A systematic review on mental health and its associated factors among educators in Malaysia

Abstract

Background

Mental health is a vital aspect of health and wellbeing that supports our capacity as individuals and as a society to make choices, form bonds with one another, and influence the world we live in. This review aims to identify and synthesize research on mental health and its associated factors among educators in Malaysia. Given the rise in mental health issues among educators, it is crucial to understand the risk factors and develop supportive environments to promote mental well-being. By investigating the causes of poor mental health among educators, this review seeks to provide recommendations based on evidence for future research priorities, policy, and practice, particularly in Malaysia.

Methods

This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. A total of 488 studies were identified from five databases namely Scopus, PubMed, Web of Science, Science Direct, and PsycINFO with 30 articles meeting the inclusion criteria. Covidence tool is used for screening and data extraction.

Results

The findings highlighted six major themes as significant predictors of poor mental health among educators in Malaysia were work-family conflict and demands, pandemic impact, work environment, physical health, personality traits, and workload.

Conclusions

The outcomes of this review support future policy research on academic well-being, aiming to improve work-life balance for educators. Stakeholders can work towards creating a more supportive, productive, and sustainable academic environment in Malaysia.

Background

The frequency of mental health issues among adults in Malaysia has risen from 8.9% in 2012 to 10.7% in 2015 to 31.1% in 2019 [1]. The findings also show that Malaysian students made up the majority of the instances that were reported [2]. An increase in suicide cases among mental health patients is also indicated by a different survey report from the National Health and Morbidity Survey (NHMS) [1]. According to the report, 10% of the 5.5 million youngsters in this country, or at least one in ten, have considered suicide. The poor mental health of professors in higher education and continuing education is a growing public health and policy concern. In a recent study done in Malaysia, it was found that clinical depression affected 27.7% of the 278 staffs from academic institution in Malaysia due to low income, working in an urban campus, low-tier job type, and inadequate workplace amenities [3]. According to estimates from the World Health Organization [4], about 300 million people worldwide suffer from depression. Depression affects people across all ages, genders, and cultures. According to the World Health Organization (WHO) in 2021, over 280 million people globally experience depression.

According to the National Health and Morbidity Survey [1], there was nearly a threefold rise in adult Malaysians’ mental health problems between 1996 and 2019. Despite the fact that mental health problems are on the rise across the country, a local study conducted in 2016 [5] revealed that the percentage of academic staff members with depression at higher education institutions is approximately 35.4%, which is three times greater than the local population. It is concerning that the impacts of mental health difficulties of educators could have a negative impact on the institution’s success as well as the staff and students’ quality of life [6]. Furthermore, it was already widely acknowledged that teaching is a very stressful profession [7]. Educators are more stressed during pandemic and are more vulnerable to anxiety and burnout due to the increased workload and expectations brought on by the outbreak [8]. Poor mental health among educators can have a detrimental effect on both educators and their students. It has been demonstrated that educators’ psychological well-being has an impact on their students’ psychological well-being as well where for instance, instructors might be less adept at good behaviour management in the classroom or more prone to exhibiting negative feelings or actions [9].

A career in academia has the potential to be enduring, motivating, and fulfilling. It is also a chance for learning, teaching, developing oneself, and accumulating achievements on a personal level. But none of these successes come without difficulties [10]. There is occasionally a widespread misconception that faculty members only work as instructors [11]. In spite of popular opinion, most higher education institutions want their staff to teach, work with colleagues, conduct research, and support both the university and the community. Multiple duties and a wide range of duty expectations create an interesting dynamic state that may have an impact on mental health and well-being [12].

