THERE IS A growing mental health crisis in Malaysia and across Asia. The World Health Organisation (WHO) estimates that one in every eight people in the world live with a mental disorder.[1] In Malaysia, according to the National Health and Morbidity Survey (NHMS) 2023, approximately 4.6% of Malaysians aged 15 and above (about a million individuals) are suffering from depression.[2]

The 2023 Malaysian Youth Mental Health Index highlights mental health trends among Malaysian youth. Around one in five youths report challenges like anxiety, depression and stress, with women more affected than men. Lower-income youths are particularly vulnerable, with financial instability exacerbating mental distress. Despite the prevalence of mental health issues, only one in three youths seek professional help, often due to stigma (60% fear being judged). Social media also affects mental health, with 50% of youths citing its negative effects, including cyberbullying.[3]

Mental health is often framed as an individual issue, as if it stems purely from personal weakness or poor coping mechanisms. This narrative ignores the broader picture—that mental health is profoundly shaped by the systems in which we live, including our families, schools, workplaces and institutions.

Challenges In Access and Stigma

Malaysia has a severe shortage of trained professionals (see Penang Monthly, June 2024 issue), and mental health remains stigmatised and frequently misunderstood, feared or dismissed. A study conducted at a private university in Malaysia reveals that while students display good knowledge and attitudes towards mental health disorders, there are still significant differences in views based on age, ethnicity and education level, indicating underlying stigmatising beliefs.[4] Such stigma fosters silence, deters help-seeking behaviour and limits timely treatment until symptoms become severe or unmanageable.

In many rural and conservative communities I’ve worked in, mental distress is perceived as a moral or spiritual failing rather than a health issue. Faith healers and religious leaders are frequently the first point of contact, and while their support can be meaningful, relying on them exclusively delays professional intervention. This delay is compounded by the taboo around discussing mental health openly, making it difficult for individuals to even recognise their suffering as valid or treatable. As a mental health professional in Malaysia, I’ve come to see that culturally sensitive engagement is essential for building trust and opening pathways to care.

A Systemic and Community Issue

Mental health does not exist in a vacuum. It is deeply influenced by economic stress, social structures and policies. These intersections are crucial to understand the root causes of psychological distress and to develop more holistic and effective interventions.

Material Wellbeing

In Malaysia, financial insecurity is a major contributor to mental health challenges. When individuals struggle to meet basic needs such as food, shelter and healthcare, the stress can lead to anxiety, depression and burnout. This is particularly significant when viewed through the lens of Maslow’s Hierarchy of Needs, where unmet physiological needs such as food and shelter take precedence, preventing individuals from focusing on emotional or psychological wellbeing. It restricts a person’s ability to address psychological concerns, amplifying feelings of hopelessness. For many, the inability to afford mental health services or the distance to available resources worsens the crisis. Without financial security, mental health care becomes out of reach.

Case Example: Hafiz* from Perlis lost his job during the pandemic and began experiencing symptoms of depression. As the sole breadwinner for his family, his financial strain exacerbated his distress. Initially, Hafiz sought my services in Penang, but after a few sessions, he had to return to Perlis due to his continued unemployment. Sessions continued online, but over time, his financial situation worsened, and he was unable to afford further sessions.

Familial Ties

In Malaysia’s collectivist society, family plays a central role in shaping an individual’s identity, emotional wellbeing and social support network. Strong family bonds may offer resilience and emotional support; however, they can also be sources of significant stress, especially when personal desires conflict with societal or familial expectations. This dual role of family providing both support and pressure can become problematic when cultural norms clash with personal identities or aspirations.

This is particularly true for vulnerable groups such as LGBTQ+ individuals, who often face rejection or misunderstanding from their families. Such rejection can lead to increased psychological distress, including depression, anxiety and suicidal ideation. A scoping review of Malaysian studies involving LGBTQ+ individuals highlights the marginalisation and mental health challenges faced by this community. The review emphasises the need for more inclusive research and healthcare practices that address the unique experiences of LGBTQ+ individuals in Malaysia.[5]

Additionally, cultural beliefs significantly influence help-seeking behaviours among Malaysians, particularly in caregiving roles. A study exploring cultural influences in mental health help-seeking among Malaysian family caregivers find that caregivers often rely on religious and cultural coping strategies, which sometimes hinder timely professional intervention.[6]

Education

The Malaysian education system is often a high-pressure environment that prioritises academic achievement over emotional wellbeing. For many students, the constant pressure to perform, coupled with high-stakes examinations and the expectation to memorise large volumes of information create a culture where mental health issues are minimised or ignored. The competitive nature of the system, where results affect not only individual students, but also reflect on the school’s overall performance, adds an additional layer of stress. This environment leaves little room for students to develop healthy coping mechanisms, often leading to severe consequences.

