Prioritising mental health in Pakistan

World Mental Health Day (10 October) provides a perfect moment in time to shine a light on our growing mental health work in Pakistan.

With a population of 216 million, one in four people in Pakistan are affected by mental health issues such as depression and anxiety. Yet mental health remains a highly stigmatised taboo in the country, compounded by low levels of awareness.

People either do not recognise that they requirement treatment, or do not seek out appropriate support. Those who do look for treatment often struggle as there are fewer than 500 psychologists and 400 psychiatrists for whole population - that is around one psychiatrist per half a million people.

The British Asian Trust has been working on mental health in Pakistan for over a decade now, working on a number of different projects with partners to improve both quality and access to services, while also reducing stigma and increasing awareness.

When the COVID-19 pandemic struck, we were ready with our partners to provide a coordinated response to the mental health crisis and collectively reached hundreds of thousands of people with information, support and counselling services.

This successful collaboration during COVID-19 resulted in the establishment of the Pakistan Mental Health Coalition by the British Asian Trust and some of its partners. The coalition brings together organisations and experts working to promote community based mental health. It enables a collaborative approach across the sector, a space for sharing learning, and strategic leadership to bring together a collective voice on key issues.

Today the British Asian Trust mental health programme in Pakistan has three pillars. Firstly to promote access to community based mental health services through primary health care settings as well as through schools.

Over the next three years we seek to reach over 200 communities with basic screening and counselling services. Through our school mental health project we have trained 168 schoolteachers from 40 public schools in identifying basic mental health issues in the classroom and making referrals for support. Our first year shows promising results with clear indication of average reduction of distress amongst the 409 adolescents identified at risk of psychosocial distress in the 40 schools. The intervention improved the teachers knowledge and created a more positive environment in the schools. We also work with the most vulnerable out of school street children and children who suffer extreme trauma.

Through our second pillar of work, we seek systemic solutions and advocate for policy level change through our leadership role in the Pakistan Mental Health Coalition. The coalition has worked together on a campaign to decriminalise suicide, and has actively sought to identify and promote quality standards of care for community based mental health services.

Recently, the coalition came together to launch a report on Malpractice in Mental Health in Pakistan: A Call for Regulation in collaboration with Taskeen Health and UNFPA, and the National Commission for Human Rights. The report shines a light on legislation, scarce and inequitable mental healthcare services, and unregulated practices and is the first time that these have been published by a statutory body which also has a watchdog and advisory role to the government of Pakistan. We hope this report will pave the way for improved regulation within the sector.

The third pillar of our work in mental health for Pakistan seeks to reduce the stigma and increase the profile of mental health amongst key stake holders to bring due attention to the cause. Over the past years we have reached millions of people with mental health messaging through mass media campaigns on TV and social media, as well as had more directed messaging in the communities we work in. Our celebrity Ambassadors such as Mahira Khan, Rahat Fateh Ali Khan, Hajra Khan and Sanam Saeed have been amazing champions of the cause and helped us reach out with kindness and hope, giving people the courage to seek support.

No one should suffer in silence with mental health issues. And while World Mental Health Day focusses attention on the issue for a day, we need to keep this focus up every day.

This World Mental Health Day the British Asian Trust renews our commitment - we won’t stop until mental health becomes a priority for all.

By Kamyla Marvi, Pakistan Director, British Asian Trust.