By Dr. Noor ul Huda
Correspondent, Awan-e-Aam · Chairperson, Mind Empowerment Council
Academic Author & Teacher Trainer, Cantab Publisher · Lahore
The Mind Pakistan Refuses to Heal
One in three Pakistanis is living with a psychological disorder. Most will never see a doctor. And the silence around it is slowly becoming the country’s most expensive habit.
Somewhere in a cramped two-room house in Lyari, a young woman has not left her bed in three weeks. Her family calls it laziness. Her mother lights incense and prays.
Her brother says she needs fresh air and a husband. Nobody calls it depression — because in Pakistan, depression is not yet a real word. It is a foreign concept, a luxury of the privileged, a weakness invented by people with too much time and not enough faith. And so she lies there, alone in a crowd of people who love her and cannot see her.
This is not a single story. It is the story of millions.
At the 26th International Conference on Mental Health held in Karachi last October, experts delivered a figure that should have shaken the nation: one out of every three Pakistanis is suffering from some form of psychological disorder. Driven by economic pressure, political uncertainty, environmental stress, and endemic social inequality, the mental health crisis in Pakistan has quietly become one of the most serious public health emergencies the country faces — and one of the least discussed.
“Taking insulin for diabetes is routine here. Seeking help for depression is still seen as a weakness — not a necessity. “
A nation in silent distress
The numbers, once you look at them, are staggering. Fifty million Pakistanis — roughly the population of South Korea — will experience a mental health crisis at some point in their lives. Research published in the Journal of the Pakistan Medical Association this year places the ratio of psychiatrists to population at approximately one per 360,000 people. The World Health Organisation recommends one per 100,000. Pakistan does not come close. What this means in practice is that the vast majority of those fifty million people will never receive a diagnosis, let alone treatment.
With 64 percent of the population living in rural areas, access to any specialist care is a distant dream. But even in cities like Lahore, Karachi, and Islamabad — where facilities exist — the barriers are not only logistical. A survey of over 1,350 Pakistanis found that only 24 percent could correctly define mental health. A quarter of respondents believed mental health was simply a matter of financial stability. Nearly half did not know which professionals were authorised to prescribe psychiatric medication. Ignorance, in this case, is not bliss. It is a death sentence administered slowly, in silence.
The economy of the broken mind
Rising inflation, record unemployment, the trauma of political turbulence, and the creeping anxiety of climate change — the last several years have assembled a perfect storm of triggers. Experts note that the deteriorating economic and political climate since 2022 has driven increasing rates of anxiety and depression across all demographics, the vast majority of cases going undiagnosed and untreated. Estimates suggest Pakistan has seen a sharp rise in suicides, with reports indicating between 15 to 35 people taking their own lives every single day. Every single day.
Young people are particularly exposed. An entire generation has come of age watching their parents’ savings dissolve in inflation, finding no work after years of education, and navigating social media’s relentless theatre of comparison — all while being told, by culture and by family alike, that what they feel is weakness or ingratitude. Women, further burdened by the specific stressors of restriction, domestic violence, and social invisibility, carry a disproportionate share of this weight. The elderly face isolation. Children in flood-hit and conflict-affected regions carry unprocessed trauma no schoolbook addresses.
“ We have built a society where it is acceptable to suffer, but unacceptable to ask for help.”
The stigma that kills
If the numbers are alarming, the culture around them is more so. In Pakistan, mental illness is routinely explained through the lens of weak faith, poor character, black magic, or personal failure. Families hide mentally ill relatives the way they hide debt — as a matter of honour. When someone finally reaches a point of crisis, the first stop is often a shrine, a self-appointed spiritual healer, or in the worst cases, a jail — since many with acute psychiatric episodes end up in police custody rather than clinical care.
Therapists and psychiatrists who do practice in Pakistan report that patients frequently arrive after years or even decades of suffering, having first exhausted every other explanation. By then, what might have been treated early has become deeply entrenched. The tragedy is not simply that we lack resources — though we do, profoundly — it is that we have built a society where it is acceptable to suffer but unacceptable to ask for help.
What a real response would look like The solutions are neither secret nor impossibly expensive — they are simply unprioritised. Mental health professionals and researchers have for years pointed to a package of practical reforms: integrating basic psychological support into primary healthcare centres, training Lady Health Workers to identify and refer cases in rural areas, deploying telepsychiatry platforms to reach underserved communities, and redesigning school curricula to introduce emotional literacy from an early age. Community-based care, rather than the distant and intimidating hospital model, could reach people where they live. Perhaps most critically, Pakistan needs a national conversation that is honest, sustained, and led not only by medical professionals but by public figures, educators, and religious leaders. Imams and mosque committees have extraordinary reach in this country. When they speak about mental health as a legitimate concern — not a spiritual failure — communities listen. That alliance has not been seriously cultivated. It should be.
The question we keep refusing to ask
Pakistan spends less than one percent of its health budget on mental health. For a country where one in three citizens is struggling psychologically, that figure is not just inadequate — it is a statement of values. It says that the mind does not count. That suffering in silence is acceptable. That the girl in Lyari who cannot get out of bed is not a patient — she is a problem to be managed at the family level, quietly, behind closed doors.
We have survived as a nation through extraordinary resilience. But resilience is not the same as health. At some point, a society must ask itself not just what its people can endure, but what they deserve. They deserve to be seen. They deserve to be heard. And they deserve to heal.
The mind Pakistan refuses to heal is not a statistic. It is your neighbour, your sister, your colleague, your child. The question is whether we will wait until it is undeniable — or whether we will finally choose, this time, to look.
