[COLUMNIST] Bridging mental health and public safety: Enhancing Malaysia’s MyPCVE framework

AS nations intensify efforts against violent extremism, lone-wolf attacks remain a persistent challenge linked to mental health, making its management vital for public safety and national security.

Mental illness disrupts cognitive, emotional, and behavioural functioning—ranging from mild anxiety to severe conditions such as bipolar disorder—and impairs daily social activities. In 2019, 1 in 8 people globally experienced a mental illness (primarily anxiety and depressive disorders; WHO, 2022), with post-COVID-19 increases of 26% in anxiety and 28% in depression. In Malaysia, the 2023 National Health and Morbidity Survey found that depression among those aged 16 and older doubled from 2.3% (about 500,000 people) in 2019 to 4.6% (around one million) in 2023. Additionally, Samsudin et al. (2024) reported that 47% of Malaysian youths exhibited at least one mental health symptom, and over 40,000 civil servants screened via the Public Service Psychological Health Digital Profiling System (MyPsyD) were at high risk for mental health problems.

The 2023 Malaysian Youth Mental Health Index scored 71.91 overall (higher scores indicate lower risk), yet individual domains raise concerns. The social support domain scored 68.29, signalling insufficient emotional, informational, and practical youth support, while the healthy mind domain scored 66.10, indicating a risk of anxiety and depression.

Concerningly, Orang Asli youths exhibit greater mental health disparities, highlighting the urgent need for improved rural support and targeted interventions.

Also, Malaysia faces a stark psychiatrist shortage: only 479 were registered in 2022, far below WHO’s recommended 1 per 10,000 people (roughly 3,000 psychiatrists).

Despite initiatives like the Minda Sihat programme and MENTARI strategy, mental health stigma persists due to cultural and religious beliefs. In Chinese families, mental illness is shunned to preserve family harmony; among Indians, fear of tarnishing reputation hinders acknowledgement; and in Malay communities, supernatural attributions prompt reliance on religious rather than professional help (Amin, 2024).

Contrary to popular belief, most terrorism offenders are not mentally ill. A systematic review by Sarma et al. (2022) found that while mental disorders are more common in the general population, elevated rates occur primarily among lone actors—a significant challenge for global P/CVE efforts. Lone actors exhibit higher rates of schizophrenia, delusional disorder, and autism spectrum disorder than group actors (Corner et al., 2016) and they are 13.49 times more likely to be mentally ill, with 52.9% socially isolated (Cornell & Gill, 2014)—a known risk factor. Their precursory behaviours aid early detection by security agencies, while low self-regulation heightens radicalisation risk, linking extremist sympathies to mood disorders, poor impulse control, anxiety, and PTSD (Bhui et al., 2020).

Mental illness combined with socio-economic factors complicates extremist radicalisation, necessitating targeted rehabilitation for at-risk individuals. Childhood experiences are crucial: parental divorce is strongly linked to mental disorders, and adverse experiences (e.g., abuse, neglect, family violence, mental illness, substance abuse) can trigger emotional, behavioural, attention, cognitive, and executive dysfunctions common among juvenile offenders (Lee et al., 2020; Justice Health and Forensic Mental Health Network, 2015). Jensen and LaFree (2016) found that criminal records, mental illness, substance use, and trauma increase the likelihood of extremist political violence, while community marginalisation, real or perceived external threats, political crises, and group-facilitated cognition also drive violent extremism.

As lone-wolf terrorism increasingly threatens Malaysia’s security, addressing the nation’s mental health crisis is urgent. Deteriorating mental health among Malaysian youths, highlighted in the 2023 Malaysian Youth Mental Health Index, may heighten susceptibility to extremist ideologies. Thus, an effective P/CVE strategy must recognise mental illness as a radicalisation precursor and integrate mental wellness interventions.

Although the Malaysia Action Plan on Preventing and Countering Violent Extremism (MyPCVE) does not explicitly include mental wellness, existing initiatives can readily incorporate it to enhance overall effectiveness, as outlined below.

Prevention

To improve public awareness and early detection of at-risk individuals, MyPCVE’s Prevention pillar should incorporate mental health screening into community outreach programmes:

• Expand the risk assessment tool (Initiative 1.1: Building Tools for Violent Extremism Risk Assessment) to include mental health indicators, such as anxiety, depression, and social isolation. It is also crucial to leverage private sector funding and expertise—such as partnerships with technology firms for digital monitoring and profiling tools or with universities for research and development of assessment tools.

• Incorporate mental health professionals into early intervention programmes (1.2: Early Intervention Programmes), offering counselling and support to individuals showing signs of mental distress. Programmes like Minda Sihat and MENTARI can be integrated into these efforts to provide culturally sensitive care. This will require expanding psychiatric capacity targeting to reach WHO-recommended levels at least within five years.