Regarding mental health’s detrimental effects on educators, research has shown that it can hasten career attrition [13], show up behaviourally as physical violence and increased hostility [14], and be linked to burnout and work discontent. On the other hand, educators who felt in charge of their own mental health reported feeling more satisfied with their jobs and experiencing less emotional tiredness [15]. Kourmousi and Alexopoulos [16] discovered that longer commutes between the educators’ home and place of employment can exacerbate stressors related to discipline and motivation. Current trends indicate that Malaysia’s public universities have a greater rate of burnout than private institutions, and local statistics further confirmed the severity of academician burnout [17]. It is difficult for Malaysian academics to engage in research, teaching, consultation, supervision, and publication activities [5, 18]. Educators and students at academic institutions must maintain good health in all areas of life if academic achievement is to increase and optimal quality of life is to be shared.

Besides that, poor academician’s well-being may have an adverse effect on both the academician and their students’ long-term mental health [19]. There may be a connection between the welfare of educators and students due to a number of intricately interwoven elements. Self-rated presenteeism among educators, is characterised as a worker who performs poorly at work due to a health issue [20]. Presenteeism may negatively impact students’ mental health since educators are unable to establish a secure and supportive learning environment and are finding it more difficult to run their classes effectively [21]. Furthermore, it could be challenging for educators who are struggling with their mental health and wellbeing to establish and model positive interactions with students [21]. Moreover, when educators encounter poor well-being, their confidence in their ability to assist students with emotional issues will diminish [22].

The experience of being an academician and the prevalence of mental health issues among educators may have changed as a result of policy changes. However, the largest shift has undoubtedly been the decision to increase access to higher education for a wider range of people. It is unclear to what degree the rise in poor mental health is also affecting educators of a comparable age, and more research is necessary to fully understand this relationship. But given the rise in mental health issues, particularly among educators, it’s important to know what the risk factors are and what can be done in these settings to make sure educators are growing, learning in settings that support mental wellbeing. Furthermore, investigating and better understanding the causes of educators’ poor mental health is essential to creating services that better match their needs and creating environments that promote the development of mental wellbeing.

The aim of this study was to review the risk factors for mental health among Malaysian academics. Our objective was to enhance our comprehension of the factors contributing to the poor mental health of Malaysian educators and with the findings will be helpful for future research goals, policy, and practice.

Methods

This review has been registered under PROSPERO, [Registration ID (CRD42024505815)] and has been approved by IMU Joint Committee on Research and Ethics (BPS I-2024 [12]). We adopted the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for this systematic review.

Identifications of literature

Five distinct internet databases namely Scopus, PubMed, Web of Science, Science Direct, and PsycINFO—were used to find literature. Targeting items published in the previous ten years, the search was carried out from the last week of April 2023 to January 2024. Keywords that should be used were determined by looking through previous research on mental health, words associated with the term “mental health”, “depression”, “well-being”, “mental illness”, “stress”, “burn out”, “mental disorder”, “psychological health”, “emotional health”, “mental well-being”, and “mental balance” were sourced. Additionally, the search capabilities of the chosen online literature databases were examined prior to deciding on the keyword string to be employed. Since the database search engines already included special symbols to encourage truncation of used keywords, they were left out. The last set of terms that were utilised was “(mental health OR depression OR well-being OR mental illness OR stress OR burn out OR mental disorder OR psychological health OR emotional health OR mental balance OR mental well-being)” AND “(factor OR risk factor OR associated factors OR aspect OR cause OR component OR influence)” AND “(academician OR lecturer OR teacher OR instructor OR educator OR scholar OR faculty member OR academia OR professor OR educationist)” AND “(Malaysia)”. In total about 488 articles searched were imported into Covidence software.

Eligibility and screening

Using Covidence software, the literature was screened through a number of stages. First, relevant articles were chosen by carefully examining their titles and abstracts. Next, the articles were closely examined to see if they met the requirements to be included in the review. To help these processes and guarantee that a logical selection of articles is chosen for the review, inclusion and exclusion criteria were established as guidelines. This allowed the researcher to accurately accomplish the goal of the study. First, only articles written in English and Malay language only were vetted to streamline the review process and prevent articles’ contents from being misunderstood owing to translation errors. Secondly, a timeline spanning a decade, from 2014 to the current year, was set, considering the development of the technological scene which may have differed too vastly in the previous decade given how rapidly technology has evolved, possibly affecting the findings regarding educators’ mental health. In addition to that, only research articles that discuss and elaborate on mental health and its associated factors were included. Besides that, only articles that have studied the samples from Malaysia has been included in this review.

