Mental health in Pakistan: an unprecedented crisis

The human mind, with its complex array of thoughts, emotions, and experiences, plays a central role in shaping our actions, relationships, and overall well-being. Yet in Pakistan, mental health, an integral part of human health, is often neglected or misunderstood. Far too often, mental health issues are viewed as personal weaknesses or societal taboos, leaving those affected to face their challenges in isolation. This silence around mental health, coupled with pervasive misconceptions, creates a harmful environment in which individuals suffer without the support and understanding they need.

Mental health problems in Pakistan arise from a combination of socio-economic, cultural and systemic factors. Poverty, unemployment and economic instability contribute to chronic stress, often leading to anxiety and depression. Societal pressures, particularly around family honor and gender roles, create immense psychological pressure, particularly on women and young people. Continued violence, political instability and conflict have left many people, especially children, traumatized and suffering from post-traumatic stress disorder. Lack of access to mental health professionals, particularly in rural areas, and cultural preference for religious or spiritual solutions over medical care further compounds the problem.

The biggest barrier to seeking help for mental health in Pakistan is the deep-seated societal biases surrounding it. Mental health issues are often viewed as personal weaknesses, moral failures, or even the result of supernatural forces. Terms like pagal (crazy) are commonly used in casual conversation, reinforcing harmful and dismissive attitudes. Those who acknowledge their struggles risk being ostracized, judged, or labeled as wronged.

This pervasive cultural mindset fosters an environment in which seeking professional help becomes an act of courage, often accompanied by fear of social retaliation. Families also contribute to this atmosphere of silence, often avoiding open discussions about mental health, fearing that it could damage their social reputation or affect their children’s prospects, particularly in matters of marriage.

The challenge is further exacerbated by a profound lack of awareness and education. Mental health is rarely discussed in schools, workplaces or even within families, leading many to ignore the signs and symptoms of mental illness. Conditions such as depression, anxiety, and other disorders are often considered temporary phases or issues of personal willpower. The absence of accurate information promotes misconceptions, making it more difficult for individuals to recognize when they need help or appreciate the importance of seeking professional care. This lack of understanding also extends to healthcare professionals, many of whom lack the training to properly identify and treat mental health issues, leading to misdiagnoses or dismissive attitudes.

Systemic failures in Pakistan’s health infrastructure exacerbate these challenges. The country has an alarming number of mental health professionals, with only a few hundred psychiatrists and an even smaller number of clinical psychologists to serve a population of more than 250 million. This severe shortage leaves large swaths of the population without access to professional care, particularly in rural areas where health services are already scarce. Public mental health facilities are limited and often overcrowded, while private services remain out of reach for the majority due to their high costs. As a result, those who find the courage to seek help often find themselves facing insurmountable logistical and financial obstacles.

Cultural and religious beliefs also intersect with mental health in complex ways. While religious traditions emphasize compassion and community support, mental health is often viewed through the lens of morality or spirituality rather than science. Many turn to faith healers or spiritual leaders for solutions, seeking exorcisms or other rituals to cure mental illnesses perceived to be the result of black magic or divine punishment. Although spiritual practices may bring comfort to some, relying exclusively on them often delays or replaces evidence-based treatments, leaving individuals without the care they need. This reliance on non-medical interventions highlights a lack of public trust in formal health systems, seen as inaccessible, ineffective or irrelevant to their needs.

Mental health education is a crucial tool to promote mental health awareness in Pakistan. It gives young people the knowledge and skills to manage their mental wellbeing and support others. Training teachers to recognize and respond to mental health concerns can create a supportive environment for students to seek help. Workplace policies must adapt to prioritize mental health by providing employee assistance programs, flexible working conditions, fair wages, and a culture that supports help-seeking.

Untreated mental health issues in Pakistan have a significant impact on individuals, leading to decreased quality of life, strained relationships and even suicide. Suicide rates, particularly among young people, are underestimated due to legal and cultural constraints. The WHO estimates the number of suicides at 19,331 in 2019-2020, including 4,560 women and 14,771 men among the victims. The economic burden of untreated mental health problems is enormous, leading to lost productivity and increased health care costs, thereby hindering national development.

The role of government in tackling mental health cannot be overstated. Pakistan’s mental health policy framework remains weak, with insufficient funding and a lack of integration into broader health care strategies. Policymakers must prioritize mental health by increasing budget allocations, expanding training programs for health professionals, and building infrastructure that brings services to underserved areas. Public awareness campaigns can help normalize conversations about mental health and reduce stigma. Collaborations between government, the private sector and civil society are essential to creating a multi-pronged approach that addresses the complex interplay of cultural, economic and systemic barriers.

Mental health education is a crucial tool to promote mental health awareness in Pakistan. It gives young people the knowledge and skills to manage their mental wellbeing and support others. Training teachers to recognize and respond to mental health concerns can create a supportive environment for students to seek help. Workplace policies must adapt to prioritize mental health by providing employee assistance programs, flexible working conditions, fair wages, and a culture that supports help-seeking. Mental health requires a shift in collective consciousness, recognizing it as a shared responsibility. Families, communities, educators, health professionals and policymakers must come together to create an environment in which mental health is treated with the same urgency, respect and attention as physical health.