Case Example: An 11-year-old was referred to me with symptoms of selective mutism. He was a bright student, but struggled in an environment that placed heavy emphasis on exam results. The relentless pressure to perform, combined with the fear of disappointing his teachers and parents, led to an overwhelming sense of anxiety. At school, he would sometimes fall silent, unable to speak even when spoken to, particularly during group activities.

Religion

Religion plays a significant role in many Malaysians’ lives, offering comfort, purpose and community. This can be beneficial when spiritual support complements emotional care, but problematic when religious teachings are used to dismiss or oversimplify mental health issues, leading to guilt, shame or delayed help-seeking. This highlights the need for sensitive, culturally informed mental health support that respects spiritual values while reducing stigma. Integrating faith with professional mental health care can support holistic healing.

Case Example: Although I am not a Christian, I did my internship at a church-based counselling centre. While there, I shadowed a case with my supervisor involving a 34-year-old woman from Ipoh experiencing postpartum depression. She had initially turned to her church’s pastoral counsellor, who encouraged her to increase prayer. While this and the Scripture offered her some comfort, her symptoms persisted. With guidance from a fellow church member and the support of our centre, she began therapy that acknowledged and respected her faith.

Minority Groups

Other systemic issues, including gender, disability and ethnicity, intersect with mental health. For example, women often bear the dual burden of managing household responsibilities alongside full-time work, leading to increased stress and potential burnout. Additionally, the Orang Asli, Malaysia’s indigenous population, face economic marginalisation and cultural erosion, which exacerbate mental health challenges. Limited access to healthcare and education further compound these issues.[7] People with disabilities also encounter social exclusion and limited access to mental health services. Despite the Persons with Disabilities Act 2008 aiming to ensure equal rights, gaps remain in service provision and societal inclusion.[8] Effectively addressing mental health requires interventions that consider these overlapping challenges.

Pathways Forward For Mental Health In Malaysia

To address Malaysia’s mental health needs, public funding must significantly increase, focusing on mobile mental health units, therapy subsidies and the integration of mental health services into public clinics. The RAHMAN Mobile Mental Health Exhibition is one such initiative that reached underserved communities in 2023, offering mobile counselling and awareness sessions across rural areas. This initiative, in collaboration with the Ministry of Health, helped increase help-seeking behaviour, especially among youths and women in remote locations.[9]

Public awareness campaigns should extend beyond online content to engage local communities deeply. The #SembangKalauBimbang campaign, launched in Sabah, involved community leaders, including village leaders, local influencers and schools to hold mental health forums in indigenous dialects like Dusun and Bajau. This approach has significantly reduced mental health stigma in these villages, showcasing the power of localised engagement in breaking taboos.[10]

Community-based organisations are frequently the first point of contact for individuals in mental health distress. However, these grassroots organisations must be adequately equipped with the right training and resources to create safe and supportive spaces for people struggling with mental health issues.

Mental health must be a fundamental component of Malaysia’s public health strategy. Initiatives such as the “Your Mind, Your Journey” campaign launched at Suria KLCC aim to normalise mental health discussions in public spaces. This initiative provided mental health education and access to resources, while aiming to reduce stigma in high-traffic locations.[11]

Mental health must be embedded in the structures of our society—how we work, educate, parent and govern. Addressing it means that everyone—policymakers, educators and religious leaders especially—must see mental health not just as a service, but as a collective social commitment and as the community’s responsibility.

*Names changed to protect identities.

FOOTNOTES

[1] https://www.who.int/news-room/fact-sheets/detail/mental-disorders

[2] https://www.thestar.com.my/news/nation/2024/05/17/a-million-depressed-malaysians

[3] 2023 Malaysian Youth Mental Health Index

[4] https://www.researchgate.net/publication/341840216STIGMAANDATTITUDESTOWARDSMENTALHEALTHDISORDERSACROSSSECTIONALSTUDYATAPRIVATEUNIVERSITYIN_MALAYSIA

[5] https://www.researchgate.net/publication/353944516CurrentResearchInvolvingLGBTQPeopleinMalaysiaAScopingReviewInformedbyaHealthEquityLens

[6] https://www.researchgate.net/publication/284015053CulturalInfluencesinMentalHealthHelp-seekingamongMalaysianFamilyCaregivers

[7] https://www.researchgate.net/publication/290191540MarginalisationoftheOrangAsliofPeninsularMalaysia

[8] https://www.researchgate.net/publication/260243509RightsofthePeoplewithDisabilitiesandSocialExclusionin_Malaysia

[9] https://mentari.moh.gov.my/rahman-mobile-mental-health-exhibition-softboard/

[10] https://says.com/my/lifestyle/air-selangor-sembangkalaubimbang-mental-health-campaign

[11] https://www.mieranadhirah.com/2023/10/your-mind-your-journey-mental-health.html