In the current review, mental health was characterized as any response to a dynamic condition of internal balance characterized by the ability to deal with life’s obstacles to operate in social roles among educators in Malaysia. Additionally, articles which do not clearly identify the relationship between mental health and its associated factors and approach the topic through the lens of educators in Malaysia were excluded to avoid misinterpretation of the results. The criteria are better presented in Table 1. To help with the title, abstract, and full-text review, all retrieved publications were exported onto a reference manager (RIS), which was then successively loaded into Covidence. To create a shortlist of pertinent papers, we first reviewed the abstracts and titles. Each complete text was evaluated for appropriateness in turn. Out of 488 articles, 8 articles were detected as duplicate by the Covidence software, and the remaining 480 studies were screened with the reference list, which was performed by two reviewers (the second and third author). The title and abstract of each paper were evaluated for relevance during the first screening step, 174 titles were removed, and 232 articles were used to screen the full text review. Several manuscripts were eliminated for various reasons after reading the entire article such as studies that did not meet the inclusion criteria as stated in Table 1. There were 30 studies that were included and found eligible for the review. The PRISMA flow diagram is shown in Fig. 1.

Fig. 1

PRISMA flowchart

Quality assessment

The methodological quality of the selected studies was evaluated by using the Covidence software. The study design, methodological rigor, sample size, and risk of bias domains were among the evaluation criteria that were predetermined in accordance with the research question. The evaluation of studies was based on how well they adhered to established quality standards in their respective domains. For documenting assessments on different bias domains, such as reporting bias, attrition bias, detection bias, performance bias, and selection bias, Covidence offered an organised framework. Before the formal assessment, a calibration exercise was carried out to guarantee consistency and dependability in the quality assessment procedure. Through consensus sessions, reviewers addressed differences and improved their comprehension of the assessment criteria. Using Cohen’s kappa coefficient to measure inter-rater reliability, significant agreement was found (κ = 0.80). Every included study was assessed in relation to the predetermined standards, and assessments of the potential for bias were noted. With few cases of notable bias, most studies showed moderate to high methodological quality overall.

Table 1 Criteria

Results

Characteristics of study

Eventually, we identified 30 articles that met our inclusion criteria which consist of two qualitative design research utilizing interpretative phenomenological analysis [23], and one mixed-method study [24] respectively. Amongst the quantitative research articles, there was one longitudinal study [25], while the rest consisted of quantitative cross-sectional studies [5, 26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51]. Participants in the studies ranged between 25 years to 65 years old. There are a few research studied on university faculty members [5, 26,27,28,29, 32, 36, 41, 43], school principal [24] public school teachers [23, 30, 31, 33,34,35, 37,38,39,40, 42]. Table 2 showed the general description of studies and Table 3 discussed the findings of the studies included.

Table 2 General description of study

Table 3 Findings of study

Synthesized findings

Work–family conflict and demands

The ubiquitous impact of work-family friction and pressures on personal well-being was one of the main themes that surfaced [26]. A recurrent issue was the effect of autonomy and workload on work-life balance, with high workloads frequently resulting in higher stress levels and a reduced ability to handle family obligations [27, 29]. Furthermore, the difficulties in juggling work and family obligations were made worse by role ambiguity, overload, and conflict in the workplace [37]. Interestingly, the perception and experience of work-family conflict were shaped by gender differences and teaching experience, highlighting the complexity of this problem even further [52].

Pandemic impact

The pandemic’s arrival presented numerous difficulties and profoundly changed the dynamics of work-life balance. Our analysis demonstrated the pandemic’s significant effects on a range of personal aspects, most notably work-family balance [28, 30]. With the increasing prevalence of remote work and virtual learning, factors like insufficient technological proficiency and e-teaching competencies become critical. In addition, the pandemic intensified pre-existing stressors and work-family conflicts, with sociodemographic variables influencing the severity of these difficulties even more.

