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Is Therapy Enough?

2 days ago
8 min read

Prepared by Alicia Lee

22 October 2026


Is Therapy Enough? Why Mental Health Responses Must Go Beyond The Individual

Is Therapy Really Enough?

Conversations about mental health tend to place the onus on the individual, where solutions to “overcoming” mental health conditions are predominantly focused on efforts to be borne by the person with these lived experiences. We are asked to try several things to “feel better”: recognise the signs, reach out for support, book those therapy sessions, get 8 hours of sleep, your daily dose of Vitamin D, stay active, and the list goes on and on. When nothing changes, we are often told, “You’re not trying hard enough!”

But rarely are we asked, “What landed you here in the first place?”

While exploring professional interventions, such as conventional individualised therapy, is worthwhile, how we cope with and respond to our environment is only part of the picture. A more holistic look into mental health is required to thoroughly understand the way in which someone may be forced to interact with the world around them. This means observing the environment itself: the social and structural conditions people are born into—ones that people cannot easily leave or “overcome”.

Social determinants are the everyday circumstances of life that shape how people live, such as quality housing, income levels, and job security (World Health Organisation [WHO] & Calouste Gulbenkian Foundation, 2014). Structural determinants sit beneath these; they are the written and unwritten rules, and the power relations that keep them in place, giving some social groups lasting advantage over others (Heller et al., 2024). These rules and relations operate through forms of exclusion such as racism, sexism, ableism and class-based discrimination, producing inequities along racial, class, gendered and geographic lines (Heller et al., 2024). These structures shape who has more job security, who can afford stable housing, and who can reach and receive care before a crisis.

This is where the limits of individualised care become abundantly clear.  When social problems are reframed as ailments to be resolved primarily by the individual, attention moves away from the structural inequalities and injustice that make people’s lives difficult to begin with; mental health conditions should therefore also be understood as community or societal problems, not just individual concerns (Moncrieff, 2022).

The WHO takes a similar view, describing mental health as a continuum that different people experience differently. It is shaped by a combination of individual, family, community and structural factors that can either protect or undermine mental health. Poverty, violence and inequality raise the risk, while decent work, safe neighbourhoods and strong community ties help protect against it (WHO, 2026). While most people are resilient, those exposed to adverse circumstances face a higher risk of developing a mental health condition (WHO, 2026). Thus, mental health, including suicide prevention, must be addressed from all angles: through individual care and the conditions surrounding it. These conditions cut across different ministries and government agencies, including housing, labour, education, welfare, and communications; addressing mental health as a nation is a task for more than just the Health Ministry.

How is Malaysia’s Progress in Holistically Addressing Mental Health?

According to the National Health and Morbidity Survey 2023, about one million Malaysians suffer from depression, with nearly half of them having thoughts of hurting themselves or suicide; the number of people with depression even doubled between 2019 and 2023. Worryingly, one in six children aged 5 to 15 also experience mental health conditions, a prevalence reported to have doubled since 2019 (Bernama, 2024). Meanwhile, data from the Royal Malaysia Police (PDRM) found suicide cases rising from 981 in 2022 to 1,087 in 2023, and 1,114 in 2024, with a slight dip to 1,079 in 2025, yet remain high according to the Health Minister (Bernama, 2026b). These figures come after the COVID-19 pandemic, a period of widespread economic and health uncertainty, though this data alone cannot indicate whether the two are connected. Some policy responses have been implemented to address mental health and suicide prevention in Malaysia. On 28 September 2026, the Ministry of Health (MOH) launched the National Suicide and Fatal Injury Registry Malaysia (NSFIRM), a system to enhance the collection of forensic data on suicide and injury-related deaths, enabling systematic analysis and trend monitoring and accurately informing policies, programmes, and services that better meet needs on the ground (Bernama, 2026b; Kaur, 2026). The ministry also launched Postvention Services Guidelines, which aim to ensure that people affected by suicide death receive psychosocial support while reducing the risk of repeated or copycat behaviour; the Mental Health and Psychosocial Support Services (MHPSS) teams will provide on-ground assistance through expertise and support to affected agencies and communities (Bernama, 2026b).

The Health Minister called for a whole-of-government and whole-of-society approach, requiring commitment from all stakeholders. Thus, the ministry is also conducting training and capacity-building programmes for relevant agencies, including the Ministry of Education, the Social Welfare Department (JKM) and NGOs (Bernama, 2026b). Extending training beyond the health sector recognises that distress may often first be encountered in schools, welfare offices, and community settings rather than in clinics.

