MARCH 29 — In February, Malaysia’s Minister in the Prime Minister’s Department, Dr. Zaliha Mustafa, came forward with a shocking announcement: more than 40,000 civil servants are at high risk of mental illness.
The alarming number points to the tremendous stresses on public servants, particularly in health services, where the strains of service, bureaucracy, and domestic life frequently converge with terrible consequences. Among these professionals, dental clinicians working in government services—either the Ministry of Health (MOH) or public universities—are faced with a unique set of challenges that increase stress, burnout, and mental depletion.
In public universities dental hospital, the dental staff with their dual role as academicians and clinicians create a constant cycle of responsibilities, with many struggling to maintain their well-being.
Being a civil servant in Malaysia is not an easy life. Although job security is normally a plus, the reality of the situation is that most end up with monstrous workloads, unnecessary bureaucracies, and minimal career growth. It is worse for health professionals, especially those working in dental services.
Imagine this: a dental clinician working in a state hospital or a university dental clinic. His/her day begins with back-to-back patient appointments, with little or no time between cases because it is in demand.
They are needed to perform intricate procedures, address patient apprehensions, and maintain accurate records—all under rigid government standards. With the vast quantity of patients and paperwork combined, little room for rest breaks is available, never mind time for relaxation.
However, matters don’t resolve with the last patient leaving. In the public universities, there’s more work beyond the realm of clinical practice. They are also scholars, and they have been charged with education, investigation, publication, and service on administrative committees.
Being great in each of these spheres—clinician, teacher, researcher—is unrealistically and prohibitively stressful. Research timelines are at odds with clinical needs, teaching chores usurp individual time, and the constant publish-or-perish burden is yet another stressor. The shadow of “publish or perish” looms over them, as promotion often relies on publication, putting many in a vicious cycle of productivity.
Financial strain is added to these issues. While civil servants enjoy secure wages and recently the pay rise, the rising cost of living, especially in urban areas, has many still having to tighten their belts. Junior dental officers and lecturers, on their entry-level salary, cannot afford to meet student loan payments, accommodation costs, and family bills.
With the attendant long working hours and financial stress, a poisoned or toxic culture of declining mental health grows silently.
The mental cost of work in the health sector cannot be ignored. Dental professionals daily have to deal with distressed patients, some of whom are anxious or difficult. Managing problem cases, especially in under-funded public clinics with limited facilities, can be a pain in the ass, which will lead to feelings of helplessness. Inadequate facilities, long waiting times, and ineffective systems are among the contributing stressors at work.
Over time, this emotional burden gives rise to compassion fatigue—a state of emotional depletion in which caregivers find it harder and harder to empathize with patients.
Work-life balance has also become a casualty in this stressful work environment. The majority of healthcare civil servants work overtime, sacrificing weekends and holidays to meet deadlines or cover gaps. Family time, leisure activities, and even basic self-care are sacrificed.
The constant juggling act between personal and professional life drains many to the point of exhaustion without any energy buffers to recover. Social relationships are compromised, and isolation sets in, further straining mental health.
Previously, the COVID-19 pandemic only made these challenges worse. Healthcare professionals were on the frontlines, with unprecedented risks, longer hours, and the emotional burden of witnessing agony firsthand. Dental care was especially hard hit, since aerosol-generating procedures carried high infection risk.
Clinicians worked in fear, afraid of introducing the virus into their homes to infect their families. Even as the pandemic started to recede, the built-up backlog of cases and increasing patient demands left indelible imprints on the mental well-being of these professionals.
Despite all this, mental health support for civil servants remains inadequate. While there are Employee Assistance Programs (EAP) and counseling services available, few employees are even aware of them or willing to use them because of cultural stigma.
Mental illness remains a forbidden subject in most working environments, with the risk of being labelled as weak or psycho if admitting to stress or anxiety. With no confidential and accessible mental health support, the rest remain silent sufferers until they hit a breaking point.
Then, what can be done to address this crisis? First and foremost, there must be a systemic shift in the thinking on mental health in the civil service. Government department heads and university vice chancellors must foster an open culture, where staff can discuss their problems without fears of being judged.
Mental health awareness courses, stress management workshops, and peer support groups must become a way of life.
Second, workforce management would be a priority. Hiring more people, especially into overburdened healthcare teams, would lift some of that pressure. More flexible work such as hybrid calendars for academic clinician staff may help restore the work-life balance.
Reducing non-essential bureaucratic tasks would also free time for productive purposes.
Third, career and financial rewards should be examined. Competitive pay, accelerated promotion tracks, and research funding for academic clinicians might alleviate economic pressures and enhance job satisfaction. Acknowledging and rewarding effort—not only through promotions but also through non-monetary recognition—can enhance morale.
Finally, mental health services must be more accessible. In-house counseling, remote access, and anonymous hotlines might encourage more civil servants to seek early help. Training managers to recognize burnout symptoms and intervene in time could prevent crises from arising.
The alarming disclosure that 40,000 civil servants are facing the risk of mental illness is an eye-opener. They are the pillars of Malaysia’s public sector—especially the health professionals who make the nation healthy. Their health has direct bearings on the quality of service they provide. Unless this issue is tackled, the crisis will be triggered by high turn-over, reduced productivity, and ultimately a weaker public sector.
It is now time for policymakers, healthcare managers, and university administrators to step up. Mental health is not a luxury; it is a requirement for a productive, compassionate civil service. By addressing the root of stress and creating a healthy workplace, Malaysia can have its civil servants—especially those in healthcare—thriving at work, rather than just clinging on. The nation’s health is at stake.
* Assoc Prof Dr. Lim Ghee Seong is an Associate Professor at Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, and may be reached at [email protected]
