KUALA LUMPUR: The recent revelation by Health Minister Datuk Seri Dr Dzulkefly Ahmad that approximately one million, or 4.6 percent of, Malaysians aged 15 and above suffer from depression is a serious matter that demands the immediate attention of all parties.
Citing the National Health and Morbidity Survey (NHMS) 2023, he said this figure represents a twofold increase compared to the findings in the 2019 NHMS.
However, experts caution that as long as the societal stigma of mental health remains unaddressed – coupled with a shortage of specialists and uneven distribution of resources – the nation will face significant challenges in managing mental health problems among its population, particularly in rural areas.
On Nov 27, Dr Dzulkefly, citing statistics by the World Health Organisation (WHO), said 10 to 20 percent of the global population experience mental health conditions at some point in their lives. This means that one in every 10 persons, or more, faces mental health challenges, which can range from conditions such as anxiety to depression, ultimately affecting their well-being.
Depression a common disorder
Psychiatry professor at Universiti Malaya Medical Centre Prof Dr Ng Chong Guan, who is also the Malaysian Mental Health Association (MMHA) deputy president, said the 2022 NHMS indicated that 26.9 percent of adolescents met the criteria for depression, with higher prevalence among females at 36.1 percent compared to 17.7 percent in males.
He pointed out that common mental health disorders among adolescents include depression, anxiety disorders and suicidal behaviours.
“According to the 2022 NHMS, 13.1 percent of adolescents experienced suicidal thoughts, with rates higher among females at 18.5 percent compared to 7.6 percent in males,” he told Bernama recently.
He also said mental health stigma plays an important role in an individual’s willingness to seek help and discuss mental health concerns, often influenced by cultural beliefs and low mental health literacy.
Dr Ng, who is also president-elect of the Malaysian Psychiatric Association, explained that various factors such as societal stigma, job insecurity, lack of management support and concerns about professional credibility hinder people from seeking help.
He said many individuals only seek assistance when their conditions become unmanageable, adding that self-stigma is particularly prevalent among the lower socio-economic groups, leading to negative attitudes towards help-seeking behaviours.
“Among Malaysian youth, societal stigma is perceived as a reputational risk, deterring them from disclosing mental health issues or seeking help,” he said, adding young Malaysians, however, value efforts to improve mental health literacy.
On the rising cases of incidents involving individuals with mental health issues, which has raised public safety concerns recently, Dr Ng said there is a perception that a mental health diagnosis can sometimes be seen as a way to avoid punishment.
“This perception may arise from a misunderstanding or mistrust of mental health conditions, particularly in Malaysia where cultural and societal influences may contribute to such beliefs.
“Mental illness is often not seen as a legitimate medical condition but rather as a weakness, spiritual issue or even an excuse to escape responsibility. This stigma leads to skepticism about the authenticity of mental illness claims, especially in challenging circumstances such as (when an accused is) facing punishment.
“In legal contexts, the belief that mental illness is a ‘convenient excuse’ can result in unfair treatment of defendants with legitimate mental health issues,” he explained.
In its special report on Oct 25, Bernama highlighted public concerns about the possibility of victims not receiving proper justice in cases involving perpetrators allegedly suffering from mental health issues.
In early October, a woman driving a sports utility vehicle was involved in an accident in Terengganu which claimed the lives of three Universiti Teknologi Mara Dungun students. The driver was reportedly having mental health issues and following the case, the Ministry of Health (MOH) said it is willing to amend the relevant laws to address the misuse of mental health conditions as a “ticket” to evade legal consequences.
Shortage of experts
Commenting on the accessibility of mental health services in Malaysia, particularly in rural areas, Dr Ng acknowledged the shortage of mental health professionals and the uneven distribution of resources, which are heavily centralised in the Klang Valley.
He said this urban-centric distribution exacerbates accessibility issues for rural populations.
“Recent reports indicate there are approximately 500 psychiatrists nationwide, equating to a ratio of about 1 (one) per 100,000 people, which is far below the WHO recommendation of 1 per 10,000.
“In rural regions such as Sabah and Sarawak, there are reports of a higher prevalence rate of mental health problems of approximately 43 percent. Barriers in these areas include limited availability of specialised services, logistical difficulties and socioeconomic factors,” he explained.
Dr Ng also opined that non-governmental organisations (NGOs) like MMHA and community groups play critical roles in bridging gaps in mental health care in Malaysia.
MMHA, for example, conducts workshops and seminars on various topics, such as Caregiver Support and Education, in providing support and education to caregivers of individuals with mental illness. Another flagship programme by MMHA is Mental Health First Aid, a licensed and accredited programme from Australia.