Work environment

Working environment is an employee’s physical and mental workspace where they carry out their everyday responsibilities. It includes physical environment, working conditions and company culture. Rusdi et al. [35] suggests that the probability to experience stress decreases with increasing workplace quality. He also found that stress and the interpersonal relationships among coworkers are positively correlated. Student misbehaviour such as bullying, absenteeism and disrespectfulness were found as one of the leading contributing factors to mental health among educators [23, 38]. Besides that, Salina et al. [36], found that job satisfaction has been shown that a person’s level of job satisfaction at work is influenced by a variety of factors, including leadership, social relationships, pay, advancement, and the job itself has influenced on academician’s mental health.

Physical health

Educators who experience burnout may also experience physical health issues. Regarding this, poor sleep quality among educators is also one of the contributing factors to depression and stress [39]. Ng et al. [42] discovered that musculoskeletal disorders is one of the significant predictors of depression among teachers.

Personality traits

According to Aziz et al. [44] investigation into the connection between personality traits and educators’ mental health in Malaysia, some personality qualities may have an impact on outcomes related to mental health in the academic setting. Desa et al. [46] study on the impact of personality on job stress among university for academician with administrative tasks highlighted the relationship between stress levels and personality features, with potential ramifications for administrative staff members’ mental health.

Workload

In an empirical study on burnout among educators in Malaysian private universities, Chen et al. [45] found that high workloads, a dearth of institutional support, and pressure to publish were the main causes of considerable levels of burnout. When Kavita and Hassan [50] analysed the occupational stress levels of elementary and secondary school teachers, they discovered that the stress levels varied depending on the type of classroom management and administrative responsibilities. This suggests that stress experiences change depending on the educational level. Occupational stressors are also a cause for teacher burnout [23]. In addition, Mukosolu et al. [51] investigated the correlation between job stress and academic and non-academic staff at Universiti Putra Malaysia. They also identified important stressors like workload, interpersonal relationships, and organisational climate. Rusdi et al. [35] showed that there is a significant positive high correlation between workloads and stress as they are often burdened with administration work. Besides that, Samad et al., [38] showed that workload plays a contributing factor of mental health in educators.

Discussion

The results of this systematic review provide insight into the intricate state of mental health among educators in Malaysia. Our review identifies 30 studies that addresses a number of significant variables that are linked to educators in Malaysia’s mental health outcomes, highlighting the possible areas of concern with identifying six possible themes that were associated with mental health issues among academician’s Malaysia. The high prevalence of mental health concerns among Malaysian academics is one of the review’s main conclusions. Academic staff members routinely reported higher levels of stress, depression, anxiety, and burnout, according to the studies in this review. This research emphasises how critical it is to respond quickly to address mental health issues in the academic community. The review also emphasises how multifaceted academic mental health consequences are. A number of variables, such as pandemic impact, personality traits, high workloads, personality factor, physical health and work-family conflict and demand were found to be the cause of poor mental health among educators in Malaysia. These results are consistent with earlier research done in different contexts and highlight the significance of addressing organisational and individual issues to support academics’ mental health.

Specific professional and demographic traits that might influence academics’ varying susceptibility to mental health problems. Early-career academics and those in junior positions, for example, have been reported to be especially vulnerable to stress and burnout. In a similar vein, female academics expressed greater psychological anguish than their male colleagues. These results highlight the necessity of focused interventions made to meet the unique requirements of various academic community subgroups. This review also emphasises how the academic setting affects mental health results. A few other factors, including perceived work-life imbalance, job insecurity, and little prospects for career progression, have been repeatedly linked to poor mental health in academics [53]. It is imperative that academic institutions tackle these structural problems in order to create a work climate that is both conducive and supportive to faculty members’ well-being.

