One in three adults in Pakistan lives with psychological disorder: Study

Pakistan’s first nationally representative mental health survey has shown that nearly one in three adults is living with a diagnosable mental and behavioural disorder, highlighting a major public health challenge affecting millions of people across the country.

The findings come from the largest and most comprehensive mental health study ever conducted in Pakistan, say researchers representing the Pakistan Psychiatric Society (PPS).

The five-year research is published in the British Medical Journal.

The survey was led by Prof Raza-ur-Rahman from Hamdard University, Karachi, in collaboration with Brighton and Sussex Medical School UK, University of South Florida, US, and psychiatric institutions across Pakistan.

Nearly 18,000 adults from all four provinces participated in the 2018-2022 study, providing the first nationally representative picture of mental health in the country.

Key findings

The study found that 32% of adults were currently living with mental and behavioural disorders, while 38% had experienced a disorder during their lifetime.

One in five adults met criteria for post-traumatic stress disorder (PTSD). More than one in 10 adults had depression, whereas 6% reported suicidal thoughts in the previous month.

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Researchers also identified significant social inequalities in mental health. Higher rates of mental disorders were found among older adults, individuals with lower levels of education and income, unemployed people, and those who were widowed, divorced or separated.

Mental health problems were associated with substantial impairment in family life, social relationships and the ability to work.

“This survey provides the evidence needed to develop effective mental health policies and services in Pakistan. It identifies who is most at risk, where support is most needed, and the scale of the unmet need for care,” said lead investigator Prof Raza-ur-Rahman, currently heading the department of psychiatry at HU.

According to him, the researchers used international standard tools to carry out the survey and the Pakistan Bureau of Statistics identified the areas for survey and provided the sample size.

He hoped that it would contribute to reducing stigma and improving access to diagnosis and treatment for millions of people.

“For the first time, policymakers, healthcare planners and researchers now have reliable national data that can be used to strengthen mental health services, allocate resources more effectively and develop evidence-based programmes across the country,” he added.

The study represents a major milestone for mental health research in Pakistan and demonstrates the country’s growing capacity to undertake large-scale, internationally recognised public health research.

Prof Anjum Memon, Chair in Epidemiology and Public Health Medicine at Brighton and Sussex Medical School (UK) and the senior co-author of the study, said: “This is a landmark moment for mental health research in Pakistan. For decades, policymakers have had to rely on fragmented local studies or international estimates. We now have robust national evidence showing, for the first time, the true scale of mental and behavioural disorders across the country.”

These findings provide an invaluable evidence base for policymakers, clinicians and healthcare planners, not only in Pakistan but also in other low- and middle-income countries facing similar challenges, he added.

Mental health, researchers say, is increasingly recognised as an essential component of national health and economic development and they recommend greater integration of mental health services into primary healthcare, increased investment in community-based support systems, enhanced training for frontline health workers and sustained national efforts to reduce the stigma surrounding mental illness.

“Pakistan currently faces major challenges in the provision of mental healthcare, including limited specialist services and a shortage of trained mental health professionals. The survey findings will help inform future policy development, service planning, workforce training and community-based support programmes,” said President of PPS Prof Wajid Akhundzada.