Mental health in Pakistan: stigma, faith and getting help
Mental illness is common in Pakistan: studies suggest 10 to 16% of adults have symptoms of depression or anxiety, yet there are only a few hundred psychiatrists for over 240 million people and most people with mental illness are never treated. Stigma — “log kya kahenge” — and the belief that symptoms are caused by jinn, nazar or sehr often lead families to faith healers first. Faith and prayer can be a real support, and they are not in conflict with treatment. But symptoms such as hallucinations, severe low mood or seizures also need a doctor. Start with a GP or a government hospital psychiatry department.
Health writers · Aslam Clinic
Mental illness is common in Pakistan and mostly untreated. Studies suggest that 10 to 16% of adults have symptoms of depression or anxiety, while there are only a few hundred psychiatrists for more than 240 million people. Stigma, cost, distance, and the belief that symptoms are spiritual rather than medical keep many families from seeking help for years. Faith can be a genuine source of strength and does not conflict with treatment — but symptoms like hallucinations, deep hopelessness or seizures need a doctor as well.
This page is for patients and, just as much, for the families who in Pakistan usually decide whether and where someone gets care. It is written with respect for faith and for the reasons people hesitate.
How common is mental illness here?
Worldwide, WHO estimates that nearly 1 in 7 people were living with a mental disorder in 2023, with and the most common. In Pakistan, a 2024 review of the mental health system reported that 10 to 16% of adults have symptoms of depression and anxiety, and 1 to 2% live with severe mental illnesses such as or . National data are limited, so these figures are estimates.
Depression often shows itself here through the body rather than words: tiredness, aches, “dil ghabrata hai”, headaches, poor sleep and loss of appetite. Many people go from doctor to doctor for these without anyone asking about mood.
The treatment gap
WHO says that, globally, only about one third of people with depression receive formal care. In Pakistan the gap is wider. WHO's 2020 Mental Health Atlas profile lists about 0.14 psychiatrists per 100,000 people, and a 2024 review estimated that roughly 90% of people with mental illness go untreated. Services are concentrated in teaching hospitals in big cities, while about 63% of the population lives in rural areas.
“Log kya kahenge”: stigma
The biggest barrier is often not money or distance but fear of what people will say. Families worry about a daughter's marriage prospects, a son's job, or the family's name. People avoid being seen at a psychiatry clinic and describe their problem as “tension” or “weakness”. Some fear that any mental health diagnosis means being labelled “pagal”.
delays treatment, and delay makes most mental illness harder to treat. It is worth remembering that seeing a doctor for depression is no more shameful than seeing one for diabetes or blood pressure — and that treatment is private.
Jinn, nazar, sehr and faith healers
Many Pakistanis believe that some illnesses can be caused by jinn, by nazar (the evil eye) or by sehr (black magic), and turn first to a pir, maulvi or aamil for dua, dam, taweez or ruqyah. These beliefs are part of the faith and culture of millions of people, and this page does not ask anyone to give them up. Prayer, Qur'an recitation and the support of a trusted religious figure can bring real comfort, hope and community.
The difficulty is that some symptoms are too often explained only in spiritual terms, while the underlying medical illness goes untreated. Researchers in Karachi heard clinicians describe patients who reached psychiatric care only after years of illness and many visits to faith healers. Some religious healers themselves distinguish between spiritual problems and illness, and advise medicine.
Several of these — confusion, fits, sudden behaviour change — can also be caused by physical illness such as infection, epilepsy, thyroid problems or low blood sugar, which is another reason a medical assessment matters. Treatment and prayer are not in conflict; many families do both, and many scholars encourage seeking medical care as part of faith.
Women, young people and older adults
- Women carry particular pressures — joint-family expectations, limited mobility, domestic violence, and the weight of infertility or having daughters in some families. Depression after childbirth () is common and treatable; in rural Rawalpindi, a CBT-based programme delivered by Lady Health Workers halved rates of depression among new mothers. A woman who cannot travel may be able to see a doctor or psychologist online.
- Young people face intense pressure around Matric, FSc, MDCAT and marriage, often with little room to say they are struggling. Sudden withdrawal, falling grades, not sleeping, or talk of hopelessness are worth taking seriously rather than calling it laziness.
- Older adults often show depression as memory problems, physical complaints or loss of interest after retirement or bereavement, and it is easily dismissed as “old age”. It responds to treatment at any age.
How to talk to your family
- Choose a calm moment and one trusted person first — perhaps a sibling or cousin — rather than the whole family at once.
- Describe what is happening in everyday terms: “I can't sleep, I can't concentrate, I feel nothing matters.”
- Compare it with a physical illness they already accept.
- Suggest starting with the family doctor, which feels less frightening than a psychiatry clinic.
- If religion is a concern, say you will keep praying — and also see a doctor.
- If you are worried about someone else, say what you have noticed and that you care, rather than offering a diagnosis.
What to expect at a hospital psychiatry clinic
Many people imagine a psychiatry department as a locked ward. Most of the work actually happens in an ordinary outpatient clinic. You buy an OPD slip, wait your turn, and are usually seen first by a trainee doctor who takes a history, then reviewed by a senior. You may be asked to fill in a short questionnaire about mood or anxiety, have blood tests to rule out physical causes, and be offered medicine, a referral to the department's psychologist, or both. Bring a family member if you want support, and bring your old prescriptions.
Admission to hospital is for a small number of people who are very unwell or at serious risk, and most admissions are voluntary. Treatment for the great majority is as an outpatient, while living at home.
Where to get help
| Option | Good for | Notes |
|---|---|---|
| Family doctor (GP) | A first assessment, common problems, checking physical causes | Can start treatment and refer on |
| DHQ and teaching hospital psychiatry departments | Assessment by a psychiatrist; severe illness; medicine; often psychologists on the team | Low cost; expect queues |
| Private psychiatrists and clinical psychologists | Faster access; longer therapy sessions | Fees vary; check qualifications |
| Online therapy | Smaller towns; people who cannot travel easily | Check the therapist's training; not for emergencies |
| Rozan Counseling Helpline | Free, confidential emotional support, including self-harm, suicide and violence | 0800-22-444 (toll-free) or 0304-111-1741; Mon–Fri 9:30 am–5:00 pm; helpline@rozan.org |
What you can do today
If you are struggling, tell one person you trust and book one appointment — with your GP or a hospital psychiatry clinic. If you are worried about a relative, sit with them, ask how they really are, and offer to go with them. In a country where the family often decides, a family member who says “let's get this checked together” can change the whole course of an illness.
Common questions
Still not sure what to do?
Reading about a symptom only goes so far. A doctor who can ask you questions and examine you will get further in ten minutes than any article can.
