Tengku Puteri Iman Afzan shares her passion for promoting mental health awareness and her personal experience dealing with anxiety
BY FATIHAH MANAF
The issue of mental health has been very much unaddressed in the past in Malaysia. Only recently, Malaysians have started to discuss it openly due to the rising cases of depression and anxiety caused by the Covid-19 pandemic.

Tengku Puteri Raja Tengku Puteri Iman Afzan Al-Sultan Abdullah is a solid mental health advocate striving to promote mental health awareness.
However, it was not something that she had initially planned to do. Still, her personal mental health challenge experience and struggles with it led her to do it. She wanted to let people know that no one should suffer in silence.
She highlighted that it was crucial to inform people on the importance of mental health and that discussion on it should be normalised.
The eldest daughter of Yang di-Pertuan Agong Al-Sultan Abdullah Ri’ayatuddin Al-Mustafa Billah Shah has had her fair share of personal experience dealing with mental health challenges.
That experience taught her to be more self-accepting. Tengku Puteri Iman Afzan is also the Co-Founder and the President of the Green Ribbon Group. This social enterprise aims to empower stakeholders involved in raising mental health awareness. She is also International Patron, World Mental Health Day 2020.
She shares with The Health her passion for promoting mental health awareness, the stigma around mental illness, the Green Ribbon Group and her personal experience dealing with anxiety.
She also addressed the rising mental health problems caused by the pandemic. She shared some of her plans to promote mental health awareness.
Your passion for promoting mental health awareness in the country is admirable. How did you develop this passion?
Promoting mental health awareness was definitely not something I planned to do. But I did have my own struggles growing up, and I still struggle today. The difference is that I understand what I’m going through, and I know how to cope and manage. I only wish I knew more when I was younger. This is the main pull factor for me.
I would like to inform everyone out there about the importance of mental health. I feel a sense of duty to help others.
You may be struggling or know someone who is struggling. You may be a caregiver to someone experiencing mental health challenges or who has been diagnosed with a mental illness. I would like everyone to feel that they matter and to know that they are cared for and supported. No one should suffer in silence. Ultimately, I would like to give a voice to the voiceless.
Do you think mental health is an illness often overlooked, and how important is it to destigmatise mental illness?
Mental illness was overlooked before the Covid-19 pandemic. Mental health, in general, was very much in the shadows, often stigmatised and seen as taboo. The mental health spectrum is broad, and mental illness has been portrayed and understood to be a psychotic illness. It is unfortunate that, in the past, we have not done enough to prevent those with lived experience from suffering from abuse, discrimination and stigma.
And in the more significant part of this spectrum are other conditions like depression and anxiety. These are people who often suffer in silence because they are afraid that people won’t understand them. With support, empathy and proper treatment, these conditions can easily be controlled and cured in many cases.
Nonetheless, I feel that the pandemic has brought a silver lining. It has created much more awareness about mental health. I think we now understand that more people are struggling with their mental health than we think.
At the same time, I think it’s important not to judge those ignorant about mental health. We must take note of and tackle the different perceptions of mental health because there are many. There is a need to educate the less informed from their perspective. There is a need to normalise conversations on mental health and mental illness.
What is your personal experience in dealing with mental health issues? You have also managed your mental health very well. How did you do it?
I have struggled with anxiety since I was a teenager. To say this out loud took some time. I started to speak about my personal experience during an interview in 2019. Since then, I have gotten so much support from the public. People need to know they are not alone. The fact that I can comfort just one person with a lived experience truly goes a long way for me.
If you do not accept yourself with all your strengths and weaknesses, how will anyone? My personal experience in managing anxiety has taught me to accept my flaws, be more self-aware, and manage my emotions internally. The state of our mind cannot be seen. The faster I learnt to manage my thoughts, the quicker I was able to bounce back. There are certain things that I can change, and there are certain things that I cannot change, and that’s okay. Without knowledge or awareness of anxiety and my struggles, I would not be doing what I am doing today – advocating for something so close to my heart. I have embraced my fears, and I am trying to channel them to good use.
I am also fortunate enough to be able to go for therapy. Looking back, this is something that I had been putting off for years. I have learned that it is okay to ask for help and lean on others when you need to. I have also learnt to be a pillar of support for others. My bestie and I bonded over the passing of her father, and we were merely acquaintances then. But I made it a point to check in with her often, and now we run the Green Ribbon Group together.

