Ecosystem Catalyst Grant

Why this is important

Mental health issues among young people in Pakistan are widespread and growing. Stress, anxiety, depression and drug abuse are among the leading concerns reported by youth (Being, 2024), with community studies estimating that between 19 and 34 per cent of young people experience socio emotional problems (Hussein, 2007). Among university students, this picture is even starker, with 70 to 85 per cent reporting symptoms of depression, anxiety or stress (Taskeen, 2024). Despite this, young people frequently describe stigma and family resistance, a lack of affordable, youth friendly services and few safe spaces for emotional expression as the main barriers standing between them and support.

The infrastructure available to respond to this crisis remains severely limited. Pakistan has only one in patient child and adolescent psychiatric unit in the public sector, with just six beds serving a population of over 220 million (Imran et al., 2021). Training in child and adolescent psychiatry and psychology is still in its infancy, with fewer than five qualified child and adolescent psychiatrists in the entire country (Hamdani et al., 2021). As a result, most young people with mental health needs are treated within adult mental healthcare facilities, which are themselves concentrated in urban centres (Hamdani et al., 2021), leaving few in patient options specifically designed for children and youth.

Access to care is further constrained by a chronic shortage of professionals and services nationwide. Pakistan has just 400 psychiatrists and fewer than 500 trained clinical psychologists for a population exceeding 220 million (PPS, 2023), contributing to a 90 per cent treatment gap. On average, young people wait 4.5 years after the onset of symptoms before receiving treatment (Hussain et al., 2018), and only 46 per cent of outpatient mental health facilities offer community based care. Services remain heavily urban centred, leaving rural and remote areas with minimal or no access, while long distances, high travel costs and weak referral pathways further limit who can reach the support that does exist.

Even where services are available, cost and mistrust often stand in the way. Most treatment is not free, and the combined burden of medication, transport and lost income deters many families from seeking care. Poor mental health literacy, enduring stigma and a broader mistrust in institutional support mean that services are frequently under used, even when they are within reach.