application. From the questionnaires that the students answered before, we concluded that 54.2% of students agreed that getting emotional support from experts, family and friends are the way to prevent mental health problems while 33.3% from medical treatment and 12.5% are practicing a healthy lifestyle. Most of the respondents know what the emotional support is and they which are 91.3% of the respondents agreed that emotional support is the best way to help and prevent the problems. 43.5% of the respondents are willing to get the emotional support from the club while 13% are not agreed with this group support because from their view, the mental health problems supposed to be a privacy and also not everyone can be trusted to keep their privacy.

We have also interviewed two experts for more datas and informations. First is Dr. Dinatul Akmal Bt Abdul Kadir, the medical officer at UKM Health Center. We have interviewed her on Thursday, December 6 at UKM Health Center at 4.00 pm. Based on the interviewed we did it before, she said that the emotional support is giving support to someone who have crisis and problems that cannot be controlled by themselves and it also one of the good preventer to help them especially the group support. Other than that, the group support is one of the way to give an awareness for students to always keep their mental health in the good condition. The activities that we can do for the group support are outdoor activities, talks, charity works and others. Second is Dr Hilwa bt Abdullah @ Mohd Nor, phycology lecturer at FSSK, UKM. We have interviewed her on Friday, December 7 at FSSK at 9.00 am. Based on the interviewed we did it before, she said that emotional support is one of the support that can help the students who are in depressed and crisis to reduce the burden their faced through family and friends. It also one of the treatment for someone who experienced mental health instability. She agreed that the emotional support that given by group support is one of the the good method to help the students. The activities that we can do are increase physical activities such as picnic, sports and others.

For the library research, according to Wikipedia, social support is the perception and actuality that one is cared for, has assistance available from other people, and most popularly, that one is part of a supportive social network. These supportive resources can be emotional (nurturance), informational (advice), or companionship (sense of belonging), tangible (financial assistance) or intangible (personal advice). Social support can be categorized and measured in several different ways. There are four common functions of social support and one of them are the emotional support. Emotional support is the offering of empathy, concern, affection, love, trust, acceptance, intimacy, encouragement, or caring. It is the warmth and nurturance provided by sources of social support. Providing emotional support can let the individual know that he or she is valued. It is also referred to as "esteem support" or "appraisal support. The support of friends and family can play a very important role in someone recovering from mental illness such as depression. The best things that friends and family can do is simply listen. They often don't need to say anything, just being willing to listen to their problems makes they feel less alone and isolated. Just a simple call or text asking them how they are is help. Sometimes they don't want sympathy, just to know we are there if they needed. Everyone will need different support, so talk to friend or family members about what they might find useful to have their with and identify things they can try to do themselves (https://www.mind.org.uk)

In mental health settings, the creation of support groups initiatives for people who experienced a range of acute life events and crisis have been introduced on behalf of people with affective disorders and members of their families since two decades ago. In general, social support is thought to affect mental and physical health through its influence on emotions, cognitions, and behaviours. In the case of mental health, social support is thought to maintain regulation of these response systems and prevent extreme responses associated with dysfunction. This regulation occurs through communication of what is expected, of appropriate norms, of rewards and punishments, and through the provision of coping assistance. There was also evidence that emotional and esteem support provided protection against a wide range of different stressful events. An essential component of these approaches has been that it is the perception that others will provide resources when they are needed that is key to stress-buffering. It is important for people to have the opportunity to explore difficult feelings. Being listened to in confidence, and accepted without prejudice, can alleviate general distress, despair and suicidal feelings. Often being listened to is enough to help someone through a time of distress. Even just showing that we are there for them and that we know they are going through a distressing time, can in itself be a comfort and for the people who feel suicidal want are firstly someone to listen which is people who will take time to really listen to them. Second, someone who won't judge, or give advice or opinions, but will give their undivided attention. Third, someone to trust which is someone who will respect them and won't try to take charge, who will treat everything in complete confidence. Lastly, someone to care which is people who will make themselves available, put the person at ease and speak calmly and someone who will reassure, accept and believe.

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3. PROCEDURE (HOW WE COLLECT THE DATA)

We collecting the data for strengthened on the issue of mental health problem by do a appointments at the counter of Ukm Health Centre to have a personal communication with Dr Ehsan Iskandar the medical officer of Ukm Health Centre. Based on data that we collect from Dr Ehsan is mostly mental health habits occurred in ages 20 – 30 years old. Other than that the estimated percent mental illness have occurred to UKM student is 5-10 cases per month, And he says that the person that faced the mental health problem some have come to see and usually the same person that going see the doctor as a follow up appointment. Dr Ehsan says that cause a habit that occurred over this illness mental patients is their environment. Other than that he says that diseases that always happen to students is depression, anxious and stress and they come to see doctor when It is severe, and the issue had long been occurring in Ukm, seriousness of this disease says Dr Ehsan is horizontal. The sympoms of mental health problem is screaming, sleeplessness, tired and the worst was the voice heard on the delicate.  According to Dr Ehsan mostly mental health problem in Ukm is Schizophrenia by depression, aggrasive and others and mostly happen this mental heatlh peoblem is to mep, extra programming and exam week. Suggested solution by this medical officer is therapy, establish a mental Club, counselling.

Other than that we collecting the data by doing a questionnaire using a google drive form and blast it to all ukm students. We blast the form in the whatsapp group such as college group, class group and ask them help to blast that google form to all their members and Ukm group that they have. We chose Ukm student as a respondent based on the issues we bring that mental health problem among Ukm students, so we choose ukm student as a respondent. There are 50 responses that we get from the google form. From the questioner we get that mostly answered the questioner is female and malay, from age 18-21 is 65.3% and 22-25 is 28.6% and other than that is 26 above. While, 79.6% from degree and 20.4% is master in Ukm. The majority of the respondent says with 68%  that mental health problem among Ukm students is the serious problem, and 36% of them know someone that faced the mental problem. By the data says that someone that they know that having a mental health problem is mostly says that they faced stress and depression, other than that is love, attention seeker family problem and others. From the ultimate case that responses by the respondents is the highest is studies which is 28%, family and relationship is 24%, financial 18% and the lowest is work 6%. Respondents says that how they manage their mental health problem such as stress and depression are talk to someone, sharing and ask for their opinions, read quran, always reading motivation stories, reading books, playing games, eat, leisure and more others. The effect from mental health problem from the data that responses is die, sleep disorder (insomnia), lone ranger, suicide, affect daily lives and productivity, lead to a serious anger issues and having suicidal thoughts, will lost focus and will start to hate ourselves and more others.

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The purpose of this report is to study about mental health problem faced by UKM Students and to determine the main causes . In addition, to assess the effects of the problem.