On World Mental Health Day, Pakistan faces deepening crisis as psychiatric drugs vanish

By Mushfiq Ahmed

KARACHI, Pakistan (MNTV) – As the world observes World Mental Health Day on October 10, Pakistan’s fragile mental healthcare system is grappling with a growing crisis. The withdrawal of major multinational pharmaceutical companies from the country earlier this year has triggered severe shortages of psychiatric medication — threatening to unravel what little progress had been made in treating millions of patients.

According to the National Psychiatric Morbidity Survey of Pakistan (2022), the country has only 480 psychiatrists for a population exceeding 240 million — roughly one psychiatrist for every half a million people.

“It’s a dire situation,” says Dr. Natasha Kersi Billia of Liaquat National Hospital in Karachi. 

“We already had too few professionals, and now, with medications disappearing from the market, relapse among patients has become inevitable.”

Dr. Billia notes that mental illness in South Asian societies is deeply intertwined with biological, cultural, and social factors. 

“Cousin marriages and interlinked family systems can increase the risk of certain hereditary mental illnesses,” she explains. 

At the same time, drug use is rising, particularly among young men and women across socioeconomic classes.

Access to treatment remains sharply divided along economic lines. Private clinics and rehabilitation centers offer quality care but are prohibitively expensive for most families. 

“Some rehabs are doing excellent work, but they charge heavily,” Dr. Billia says. “Public hospitals, meanwhile, are overcrowded and underfunded.”

Government-run services, such as those by the Anti-Narcotics Force (ANF), provide free three-month rehabilitation programs, but facilities are overwhelmed and waiting lists stretch for months. 

Experts argue that Pakistan needs multidisciplinary care systems involving psychiatrists, psychologists, occupational therapists, and speech therapists — but such models remain rare and costly.

Stigma, superstition, and systemic neglect

The social stigma surrounding mental illness continues to compound the crisis. “When patients return after treatment, they often face unemployment and rejection,” Dr. Billia says. 

“It pushes them back into despair and poverty.”

Cultural taboos and superstition frequently drive patients to faith healers or unqualified practitioners instead of doctors. 

“People delay getting proper help, and by the time they do, their condition has worsened,” she adds. 

Even recovered patients struggle to reintegrate, facing discrimination in schools and workplaces due to widespread misconceptions.

Dr. Billia stresses that responsible media representation can help dismantle these stereotypes. 

“TV dramas often portray people with mental illness as violent or unstable. That narrative must change if we want empathy and awareness.”

With psychiatrists in short supply, she believes primary care integration could help fill the gap. Training general physicians to manage common disorders such as depression and anxiety — as encouraged by the World Health Organization’s Mental Health Gap Action Programme (mhGAP) — could make mental healthcare more accessible nationwide.

But long-term progress, she insists, depends on sustained investment and national awareness. 

“Schools, colleges, and workplaces must have trained counselors,” Dr. Billia says. “Regular programs can help people recognize symptoms early and seek help before conditions worsen.”

Unless Pakistan acts urgently — by making medicines affordable, funding mental health institutions, and combating stigma — millions will remain untreated. 

“Mental health is not a luxury,” Dr. Billia reminds. “It’s a human right — and in Pakistan, it’s time we start treating it as one.