I also try to work on my well-being in general. My husband, family and friends are my support system, and they have such a positive impact on my life. My son is turning two next month, but he brightens up my day without even realising it. I love reading, and I love the outdoors. Hiking is my current obsession, but I try to get a good sweat session at home or focus on some mindfulness and yoga given the lockdown restrictions. I have learnt to appreciate and enjoy the simple things in life.
There’s been an increase in the number of people affected by stress, depression and anxiety due to the pandemic. How can this be addressed?
Our public health delivery system is quite good compared to most developing countries. Every public hospital in the country has mental health services. The waiting time may be long, but the primary public sector health delivery infrastructure is in place.
We have a shortage of mental health professionals, particularly clinical psychologists, qualified counsellors and mental health social workers. Still, I believe the government is gradually working towards addressing this concern.
On the other hand, the private sector is more urban-based and essentially involves out-of-pocket payment. Suppose the private sector can accommodate a significant part of the demand. In that case, the burden on the public sector will be easier to manage, and the waiting time will be shorter. For this to happen, private mental health care must also be included in the conditions covered by insurance. This is part of my agenda this year.
However, I don’t think supporting those with lived experience is purely the government’s responsibility or the private sector’s. Moving the mental health agenda forward in our country is a marathon, not a sprint. We won’t see changes overnight, so the key is to keep the momentum going.
The onus is on us to check up on one another. We must try to find some normalcy in the fact that uncertainties could remain for some time. The simple act of asking “How are you?” is in itself an investment that can be made by each and every one of us. The pandemic should be seen as an opportunity to encourage more and more people to talk about their struggles.
We must normalise that mental health isn’t something to be afraid of or be ashamed of. What’s important is how we manage our mental health when we struggle just a little bit more than usual and support those with lived experience.
Your efforts have been recognised by the World Federation for Mental Health, the World Health Organisation and other United Nations agencies. Can you tell us of your plans to promote mental health awareness?
I am wary of setting a big mission for a small team of four. We have big goals to reach, but we are not afraid to start small.

A personal goal is to promote mental health education and connect practitioners, caregivers, and volunteers nationwide and globally to share knowledge and best practices. This is important for us at the Green Ribbon Group simply because we are not professionals ourselves.
The critical thing is for us to ensure support, not only for those with lived experience but also for their caregivers. We need to move towards a community approach to mental health. We need to instil the mindset that mental health is the responsibility of all. And we need to start communicating how we can play a supportive role. For instance, how can we listen effectively without judging? For these reasons, the Green Ribbon Group is sponsoring anyone willing to undertake the Mental Health First Aid course run by the Malaysian Mental Health Association. I hope that small steps like this will trickle down into efforts to raise awareness and break the stigma in communities.
What would be your message to Malaysians on the importance of mental health awareness?
For those of you with lived experience, please know that there are people who care for you and are willing to help you. If anyone reading this would like suggestions on where to go for help, please head over to the Green Ribbon Group’s website at www.greenribbongroup.com. We have compiled a list of helplines and affordable places to visit. @greenribbongroup.my on Instagram also has a bunch of infographics to help you manage your mental health and wellbeing.
It’s worth remembering that you cannot pour from an empty cup, but you will be able to move mountains if nurtured. I have to keep reminding myself of this. It’s essential to have a mental health day or a moment if a day is too difficult. Just some downtime to yourself to sit back, unwind and relax. We all need a time out, and we shouldn’t feel guilty about it.
Finally, we should be mindful that others may be going through a tough time that perhaps we know nothing about. I hope we can extend a helping hand to one another a lot more. Sometimes I feel it is almost foreign to ask someone, “How are you?” We need to go back to basics and keep in mind that kindness and compassion go a long way. — The Health
