Amid an ongoing workforce shortage and the non-renewal of contracts for healthcare personnel, a further crisis is emerging within the Ministry of Health (MOH).
As August 2026 approaches, Malaysia faces a critical shortage of mental health counsellors in primary health care facilities, raising concerns over service continuity and access to care.
In 2020, the government recognised the urgent need to strengthen mental health services at the primary care level and appointed 200 Psychology Officers (Counselling) on a Contract for Service (CFS) basis, with annual to biennial terms.
These officers were deployed across State Health Departments (Jabatan Kesihatan Negeri), District Health Offices (Pejabat Kesihatan Daerah), and predominantly within public health clinics (Klinik Kesihatan), forming a key component of community-based mental health service delivery.
Over the past six years, these services have, on an annual basis, reached more than 40,000 patients, delivered approximately 90,000 individual counselling sessions, and implemented more than 2,500 mental health programmes, reflecting sustained and high service utilisation at the primary care level.
However, the continued reliance on short-term contractual arrangements has created structural vulnerability, particularly in the context of non-renewals.
Efforts to expand community-based mental health services were further reinforced with the establishment of the National Centre of Excellence for Mental Health (NCEMH) in 2022, which serves as the central coordinating body for mental health initiatives.
These policy measures represent steps towards addressing Malaysia’s mental health system needs, while also reflecting its obligations as a Member State of the World Health Organization (WHO).
Under international frameworks, countries are expected to establish robust governance of mental health systems, ensure sustainable financing and workforce capacity, and provide comprehensive service coverage across both inpatient and outpatient settings.
The WHO Mental Health Atlas 2020 and WHO Mental Health Atlas 2024 emphasise the integration of mental health services into primary health care, including both pharmacological and psychological interventions, with a target of at least 75 per cent of facilities providing such services.
This is a benchmark that Malaysia has made progress towards achieving, although sustainability and long-term system capacity remain areas for closer scrutiny.
Community- and national-level policy measures reflect progress in strengthening Malaysia’s mental health system and demonstrate a degree of anticipatory policy response to emerging population needs.
This is reflected in the National Health and Morbidity Survey (NHMS) 2023, which estimated that approximately one million Malaysians aged 16 years and above are experiencing depressive symptoms — double the prevalence reported in 2019 — with a substantial proportion reporting suicidal ideation.
Younger age groups were found to be disproportionately affected, underscoring the importance of sustained and adequately resourced community-based interventions.
Notably, one in six children were identified as experiencing mental health concerns, similarly representing a twofold increase compared to the corresponding findings reported in 2019.
This trajectory is consistent with earlier system-level developments, including the establishment of NCEMH in 2022.
However, despite these developments, it is important to note that these short-term contractual arrangements are approaching their conclusion on August 2, 2026, alongside those of many other medical and allied health professionals.
The 2025–2026 contractual arrangements were introduced as an interim measure, following continued administrative and bureaucratic barriers in transitioning CFS positions into Contract of Service (COS) or permanent roles.
With the deadline approaching, efforts to transition these Psychology Officers (who have been trained and deployed within community mental health settings) appear to be encountering similar structural constraints, raising concerns regarding continuity of service and workforce stability.
While the Government has consistently emphasised mental health as a policy priority, concerns remain as to whether these commitments are being translated into tangible and effective measures for the rakyats.
Amid ongoing global pressures, including rising energy and fuel costs and broader economic instability, an increase in mental health needs is to be expected, particularly as financial constraints limit access to private mental health services.
Concurrently, current pressures within the public health care system raise significant concerns, as they risk exacerbating existing social determinants of health and further widening inequities in access to care.
In light of these intersecting challenges, urgent and coordinated policy action is required to ensure the sustainability of Malaysia’s mental health system.
This includes the transition from short-term contractual arrangements to stable and adequately resourced workforce structures, alongside sustained investment in community-based mental health services.
Failure to address these structural gaps risks undermining recent progress and compromising equitable access to care, particularly for vulnerable populations.
As a matter of public health obligation, strengthening system capacity is no longer optional, but essential to meeting current and future mental health needs.
The author is a licensed and registered counsellor in public service. CodeBlue is providing the author anonymity because civil servants are prohibited from writing to the press.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
