More than 32 million Pakistanis are living with a mental health condition, and the number is rising, the Ministry of Health told the National Assembly. That is roughly one in eight people. Against that, only 1,050 psychiatrists are registered, about one for every 245,400 citizens. These are the ministry’s own numbers, which makes the gap hard to explain away.
The headline ratio is also generous, because registered is not the same as practising. At the October summit, the health minister himself said Pakistan has fewer than one psychiatrist for every 500,000 people. The specialists are also unevenly spread. Punjab has 406, Sindh 228, Khyber Pakhtunkhwa 122 and Balochistan just 44. Services remain fragmented, under-resourced, and largely concentrated in urban tertiary centres, leaving much of the country far from a specialist.
The result is a treatment gap that is almost total. WHO figures cited at the summit put access to mental health services at only about 5% of the population, a gap of roughly 95%. The cost is not abstract: mental disorders are the leading cause of years lived with disability nationally. The crisis is not mainly a queue outside hospitals. It is millions of people who never reach a hospital at all.
Several causes are visible
Decades of terrorism, displacement and disaster take a toll, and research on Pakistan finds a significant link between trauma exposure and higher rates of psychiatric disorders.
Economic pressure matters too: the federal health minister called mental health an emergency linked to the economy. And stigma keeps families silent. A minister of state conceded that mental health has long been treated as a private difficulty, not a public responsibility.
The government deserves credit for moving. The National Mental Health Policy 2026-2035 was launched on 1 October, and the summit’s Islamabad Declaration committed Pakistan to sustainable financing and community-based care. But we have to ask three questions.
If a policy already promised community care and primary-care integration in 2003, what did 23 years deliver, and why will 2035 be different? A WHO assessment recorded a policy, revised in 2003, that already advocated exactly this. The vision has never been the problem. Without a clear account of why it stalled, the new policy risks repeating the old one.
Secondly, will every province commit ring-fenced budgets and published targets, or will this remain a federal document that provinces may ignore? Health has been a provincial subject since the 18th Amendment, which means clinics, staff and medicines are decided in provincial capitals. At launch, implementation plans were still to be developed. A policy no province is bound to fund is a statement of intent, not a plan.
Thirdly, if Rs67.77 billion and a 51:49 federal-provincial split could be found for hepatitis, what figure will the state put on a condition affecting 32 million, and by what date? The ministry’s report notes this programme was approved for July 2024 to 2027. The state has shown it can build a funded, cost-shared, time-bound programme. Mental health is owed the same.
What would close the gap:
- Use primary care. Train doctors, nurses, and Lady Health Workers to screen and treat common conditions. Task-shifting is a WHO strategy designed for settings short of specialists.
- Fund it like hepatitis. Create a costed programme with the same federal-provincial split, ring-fenced provincial budgets, and yearly targets.
- Train and retain specialists. Expand psychiatry training seats and offer real incentives for postings in Balochistan and KP.
- Reach remote districts through technology. India runs a district mental health programme in 767 districts with a national counselling line, and Bangladesh is expanding telemedicine. Pakistan can adapt both.
- Start in schools. National programmes for child and adolescent mental health through schools were launched at the summit. They now need scale.
- Report publicly. Present an annual implementation report to the National Assembly with measurable targets.
A policy does not treat patients. Staffed clinics, trained workers, and funded provinces do. Pakistan has now counted its patients, written the policy, and signed the declaration. The next test is whether the budgets and clinics follow.
Read More: Pakistan Mental Health Survey: 1 in 3 Adults Affected
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