Why stammering is a mental health issue

At any one point in time, 29% of Malaysians experience symptoms of common mental health conditions such as feeling sad, worthless, worried, and anxious.

Despite this, the majority of the population are unable to identify signs of poor mental health or the causes and treatment of mental health conditions.

As shocking as it sounds, this should come as no surprise. Mental health literacy is at an all-time low in the country, as revealed in statistics in a recent report by Relate Mental Health Malaysia.

Case in point: I only realised I had a disorder that has been directly affecting my mental health after hearing about it on a recent TedX talk – and I work for a health think tank.

The earliest I remember stammering was during a Year Six Bahasa Malaysia class in primary school. I could not come up with an answer to a question by the teacher, who also happened to be the school disciplinarian.

Instead, I started slurring. I could not speak coherently. “Sa-sa-saya tak tahu, cikgu,” I mustered with whatever courage I had at that moment.

I was forced to remain standing at my seat, despite not knowing the answer, until the end of the class. When I finally got to sit down, it was only because the bell had rung, and the school day had ended.

As I found out much later on, I was suffering from stammering, also known as stuttering, a relatively common speech problem in childhood, which can persist into adulthood – as was the case for me.

Those of us who stammer can’t deliver certain words at times – it gets “stuck” on our tongues, and we can’t continue speaking fluently. Instead, we quickly come up with another word to use or stop speaking entirely, to hide the stammering.

Stammering can be caused by certain drugs, medicines, or psychological or emotional trauma. It is commonly detected during early childhood and can be acquired in older children and even adults as a result of a stroke or head injury.

It’s estimated that 1% of the world’s population stammers.

It has been 11 years since I realised I had a stammering problem. I have come a long way since then. I am an experienced journalist and writer, and now a programme officer with a prominent research outfit.

Who could have imagined that the boy who couldn’t speak would end up conducting interviews and chasing after politicians for exclusive stories, or end up doing public speaking and theatre? I certainly didn’t.

I expected to work an office job, behind a screen, and away from everyone else, so that I didn’t have to speak.

At one point, I even wanted to print out cards to give to people before speaking to them so they knew in advance that I could not speak properly, especially during interviews – because how could you realistically expect to land a job if you could not speak like everybody else?

In fact, studies show that employers hold negative attitudes towards people who stammer, affecting their likelihood of successful recruitment or promotion. Those who stammer face casual discrimination among their colleagues as well.

So, things are definitely not easy. Stammering happens at random and this means there is always a chance that I will be unable to speak coherently during meetings, speak to my friends and family properly, much less talk to interviewees.

It also means that I cannot pick up the phone or call somebody without having anxiety or fear that I will stammer. And make no mistake that unchecked anxiety can spiral to a whole umbrella of issues, which can easily lead to depression as well.

Stammering-induced anxiety brings about rapid breathing, a fast heart rate, sweating, fidgetiness, and difficulty concentrating, all of which make working as a person who stutters mentally and physically unbearable.

One way that the narrative can be changed for people like me is educating the public on stammering, how it is uncontrollable and is rarely cured in full, and that it has no effect on a person’s intelligence. Discrimination and social stigma should not take place.

But can this happen in Malaysia? As far as I can tell, treatment for stammering is largely child-specific, and it is easier to find children-specific clinics and experts who can treat stammering.

Adults, on the other hand, are directed to the nearest private hospital, where the cost of treatment can be hefty.

How about government hospitals then? According to the Ministry of Health, there were only 104 speech-language therapists serving in the ministry as of 2015, and six new therapists joining every year from 2001 to 2010.

Hence, patients would have to wait for a longer time to meet these experts due to limited manpower.

Then there are some who feel that stammering has no direct correlation with mental health disorders.

Thankfully, the science is there to debunk that – previous studies have shown that adult stammerers had social phobia, and mental health disorders, with most recovering from these after receiving treatment for stammering.

I do hope that people like me are able to be as happy and healthy as they should be, notwithstanding their speech disorder.

Besides the character-building, resilience, and empathy we get out of persevering, we deserve supportive policies and information in schools and workplaces to help us flourish in life.

Having a supportive, non-judgmental network of friends and confidants, and exposure to mental health content has helped me greatly in this regard.

Speaking and hearing about why it is fine to stammer, and not being called out for stammering, are also helpful.

I guess it does get better, doesn’t it? Let’s hope so anyway.

Vinodh Pillai is programme officer for the Galen Centre for Health and Social Policy.

The views expressed are those of the writer and do not necessarily reflect those of FMT.