“Besides that, MMHA also offers community psychological support services, including counselling, psychotherapy and other mental health support services at subsidised rates, making them more accessible to those in need.
“Other NGOs such as Befrienders offer crisis helplines and interventions to provide immediate support to individuals experiencing mental health crises. Community-based peer support groups help individuals with mental health issues by sharing experiences, reducing isolation and building support networks,” he said, adding that this approach fosters culturally sensitive support, particularly in rural and underserved areas.
Dr Ng said MMHA often collaborates with government agencies, the private sector and international organisations to expand the reach and impact of mental health programmes, which include campaigns like ‘Let’s Talk Minda Sihat’ by MOH that encourage open conversations about mental health to reduce stigma.
“The challenges of (addressing) mental health issues in Malaysia require a multifaceted approach, including increasing the number of mental health professionals, ensuring equitable distribution of resources and integrating mental health services to ensure broader accessibility across both urban and rural areas.
“There is a growing recognition of the need to ‘task share’ mental health services across NGO stakeholders. Through these roles, NGOs and community groups have significantly contributed to improving mental health awareness, increasing access to care and advocating for systemic changes in Malaysia’s mental health landscape,” he added.
Workplace pressure
Sharing his insights, occupational health specialist and president of the Malaysian Occupational Health Practitioners Association Dr Shawaludin Husin said workplace stigma surrounding mental health can have profound effects on employees who genuinely need support or treatment.
The impacts of such stigma include fear of disclosing their mental health conditions to employers or colleagues due to concerns about discrimination, job loss or negative judgments. This fear can also lead employees to delay or even avoid seeking professional help despite needing it.
“Stigma can cause stress, anxiety and feelings of shame, which can disrupt an employee’s ability to function effectively at work. Employees facing stigma may feel isolated from colleagues and find it challenging to build healthy relationships.
“This situation can also result in decreased productivity, workplace absenteeism and higher job turnover rates,” he said, adding that many people still lack clarity on the stressors that can lead to anxiety and depression.
He said while financial problems are generally the main source of stress, other contributors include relationship pressures involving partners, family members and friends, as well as communication challenges, whether verbal or non-verbal, including online interactions.
“Nowadays, people spend time on social media, commenting here and there, getting stressed over things and then ‘breaking down’ (becoming emotionally disturbed). It may sound amusing but that’s the reality.
“In the workplace, aside from financial issues, factors such as time management, co-worker dynamics and individual personality traits also contribute to stress. Personality traits vary, with some individuals being calm and positive while some are neutral and others, quick-tempered,” he said.
Don’t judge
Dr Shawaludin also pointed to a report on Oct 1 stating that over 40,000 civil servants in the country are at high risk of experiencing psychological health issues that require immediate intervention to prevent mental disorders.
This finding is based on research conducted through the Psychological Health Profiling Digital System for Public Service Officers (MyPsyD), launched on March 1 this year as part of the government’s latest initiative to enhance risky behaviour prevention programmes.
“When a colleague, for instance, seeks counselling, or psychological or psychiatric help, others often label them as mentally ill or, worse, crazy. In reality, the person concerned is taking the right step by seeking social support to talk (about his/her problems) and receive mental health intervention.
“Due to people’s mentality and societal stigma, some individuals prefer to share their concerns with artificial intelligence (AI), which is perceived as more understanding, non-judgmental and even capable of being a good listener. However, there’s concern that prolonged reliance on AI for such interactions might lead to other issues,” he said.
Dr Shawaludin added that stress has both positive and negative aspects, noting that good stress can motivate employees to perform their duties with greater enthusiasm. In contrast, negative stress can result in panic, anxiety, irritability, emotional instability and taking sick leave frequently.
“When emotions are consistently poorly managed, other health issues may arise, including obesity, diabetes, hypertension, anxiety and insomnia,” he said.
He said various models exist for managing mental health in the workplace, including the Employee Assistance Programme, which involves an independent body or third party acting as a consultant, encouraging employees to openly share their problems.
“The Mental Health First Aid model, popular in Australia and New Zealand, operates as a group or community support for sharing and expressing feelings. This model is akin to MOH’s ‘Let’s Talk Minda Sihat’ programme, which encourages the public to seek support and help to achieve mental well-being,” he said.
Pointing to the Occupational Safety and Health Act 1994, he said it aims to ensure the safety, health and welfare of all individuals in the workplace.
“Based on the concept of self-regulation, the primary responsibility lies with those creating the risks (employers) and those working with the risks (employees),” he said, adding mental health is also covered under this Act.