These initiatives show that the government is beginning to treat structural conditions as part of addressing mental health, as seen in the workplace. For instance, the Department of Occupational Safety and Health (DOSH) under the Ministry of Human Resources has developed the 2026 Occupational Safety and Health Guide for Flexible Work Arrangement, which requires employers who adopt flexible work arrangements (FWA) to assess psychosocial risks such as work-related stress and mental fatigue (Tan, 2026). By requiring employers to consider these risks, the guide recognises that working conditions shape mental health and that addressing it requires shared responsibility across sectors, rather than relying entirely on the Ministry of Health. In fact, the MOH is developing its own workplace mental health policy in consultation with MOHR, DOSH, the Malaysian Employers Federation (MEF) and the Malaysian Trades Union Congress (MTUC) (Bernama, 2026c).

Collaboration also shapes how some services are delivered. Mentari—the MOH’s community mental health centres—supports rehabilitation and return to work. The Health Minister recently reported that 76 per cent of psychiatric patients in the programme were reintegrated into the workforce, as of June 2026 (Bernama, 2026a). PeKa B40, the MOH’s free health screening scheme for low-income adults, reaches people through the welfare system, where eligibility is tied to receiving Sumbangan Tunai Rahmah (STR), and mental health screening is included (ProtectHealth, n.d.; MyGovernment, n.d.). Meanwhile, the Ministry of Women, Family and Community Development (KPWKM) runs the Talian Kasih 15999 helpline with counselling available (Bernama, 2020; Malaysian Mental Health Association, n.d.), and JKM has provided crisis intervention and psychological support to affected families (Rahim, 2025). In Budget 2027, the government expanded its Second Chance Policy for bankruptcy discharge to primary caregivers of family members with disabilities, patients with chronic illnesses, senior citizens, gig workers and people without fixed income (Amin, 2026). This initiative was not presented as a mental health measure, though it addresses a source of financial strain. What More Do We Need?

While these are great partnerships and initiatives, they still appear to be built as individual programmes rather than through a centralised mechanism that applies a mental health lens across ministries; existing measures cluster around crisis and post-crisis response and data, with early detection and community rehabilitation as an afterthought. For instance, of the 328,302 people screened through the PeKa B40 scheme in 2025, nearly 46 per cent were found to have at least one previously undetected health concern, including non-communicable diseases (NCDs), a risk of anxiety or depression or both (CodeBlue, 2026). However, the scheme does not currently cover treatment or medication costs, and its other benefits (i.e., medical devices, cancer treatment completion incentive and transport) do not extend to mental health care (ProtectHealth, n.d.); thus, when someone screens positive for a mental health concern, they may be referred to another service or healthcare professional instead of receiving immediate treatment and support.

Publicly available information does not indicate how many people screened positive actually receive immediate care. Crucially, screening and referral typically begin when distress is already present, thus neglecting the conditions that are actually contributing to their poor mental health, such as unaffordable rent, precarious work, or unpaid caregiving responsibilities. This form of financial strain is closely linked to the poverty-related conditions that a systematic review identified as risk factors for common mental disorders, including anxiety, depression, and somatic symptom disorder, in low- and middle-income countries (Lund et al., 2010). This connection is also reflected in the Ministry of Health’s (MOH) observation that high rates of mental health issues in Kuala Lumpur are associated with the stressful living conditions of urban B40 households, including the rising cost of living (Kalaiselvan, 2023).

Closing this gap starts with building mental health into policy-making itself. Just as gender considerations or gender mainstreaming are assessed before policies are enacted, a mental health assessment, such as who might be harmed and how, must be applied when drafting housing, labour, education and social protection policy. This also means making mental health care accessible before a crisis occurs and making it affordable for those who need it. Therapy is worthwhile, but it is failing the people who are most exposed to structural stressors, and who cannot afford it. Linking mental health screening to treatment, and extending community-based support to people who are not yet patients, would make individual care complementary to structural change rather than a substitute for it. Most importantly, lower-income and marginalised communities must be included in shaping these policies, rather than treated as subjects. This year’s World Mental Health Day theme, “Lived Experiences Heard: Real Voices, Real Change”, emphasises this importance (World Federation for Mental Health, 2026), as those who have navigated unaffordable housing, job insecurity, discrimination, or inaccessible services would understand the policy gaps better than anyone else. Only when their input is included can Malaysia effectively design, monitor, and evaluate its mental health policies across all areas of life.

If you or anyone you know is struggling with mental health, you may contact the following hotlines:

 
 
 

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