Nearly one in three adults in Pakistan lives with a diagnosable mental or behavioural disorder, according to the country’s first nationally representative mental health survey. The National Psychiatric Morbidity Survey, published in BMJ Public Health, interviewed 17,773 adults aged 18 and above in Punjab, Sindh, Khyber Pakhtunkhwa and Balochistan between 2019 and 2022.
The survey found that 32.3 percent of adults currently have a mental or behavioural disorder, and 37.9 percent have had one at some point in their lives. Neurotic, stress related and somatoform disorders were the most common, affecting 24.5 percent of adults.
Post traumatic stress disorder (PTSD) followed at 19.9 percent and mood disorders at 11.6 percent. Recurrent or episodic depression affected 10.6 percent of adults, and schizophrenia and related psychotic disorders affected 2.7 percent.
The survey also recorded a high level of suicidal distress. In the month before the interview, 6.2 percent of respondents reported suicidal thoughts or behaviour. Of these, 4.1 percent had passive suicidal ideation and 3.2 percent had active suicidal ideation. Over their lifetimes, 1.1 percent had attempted suicide and 1.8 percent had made a suicide plan or had intent.
Mental illness was closely linked to social and economic disadvantage. Prevalence rose with age, reaching 60.7 percent among adults aged 50 to 59, compared with 15.8 percent among those aged 18 to 29. Divorced, widowed and separated people, as well as the unemployed, homemakers, students and retired people, faced a higher risk. Higher education and income were linked to lower prevalence.
The disorders also disrupted daily life. Using the Sheehan Disability Scale, researchers measured the effect of illness on work, family and social functioning. The highest levels of disability appeared among people with alcohol use disorders, bipolar disorder, schizophrenia, generalised anxiety disorder and PTSD.
The survey used a stratified, multistage cluster sampling design developed with technical support from the Pakistan Bureau of Statistics. Trained male and female interviewers used the Urdu version of the Mini International Neuropsychiatric Interview, a validated diagnostic tool aligned with ICD 10 and DSM 5. Pakistan’s National Bioethics Committee approved the study.
Prof Anjum Memon, senior co author and Chair in Epidemiology and Public Health Medicine at Brighton and Sussex Medical School, called the findings a landmark for mental health research in Pakistan. He said policymakers had relied on scattered local studies or international estimates, and the survey now gives them solid national evidence on the true scale of the problem.
The results also point to a wide gap between need and care. Pakistan, with more than 247 million people, has an estimated 0.19 psychiatrists per 100,000 people, or roughly 470 nationwide, most of them based in cities. Mental health receives less than 0.5 percent of the healthcare budget, and specialised services remain limited, fragmented and out of reach for much of the population.
Experts say the findings give policymakers, clinicians and health planners in Pakistan, and in other low and middle income countries, a firm evidence base. They recommend integrating mental health services into primary healthcare, expanding community support, training frontline health workers, increasing investment and continuing efforts to reduce stigma.
Prof Wajid Akhundzada, President of the Pakistan Psychiatric Society, said the country faces major challenges in delivering mental health care, including few specialist services and too few trained professionals. He said the findings will inform policy, service planning, workforce training and community programmes.
The researchers note that the survey captured a single point in time, so it shows how common these disorders are but cannot prove their causes. They add that conflict, displacement, natural disasters, economic instability and the COVID-19 pandemic may help explain the high rate of PTSD.
The release comes as Pakistan puts its National Mental Health Policy Framework 2026 to 2035 into action. The framework aims to bring screening, treatment and community support closer to people through primary healthcare and local services, rather than limiting care to major hospitals
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