One of the most important variables in regulating a person’s daily life is work-life balance, which is defined as the state of being in balance between a person’s wishes and expectations regarding his or her employment and his or her personal life expectations. Raising academic performance nowadays depends on a number of aspects, one of which is the capacity to combine work and personal obligations [54]. Activities related to family and other personal pursuits can interfere with work and sap the enthusiasm and energy required for it. Achieving work-life balance is crucial for every individual. According to the work-life spillover theory, an individual’s attitudes, feelings, abilities, and behaviours from one domain to their personal or professional life flow into the other. Both positive and negative outcomes are possible from spillover, which can happen in two ways which is from work to personal life and from personal life to work [55]. Additionally connected to job happiness, organisational commitment, and organisational citizenship are good work-life balance and reduced work-life conflict. Academics should pay special attention to work-life balance and job stress concerns since they might lead to conflict while balancing several duties from the same or distinct roles example work and personal life [56].

Studies reveal that a variety of jobs may negatively impact an employee’s health [57] Comparably, research suggests that educators are vulnerable to a variety of negative health effects, which may apply to the teaching profession as well. This involves not only noticeable and detrimental impacts on their physical health but also the emergence of mental health issues such as depression [58]. Research in this field, for instance, has revealed a higher prevalence of cardiovascular illnesses as well as somatic complaints including headaches [59]. It is crucial to comprehend and preserve academician’s health for a variety of reasons. In its broadest sense, absenteeism among educators such as teachers on sick leave probably costs schools, the educational system, and society a lot of money [60]. This includes having a direct impact on school systems through higher absenteeism from class, and contributions to teacher dropout rates which are higher than those of most other professions [61].

The Job Demands-Resources theory states that, a job’s characteristics are composed of two elements which are job demands and job resources (62–63). job demands, which are directly linked to financial or psychological consequences, are the aspects of a job that require effort from employees, such as work overload and role conflict [63]. The JD-R theory states that two processes are initiated by job demands and job resources which are a health impairment process and a motivational process [64]. Chronic job demands drain workers’ physical and mental resources, which can result in health issues and energy depletion, or a state of tiredness, in the process of health deterioration. It is assumed in the motivational process that job resources have the capacity to motivate and result in high levels of work engagement, low levels of cynicism, and superior performance. This model is appropriate for explaining how educators’ experiences are related to outcomes related to their well-being both individually and collectively. One of the well-being outcomes that is being explored in this review is mental health, is directly taken into account by the JD-R hypothesis as an indication of the well-being of the employees [62]. The literature indicates a high correlation between mental health and work overload [65]. It was shown that the proportion of persons with mental health disorders in the teaching profession is higher than the broader public (65–66). Previous research indicates that the primary cause of educators’ elevated stress levels is their extensive workloads [67]. According to study by Pace et al. [68], educators are assigned hefty workloads and ever-increasing administrative responsibilities, with or without additional income.

A personality attribute lessens stress and aids in the development of a happy outlook on life. Desirable characteristics and appearance are both components of personality. As a psychological variation, personality can actually influence all human behaviours, both in the social and personal spheres [69]. Five main personality traits were used by Costa and McCrae to explain individual differences which are neuroticism, extraversion, openness, agreeableness, and conscientiousness [70]. Numerous research has indicated that personality traits and mental health are negatively correlated [71], but a large body of research has also demonstrated a positive link between personality traits and general health subscales (72–73). In this context, extraversion is thought to be one of the key determinants of health, as demonstrated by Bernard et al. [74]. Extroverts seem to take measures to lessen their anxiety and mental stress and ultimately improve their own mental, social, and physical health [75]. This is because extroverts naturally enjoy social support in their intimate relationships, communications, and socialisation [76]. Based on the two studies which discussed about personality traits in this review showed that extraversion was linked to greater mental wellbeing which is happiness [44] and extraversion showed negative correlation was with job stress [46].

