Milkar: let’s change the future of mental health

By Richard Hawkes 
Chief Executive, British Asian Trust 

In Pakistan, the scale of the mental health crisis is staggering. Millions of people live with unmet mental health needs - almost 90% remain without access to care. Despite this desperate need, less than 0.5% of Pakistan’s national health budget is allocated to mental health. 

It would be easy to suggest that the solution is simply to train more doctors, counsellors and psychologists. Without proper investment, infrastructure, policy and regulation, even the most skilled professionals cannot reach their optimal potential to address the needs of the population. And without addressing stigma, awareness and quality of care, many who need care will not seek it. 

At the British Asian Trust, we believe the issue requires a sustainable solution so many generations to come can benefit from it. This means that we must start by educating people about the importance of honest and open conversations about mental health and normalise acceptance of mental health issues just like issues related to our physical health. A second vital component is to invest in youth and young people, as 65% of Pakistan’s population is under 30 and this is where the greatest impact would be. We also believe that capacity building is not only for psychiatrists at the tertiary care level but requires a multi-cadre approach which would include general physicians, nurses, community health workers and teachers. Lastly, our work cannot only be limited to training people, or creating short-term spaces for services, but bring together the best of experts to develop codes of conduct, quality frameworks and minimum standards of care that can enable uniform service delivery across the country which is imperative now if we need to address the country’s mental health emergency. 

I am proud of the role the British Asian Trust is playing, through our nationwide mass media campaign, Milkar-Aao Baat Karein, which is addressing stigma, spreading awareness about basic mental health and encouraging conversations. We have created space for dialogue that can enable individuals to seek care. Our other programmes, especially those focused on service delivery such as integration into primary care, have supported care for 50,000 people in need of services and have strengthened more than 50 telehealth clinics across Pakistan. Additionally, contributing to the quality of services, we have worked with government departments, mental health professionals and service providers to develop a Code of Conduct for mental health, which has been endorsed by the Minister of Health, Sindh, and served as a stepping stone for the development of minimum service delivery standards with the Government of Sindh. 

The way forward  

World Mental Health Day is a reminder that the challenges are immense, but so too is the opportunity. If we act with urgency, collaboration and innovation, Pakistan can build a mental health system that not only provides care but also restores trust, dignity and quality  

The British Asian Trust remains committed to leading this change in perspective. We remain committed in working alongside our partners, the Government and communities to ensure that we can enable access to quality, regulated and efficient mental health care that is needed by millions in Pakistan.