Pakistan does not have a strong publicly funded primary health care system and as many as 90% of people seek healthcare in the highly unregulated private sector, paying out-of-pocket (Eastern Mediterranean Health Journal, WHO, 2018). Government provision of mental healthcare at the primary/community level is almost non-existent – reaching just 0.34% of the population (WHO, 2009). It is estimated that 1 in 4 people in Pakistan have a mental health issue (over 50 million people), yet there are only 500 psychiatrists to support them. Even before the COVID-19 pandemic devasted lives and livelihoods, the prevalence of issues such as anxiety and depression in Pakistan were being driven by high levels of poverty, natural and manmade disasters, social and economic inequality, and rapid urbanisation.
British Asian Trust focus on integrating mental health information and support within existing health services in the community to improve access to care, combined with targeted awareness raising activities to improve understanding and reduce stigma, thereby driving demand. They have been working to improve support for mental health in Pakistan since 2012 and have been supported by the Vitol Foundation since 2019.
In the programme currently funded by the Vitol Foundation, they are supporting partners Sehat Kahani and Global Institute of Human Development (private and public sector providers) to integrate mental health into their services and supporting their frontline health workers to screen, support and refer people for mental health services. 18,000 people in low-income urban, peri-urban and rural communities in the Sindh Province in Pakistan will be supported through this intervention. In addition, they have refined their approach to generating local demand through their creative and resourceful partner Taskeen.
Lastly, this project aims to address systemic barriers at a wider heath system level by developing a University-led curriculum to train all primary health professionals in mental health, developing quality standards for all mental health provision in Pakistan, and raising mass awareness around mental health across the country.