The message that mental ill-health is a common problem and also treatable is being taken to the people in Pakistan through our newly funded programme.

Through our Ramadan campaign, your donations, match-funded with the generosity of CareTech Foundation and COSARAF, have allowed us to focus on much-needed interventions to tackle the crisis in mental health care in Pakistan. The money you helped raise is already being put to work, providing people with access to mental health services and breaking down the stigma of silence surrounding mental ill-health.

We have been working with two established partners in the country: Interactive Research & Development and Sehat Kahani. Both are tackling the existing lack of services for marginalised communities (especially women and children), cultural conservatism and poverty. They are focusing on building cost-effective, quality health care services to bring about wide-scale change.

Interactive Research and Development have established the ‘Strengthening Ties through Awareness Raising’ (STAR) project with us, in Karachi. Community mobilisers go door to door to raise the subject of mental illness and encourage people to attend and participate in community ‘Muhala’ meetings. At these meetings, lay-counsellors conduct group conversations about mental health. So far, nearly 1,800 people have participated in small groups of 10-15 people.

The obvious value of these meetings is that they are opening up conversations about mental health and providing an opportunity to screen people for depression and anxiety. They are also an opportunity for those in need to access counselling, to sign up to receive regular positive-thinking messages sent via SMS; and to be connected to a helpline for additional services and how to access them. Based on assessment, 659 participants have so far been screened, and of these 15% were found symptomatic of depression and referred on for counselling sessions.

“My daughter told me good things about you and your work in mental health. I am very thankful that you came in our area.” Aneela, a participant in our STAR project with IRD.

The opportunity to explore feelings improves the mental wellbeing of participants, and by making mental health issues relatable and accepted, these conversations increase general awareness and improve uptake of mental health services. The STAR programme is already ensuring that people with mental health problems are getting more understanding and support from their families and the broader community.

Another benefit of the programme is that through their local engagement, IRD has been able to identify people in the community to act as influencers, also passing on the mental health message.

Our other project, called ‘Sehat Karkun’, also trains community health workers. It encourages individuals to get help via partner Sehat Kahani’s network of e-health centres. Currently, three of these clinics, which were originally established to offer cost-effective female-focused general health care, largely through online information and video appointments with female doctors, now offer mental health screening and counselling using the same technology. Intermediary nurses at the clinics have been given training in mental health care, and people requiring more serious mental health interventions are referred on to psychologists and psychiatrists, as necessary.

“We had a lot of patients coming in with mental health issues before the training. We didn’t know how to deal with them… we did not even know the proper technical words to describe what they were going through … I am happy to take part in this programme and bring help to my community.” Tabinda Arshad, a nurse, working for the past four years at one of Sehat Kahani’s e-hub clinics, who recently received her certification as a Mental Health First Aider.

These projects are still in their learning phases, but the community responses have been very positive. We are also starting work with a third partner, Basic Needs Pakistan. Further data, to show the impact and outcomes of the work will be available in future updates. Meanwhile, it is clear that the programmes that are in progress have additional benefits, including increased empowerment, confidence building and livelihood opportunities.