Besides that, one of the significant predictors for mental health during pandemic period were anxiety, fear, frustration, loneliness, anger, boredom, depression, stress, avoidance behaviour [77]. Cullan et al. [78] predicted a significant rise in depression and anxiety symptoms among those without a history of mental illness, with some eventually developing post-traumatic stress disorder. During pandemic social distancing, which have caused the closure of all educational facilities and a rapid shift to online learning, severely disrupting the education industry. There were many challenges faced by the educators due to the lockdowns and other limitations on movement which has impacted their mental health. Academic staff members will need to gain confidence teaching remotely and navigating the technological difficulties associated with virtual classrooms. Besides that, even before pandemic, contract employees like sessional lecturers and part-time researchers naturally faced job instability. Many contract or part-time employees do not receive employment benefits such employment provident funds or social security, in contrast to permanent employees. Additionally, they rely on whether the courses they instruct are offered during that specific semester. At other times, their contract’s continuation depends on their immediate superiors’ approval. Overall, the disruptions have increased mental stress and the likelihood of burnout among educators [79].

The researchers stressed that a major risk factor for occupational stress in contemporary higher education institutions is the mental health of academics. Although academics are becoming more aware of mental health concerns, there is still a significant lack of information in the literature about interventions and support systems designed with this group in mind in Malaysia. Subsequent investigations ought to concentrate on assessing the efficacy of several interventions, including workshops on mental health, counselling services, and organisational modifications targeted at mitigating stress and fostering academic well-being. To sum up, this systematic review offers insightful information about the mental health of Malaysian academics. Our findings add to the expanding body of work addressing mental health issues within the academic community by identifying critical characteristics linked to poor mental health outcomes.

Conclusion

This review uncovered a wide range of variables and possible pathways via which they impact mental health and increase the risk of mental illness among academics. Understanding the factors influencing educators’ mental health and well-being may help them create coping strategies that increase their ability to manage the pressures of working in an educational environment. This review highlighted six major themes as significant predictors of poor mental health among educators in Malaysia were work-family conflict and demands, pandemic impact, work environment, physical health, personality traits, and workload. This paper asserts immediate attention for future mental health intervention to be provided among the educators in Malaysia by addressing the mental health factors contributing to the well-being of educators across various institutions can enhance the quality of the education system in Malaysia and facilitate their career development.

Limitation

The primary limitation of this review is that it does not provide a comprehensive analysis of the main factors of mental health decline, nor does it deal with how the problem can be dealt with effectively within the context of Malaysia. The scope of the study was limited in terms of potential challenges and barriers to implementing mental health interventions in the Malaysian academic setting. Besides that, this review explored on various mental health and its associated factors and didn’t focus on one single factor, thus, there could be more comprehensive application of intervention could be designed if only focused on specific factor influencing mental health. Although the search criteria were intended to include every phrase often used in studies concerning mental health and financial hardship, it is possible that some studies were overlooked due to the vast range of labels and descriptions given to these events. There was limited generalizability of the results to different settings because most of the studies utilised cross-sectional designs of single education system at one moment in time, and others had small sample sizes unrepresentative of their target populations with poor response rates. While the inclusion of a substantial number of studies undertaken globally to provide a global picture is a strength of this analysis, education vary throughout nations. This restricts the applicability of some of the review’s conclusions to mental health educators employed by the in Malaysia. The fact that the factors this research found come from research that only lasted ten years is another drawback. Even yet, a few elements from the past research will still apply to this review.

Recommendation

It should be the goal of future studies in this field to overcome some of the shortcomings noted in the body of current knowledge. Further longitudinal research is required to investigate the causal relationships and interactions between mental health and its associated factors among educators in Malaysia. Therefore, it is necessary to investigate the methods by which these elements interact in greater depth. Further studies are necessary to comprehend the relationship between pertinent mental health and its associated factors within demographics, since some groups are probably more exposed to and prone to poor mental health than others. The finding of this review enables future policy research on wellbeing for educators to better facilitate work-life balance and enables to conduct of qualitative research on specific sub-groups according to their study program offered to tailor interventions effectively considerably more work should be conducted which increase support system such as restructuring issues about students’ misbehaviour.