As in most health systems, the Malaysian government is largely responsible for the care of the mentally ill since such patients rarely have the purchasing power to make them attractive customers for commercial private hospitals. Not surprisingly there is a major shortage of psychiatrists in Malaysia with a ratio of one per
200 000 of the population. The government is considering requiring private hospitals to establish psychiatric units which would receive financial subsidies from the government. Although such care would be provided in the private sector, thereby breaking the visible nexus between the state and responsibility for mental health treatment, the government would still be largely responsible for the financial costs of such care within an essentially welfare model.