Complement, Not Compete: Softening the Mindset Blocking Psychologists in Healthcare

By The Insight Circle, 5th September 2025

"He who is not everyday conquering some fear has not learned the secret of life"- Ralph Waldo Emerson

When Dogma Becomes Hegemony

Dogma, in any system of thought, is a fertile ground for blind spots that obscure a clearer perception of reality. These mental imprints often crystallize into misguided ideals, which then permeate and shape the very tenets of health policy—policies that ultimately bear critical consequences for ordinary lives. Medicine is no exception. Here, dogma is often mistaken as the panacea for mental health, elevated to the status of unquestioned truth—while sidelining vital partners, particularly psychology.This is when the dominance of a single faction—anchored in blind faith in one idea—silences other voices that seek to contribute and be heard. In time, it becomes a kind of religion—the “medicalization” of medicine—pushing the field further away from the comprehensive, collaborative spirit required of a truly multifaceted healthcare system.

The Spoils of War

Meanwhile, in the present, the haunting echoes of this enduring conflict within our healthcare system have quietly simmered to the surface. The entrenched medicalisation of healthcare continues to reverberate in “cloak-and-dagger” turf wars between physicians and psychologists—both equally committed to patient outcomes, yet divided by a profound power imbalance (Deva, 2004). The decisive blow came with the Mental Health Act 2001 and the Mental Health Regulations 2010, reinforcing a system that rewards a psychiatric-centric approach to care (Khan et al., 2015). This marginalisation—less malicious than systemic—has its roots in historical medical dominance and regulatory blind spots, relegating psychology to a lower-tier service. As the smokescreen clears, the consequences are undeniable: rising rates of mental health disorders, poorly controlled chronic diseases, and widespread difficulties in self-management.

The Body Count

Now, this strife has reached its boiling point. In an unhealthy population—where the absence of sustained behaviour change, coping skills, and emotional resilience runs deep—non-communicable disease (NCD) burdens have swelled to a magnitude that health policies rooted in medicalisation alone have never been able to bend, let alone contain (NHMS 2024). In the midst of this dilemma—scrambling for answers long denied—we now find ourselves staring into the pit of despair, forced to bear the full weight of our own indiscretions. The nation is gripped by a severe shortage of psychologists: just 400 clinical psychologists serve a population of 35 million, compared with the WHO’s recommended ratio of 1 per 5,000 people (The Star, 2025). In this regard, Malaysia is lagging far behind. Neighbouring countries such as Thailand and the Philippines have shown greater foresight—formally integrating clinical psychologists into their public health systems nearly 30 years ago, and today sustaining a vibrant and functional workforce within the sector (Wannasewok et al., 2022; Lally, Tully & Samaniego, 2019).

The Hour of Action

While Malaysia hesitates, waiting for other countries’ initiatives to bear fruit before taking action, time is a luxury we no longer have. The nation needs a hard reset—and it needs it now. We cannot keep one foot on land and the other in water, hoping our problems will somehow resolve themselves. A leap of faith is required. This reset is inevitable, though it can be undertaken gradually. Several immediate strategies are already on the table—awaiting only the mental resolve to see them through

1.       The moral imperative – The siege mentality within the corridors of power—and the petty quarrels that stem from it—must be laid to rest. We must place the nation’s interests above personal gain, above protecting rice bowls, and above undermining the welfare of those who depend on our decisions. Health practitioners, whether physicians or allied health professionals, must remember that the privilege of power comes at the cost of denying others that same luxury—ordinary citizens who are simply yearning for something better. What is needed now is a grand reconciliation within our healthcare fraternity: to lay down our guard and work collectively, not for self-interest or profit, but for the good of the nation.

2.       Mental health is not psychiatry alone – Forcing psychologists to work outside their vocation, and compelling them to remain “strangers in their own land”, undermines the very lifeline that once helped develop psychiatry as a discipline. The medical fraternity should collectively champion a Psychology Act that grants psychologists legal standing and independent registration. Clear definitions of practice would protect scope, grant autonomy, and prevent dependence on medical goodwill. Such clarity would also help avoid overlap between the core competencies of counsellors and psychiatrists—an overlap too often perceived as professional competition. Precedents for this exist across the region, most notably in the Philippines with the passage of the Psychology Act of 2009.

3.       Test the waters with novel pilot incubator projects – Are we too afraid to invest in structural reforms, paralysed by fears of fiscal backlash from initiatives that may end up “dead in the water”? With so many homegrown, cutting-edge mental health and NCD projects pioneered by local talents, a genuine synergy between policymakers and researchers may hold the key to demonstrating how psychologists already shape lasting change in the lived experiences of people with NCDs and mental health conditions. Evidence from community-led projects shows that shifting from a hospital-centric model to community-driven interventions fosters personal recovery and well-being in low- and middle-income countries (Chutiyami et al., 2025). The proof of concept is already here. The next step is clear: bringing psychologists and counsellors into the fray—and harnessing digital innovations to amplify their reach.

Finding Closure

These steps are within reach and readily implementable. What remains absent is the courage to act. While we bicker over which ideas should hold sway, the pleas of countless Malaysians fall on deaf ears. A hard reset is unavoidable. Sacrifices must be made, and bold leaders must rise to the occasion—prepared to do not what is convenient, but what is conscionably right.