• Train community leaders and volunteers to spot mental health issues and refer individuals to appropriate services, supporting MyPCVE’s community vigilance and timely intervention (Initiative 1.4: Community Watch Program). Additionally, expand training to include frontline personnel—teachers, counsellors, and prison staff—who play a critical role in detecting early mental health risks among potentially radicalised individuals. Drawing on global P/CVE strategies, these professionals should receive rigorous training to evaluate and refer potential threats while safeguarding patient confidentiality.

Enforcement

The Enforcement pillar should tackle extremist actors' mental health by strengthening legal frameworks and law enforcement training:

• Include modules on mental health awareness into law enforcement training (Initiative 2.1: Enhancement of Integrity and Competency Training) to help officers identify and respond to individuals at risk of radicalisation.

• Revise laws such as SOSMA 2012 and POTA 2015 (Initiative 2.4) to require mental health assessments and rehabilitation for detainees, ensuring care rather than punishment.

• Launch public campaigns (Initiative 2.12: Public Awareness Campaigns on Extremist Laws) to educate on the link between mental health and extremism, reduce stigma, and encourage early help-seeking.

Rehabilitation

The Rehabilitation pillar should adopt a more holistic approach to deradicalisation by addressing the mental health needs of detainees and their families:

• Include mental health professionals on assessment panels to evaluate detainees’ psychological states and tailor rehabilitation programmes (Initiative 3.1). Global P/CVE best practices endorse a multi-stakeholder, coordinated approach—aligned with MyPCVE’s strategic collaboration and intelligence sharing. Accordingly, security agencies, mental health professionals, and community organisations should set up shared databases and communication channels. Additionally, experts should assess at-risk individuals and develop ecologically sound radical profiling tools.

• Allocate dedicated funds for mental health services (counselling, therapy, and family support) in rehabilitation programmes (Initiative 3.4). This could include grants for local NGOs, pilot projects in underserved areas, or technology upgrades for digital mental health profiling (using AI and other 4IR tech). However, MyPCVE must also adopt a robust Input-Output-Outcome-Impact (IOOI) framework to assess programmes before funds are disbursed. IOOI framework is logical and robust reasoning (solely based on science and data) of the entire causal path from inputs (scarce resources/capitals) to outputs (tangible and intangible manifestation of intervention activities) to outcomes (real-world benefits / changed lives) and finally to impacts (higher-level intergenerational goals).

• Collaborate with mental health organisations to provide ongoing support for former detainees, helping them reintegrate into society and reducing the risk of recidivism (Initiative 3.7: Multi-Agency Reintegration Program).

Reinforcement

Comprehensive P/CVE strategies actively counter extremist ideologies. Complementing MyPCVE’s “Reinforcement” pillar, community outreach programmes are essential to strengthen support systems and familial bonds by teaching peaceful conflict resolution, effective communication, and emotional intelligence. These initiatives boost community resilience and enable early detection of socially isolated individuals vulnerable to radicalisation through partnerships with schools, civil society, religious organisations, and employment agencies. Thus, the Reinforcement pillar should focus more explicitly on building mental resilience and reducing stigma through education and community programmes:

• Integrate mental health education into university courses to highlight its role in preventing extremism (Initiative 4.1: Refining Compulsory General Studies). Enhancing mental health literacy through public awareness and culturally sensitive outreach can overcome stigma, respect diverse views, and foster a more inclusive, MADANI-aligned P/CVE approach.

• Prioritise youth involvement in mental health awareness. Leverage programmes like Rukun Tetangga and MENTARI to empower young people to volunteer, research, and lead mentorship efforts, countering extremist narratives and strengthening community resilience.

• Develop family-centred mental health programmes (Initiative 4.8: Family Happiness and Well-Being Index) in underserved communities like the Orang Asli to reduce extremist vulnerabilities. Culturally relevant improvements in village conditions, self-confidence, and familial bonds boost youth resilience (Noordin et al., 2024). Local partnerships among welfare departments, NGOs, and volunteer groups are essential for targeted interventions and a grassroots P/CVE approach.

• Partner with religious and community leaders (Initiative 4.17: Instilling Moral Values) to better address cultural and religious factors driving mental health stigma, fostering an inclusive, supportive environment for those with mental illness.

Beyond its public health impact, mental illness is an antecedent of violent extremism—especially lone-wolf terrorism. Integrating mental health into MyPCVE’s four pillars— Prevention, Enforcement, Rehabilitation, and Reinforcement—will strengthen community resilience against extremist ideologies and reduce violent threats.

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Dr Margarita Peredaryenko and Avyce Heng are part of the research team at EMIR Research, an independent think tank focused on strategic policy recommendations based on rigorous research.

** The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the position of Astro AWANI.

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