Dr Saima Bashir
MENTAL health in Pakistan has long been treated as a peripheral concern, despite its profound human, social and economic consequences.
Current estimates suggest that one in five Pakistanis will experience a mental health condition during their lifetime. Yet more than 90 per cent of those affected are unlikely ever to receive treatment. The economic burden is striking: from Rs. 250 billion in 2006, it has more than doubled to over Rs. 616 billion in 2020. Despite this, allocations for mental health remain under half a percent of the national health budget. The mismatch between need and investment has left the country grappling with a silent but acute public health emergency.
The drivers of this crisis are both structural and situational. Political instability, declining household incomes and persistent unemployment have created conditions of prolonged stress. Suicide has become a particularly worrying indicator, especially among young people—more than 70% of reported cases involve individuals between the ages of 10 and 30. Women are also disproportionately affected. In Gilgit-Baltistan, the suicide rate among women is among the highest documented in the region, pointing to deep social and cultural vulnerabilities. Climate shocks have further aggravated the situation. The 2022 floods not only displaced millions but also destroyed livelihoods, schools and healthcare infrastructure, leaving lasting scars on affected communities. Nearly three years later, some 20 million people still rely on humanitarian assistance and around 1.5 million remain displaced. For many, the trauma of loss, uncertainty and disrupted community life continues to shape their daily reality.
Despite this, mental health services in Pakistan remain limited and fragmented. Fewer than 600 psychiatrists serve the entire country, with most based in major cities, leaving rural populations without access to specialized care. Primary health facilities are poorly equipped to respond even to common conditions such as anxiety and depression. Medical and nursing curricula devote minimal attention to psychosocial care, while the continuing outmigration of skilled professionals has further depleted human resource capacity. Although provincial mental health laws exist, weak enforcement has meant little change on the ground. As a result, the treatment gap is filled largely by private providers, informal healers, or simply left unaddressed due to stigma and lack of awareness.
It is in this context that the recent launch of the National Mental Health and Psychosocial Support (MHPSS) Implementation Plan 2025–2030 marks an important policy milestone. Developed by the Ministry of Planning, Development and Special Initiatives, the plan situates mental health firmly within the national development agenda, consistent with the Uraan Pakistan vision of equity and empowerment. The plan introduces a multi-layered model of care. At the community level, trained volunteers under the “Hamdard Force” will provide basic psychosocial support and referral. Clinical psychologists will manage stress-related conditions. Primary care doctors will be trained to diagnose and treat common disorders, while psychiatrists will provide specialist services and supervision at higher tiers. Digital platforms—a web portal, mobile applications, and e-learning tools—will support training, referrals, supervision and data collection. By embedding services into primary healthcare and decentralizing delivery, the plan aims to narrow the treatment gap and reach vulnerable populations.
Institutional reforms are also built into the framework. A Mental Health Strategic Planning and Coordination Unit within the Planning Commission will provide the necessary stewardship to align fragmented initiatives, strengthen provincial implementation, and ensure integration of mental health into broader social sector reforms. The placement of this unit within the national planning architecture signals an important shift: mental health is no longer to be treated as a narrowly medical issue but as a critical dimension of development and human capital. Still, the success of the plan depends on political will and resources. Provinces must incorporate MHPSS into their annual development programmes with clear funding lines. Extending the Sehat Sahulat Programme to cover mental health services would make universal health coverage more meaningful. Reforming medical and nursing curricula to include psychosocial care is essential, as is expanding human resource capacity from community workers to specialist practitioners. Finally, stigma must be addressed through sustained awareness campaigns that normalize help-seeking and reduce discrimination.
The economic case for action is compelling. Global evidence shows that every rupee invested in mental health can yield up to a fivefold return in improved productivity and reduced healthcare costs. For a country that speaks often of its demographic dividend, neglecting the mental wellbeing of its young population risks undermining both human capital and long-term economic resilience. The MHPSS plan is not a cure-all, but it provides a credible and evidence-based framework for reform. The challenge now lies in sustained implementation. Pakistan has delayed too long in addressing its mental health burden. To continue on this path would be to allow preventable suffering to persist in silence. This moment should instead be seized as an opportunity to invest in dignity, resilience and the future of the nation.
—The writer is a former Member Social Sector and Devolution, Ministry of Planning, Development & Special Initiatives.
