Dr Shabana Safdar Khan
On World Mental Health Day, the devastating statistic—that a person takes their own life somewhere in the world every 43 seconds—serves as a brutal reminder that the need to prioritize mental health has reached a critical, global inflection point. Mental distress is no longer a marginal issue; it stands among the most pressing global health burdens of our time. The World Health Organization (WHO) starkly estimates that more than a billion people globally are currently living with some form of mental disorder. The most tragic and shocking indicator, suicide, continues to claim approximately 700,000 lives annually. However, this crisis extends far beyond that harrowing figure, manifesting in rapidly accelerating rates of anxiety, crippling workplace burnout, severe adolescent depression, and a relentless surge in substance abuse that is outpacing the capacity of most governments to effectively respond.
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The human toll of this silent epidemic is acutely felt in East Asia, where a punishing culture of hyper-competition drives staggering statistics. Despite its remarkable economic prosperity, South Korea bears the tragic distinction of possessing the highest suicide rate in the OECD, with approximately 26 deaths per 100,000 people—more than double the organization’s average. This alarming rate is directly fuelled by relentless academic competition and punishing, often inhumane, office hours. Similarly, China is experiencing significant cultural backlash against its notorious “996” work culture—laboring from nine in the morning to nine at night, six days a week. While social media protests and viral cases of employee breakdowns have compelled some corporations to tentatively roll back excessive overtime, the structural incentives embedded in these societies continue to reward overwork. Compounding this, effective and accessible mental health services remain scarce. This toxic combination of pervasive stigma, relentless pressure, and inadequate care has created the conditions for a deeply rooted societal crisis that researchers now aptly term a silent epidemic.
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The Western world offers little respite. Rates of clinical depression and anxiety spiked dramatically across nations during the recent pandemic and show persistent signs of holding at elevated levels. The United States, locked in its second decade of a spiralling opioid crisis, exemplifies how the lines between severe substance abuse and underlying mental illness have become fatally blurred. Meanwhile, in regions of Africa, decades of prolonged conflict, mass displacement, and chronic instability have produced entire generations suffering from severe post-traumatic stress disorder (PTSD), yet these populations exist with almost no formal psychiatric support or trauma-informed care available to them. The financial consequences of this global inaction are staggering: the estimated economic cost of untreated mental illness runs into the trillions of dollars globally, calculated through immense loss of productivity, rising national healthcare spending, and a profound diminution of human capital and potential.
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Pakistan, unfortunately, is caught in the same devastating global current, yet it lacks the systemic infrastructure—the “raft”—needed to navigate the crisis. Domestic studies conservatively suggest that up to a third of the population suffers from common mental disorders, while national suicide rates have climbed significantly, now hovering near 10 per 100,000 people. Until as recently as 2022, the law itself was a barrier to disclosure, as attempted suicide was criminally punishable, a policy that actively discouraged individuals from seeking life-saving help. Though the law has changed, stigma remains deeply entrenched in society; merely admitting to feeling depressed or overwhelmed still risks widespread ridicule, judgement, and even social ostracism.
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For the courageous few who manage to overcome the cultural barrier and seek professional care, they often encounter a broken system. Private therapists charge exorbitant, often prohibitive fees, placing expert help out of reach for the vast majority of citizens. Simultaneously, public provision of mental healthcare remains severely skeletal, particularly outside the major urban centres. For most Pakistanis, the foundational notion of proactively caring for one’s mental well-being—the idea of preventive self-care—scarcely exists as a viable concept.
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The path forward requires radical, systemic change. First, mainstreaming mental health into primary care is essential. This would ensure that family doctors, who serve as the gatekeepers of healthcare, are properly trained to detect early symptoms of mental distress, screen patients effectively, and make timely referrals, rather than simply ignoring or dismissing psychiatric symptoms. Second, there must be significant, targeted investment in affordable psychotherapy by establishing community counsellors, creating subsidised public clinics, and exploring robust digital platforms that can deliver teletherapy across diverse geographies. Third, fundamental workplace reform is non-negotiable; this includes rigorously enforcing legal limits on working hours and creating mechanisms to make employers genuinely accountable for the psychological well-being of their staff. Finally, sustained, government-backed awareness campaigns are required to persistently chip away at the destructive wall of stigma that prevents people from speaking up and seeking help.
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Ignoring mental health is not a cost-saving measure; it is a profound societal liability. Societies that fail to address this crisis pay an immeasurable cost in both lost lives and lost human output. The central lesson echoed in the corporate towers of Seoul, the vast urban sprawl of Shanghai, and the struggling public clinics of Islamabad is fundamentally the same: mental well-being must never again be an afterthought or a secondary concern. It is, unequivocally, the first order of business for a healthy, prosperous, and stable nation.
