Mental Health COVID-19

Malaysia's Largest Mental Health Dataset

Article by Dr Tiffanie Ong

As a comprehensive digital therapeutics company that specialises in the prevention and management of non-communicable chronic diseases and mental health conditions, Naluri has amassed a cross-sectional dataset from more than 20,000 Malaysian working adults that provide a unique insight into the state of the nation’s mental wellbeing and warns of a larger, more menacing problem if actions are not taken to course correct. 

Deterioration of mental health

The data, collected using the Depression, Anxiety and Stress Scale (DASS-21), reveals a more than two-fold increase in the number of high-risk individuals – those experiencing severe symptoms in at least one dimension of their mental health (either depression, anxiety, or stress) – from 22% in Feb 2020 to 46% in March 2020, when the first wave of COVID-19 swept through Malaysia and when the World Health Organisation first declared the disease a pandemic. (Figure 1)

Figure 1 
Distribution of risk levels based on DASS-21 (Depression, Anxiety, Stress) from August 2019 to July 2021

DASS Results (Aug 2019 to July 2021)

Source: Naluri’s mental health assessment dataset

A closer look reveals that the overall deterioration of mental wellbeing was largely driven by an increase in symptoms of depression (Figure 2) and the co-occurrence of depression with anxiety (Figure 3). This is significant because the increase in the co-occurrence of depression and anxiety suggests more people are at higher risk. This is because comorbidity is associated with more severe symptoms and therefore more severe impairment of functioning, slower response to treatment, higher rates of recurrence, as well as an increased likelihood of suicide

Figure 2


Figure 3


Source: Naluri’s mental health assessment dataset

This development is perhaps unsurprising – the pandemic and the country’s various abatement initiatives (which have included several iterations of lockdowns and movement control orders) have caused economic uncertainty, fear of infection, limits on social interactions, as well as new challenges with remote work and schoolingFrequent changes to the rules and restrictions have exacerbated the matter and have also led to high levels of uncertainty about the future and worry about being able to meet one’s needs in the present.

While the Malaysian Ministry of Health and other relevant associations have made great strides to increase the mental health support available for the public, these initiatives are largely focused on addressing the needs of those who are already suffering from a mental health condition or are aware that they are at high risk of developing one. However, as demonstrated by the Naluri dataset, there is also a need to cater to the wider segment of the population, specifically individuals who may not currently be experiencing any symptoms or only mild to moderate symptoms of psychological distress.

A Strong Case for Early Intervention

Like any chronic health condition, early detection and management can considerably mitigate risk factors and prevent further deterioration. For example, early screening and preventive lifestyle interventions including a healthy diet, exercise, and stress management techniques have been proven to be effective treatments for diabetes. Similar interventions can be taken against depression, anxiety, and other mental health conditions as well.

Naluri’s dataset over the last 24 months indicates several examples of often significant deteriorations, from low risk into mild risk, and then more worryingly, from mild risk into moderate and high risk, calling for a greater emphasis on early intervention and preventative care. (Figure 1) Failing to intervene at this early stage could signal more far-reaching problems that point to more preventable tragedies

And while a global pandemic is perhaps the most extreme example of a collective setback, it has highlighted the importance of nurturing psychological resilience –  the ability to mentally or emotionally cope with crises, overcome obstacles, and recover quickly from setbacks or failures. Naluri’s raison d'être is to address this very need. By leveraging AI technology, Naluri is positioned to identify at-risk individuals, provide proactive, personalised interventions, and demonstrate quantitative improvements that in turn reduce the likelihood of further deterioration. 

To do that, Naluri employs screening tools that include DASS-21 and a resilience assessment that help identify those at high or severe risk for clinical attention and those at mild or moderate risk for timely, proactive care.   

Using the results of these assessments to establish a baseline for mental health and resilience, individuals can then be provided with risk-stratified interventions that range from self-guided learning to more longer-term structured support through a network of professional coaches that include clinical psychologists and registered counsellors among others. 

Delivered digitally, Naluri’s programme is effective, accessible, and affordable to empower more people to take control of their well-being and can be applied to help individuals as well as large teams as part of a comprehensive employee assistance programme. 

Data in the spotlight

Differentiating itself from traditional models of care that are reactionary, siloed, and activity-based, Naluri relies on millions of data points daily to deliver its digital therapies intended to supplement (not yet replace) more conventional care, but if you ask co-founder and CEO, Azran Osman-Rani, the ambition is to make Naluri a fully reimbursable healthcare option. As we transition into an increasingly evidence-based healthcare system that depends on technology to scale, it becomes critical for providers, policymakers, and researchers to embrace near-real-time data to empower decision making and policy.

And this brings us back to Naluri’s growing dataset. While the DASS-21 results provide a better understanding of Malaysians’ mental health, the full picture is far from complete. The pandemic may have forced mental health into the limelight, but it has also highlighted significant gaps in understanding and supporting mental health data, especially in the region. Existing mental health reports tend to be outdated, Western-centric, or not readily available, and Naluri is committed to democratising access to anonymized data in the interest of advancing the collective study, support of, and destigmatisation of mental health.

Help is available 

Naluri provides professional support for every risk level – from low to severe – and offers risk-stratified interventions to deliver clinically significant health outcomes. Naluri's offerings include sleep management programmes, workplace and financial stress management,  and resilience-building programmes that serve as early-stage preventative interventions. To learn more about Naluri's distinct health care proposition and how it can empower your organisation through a comprehensive employee assistance programme, please email

If you or someone you know is struggling with depression, anxiety, high stress, or suicidal ideation, please reach out for immediate support. Professional mental health support is available 24/7 for free:
Malaysia- +603-8408-1748
Indonesia: +62-21-2789-9801
Singapore: +65-3159-1324
Philippines: +63-2-8548-8280
Thailand: +66-2-026-8775

Alternatively, schedule a remote or online therapy with Naluri’s clinical psychologists and expert counsellors or contact the 24-hour careline for immediate support.