A call to action: Combating suicide stigma, promoting mental health in Pakistan

On this World Mental Health Day, the need for awareness and action on suicide prevention in Pakistan is more urgent than ever. Suicide rates have surged from 7.3 per 100,000 in 2019 to 9.8 in 2022, highlighting a troubling trend.

In rural and impoverished areas, where access to mental health care is almost non-existent, the problem is particularly severe. This year alone, we’ve witnessed alarming headlines—of lives lost and families shattered.

Yet, suicide remains a taboo issue, largely overlooked and untreated due to the complex interplay of social, religious, and legal barriers. As a society, we continue to avoid open discussions about suicide, failing to confront the underlying causes of these preventable tragedies.

According to the World Health Organisation (WHO), Pakistan's suicide rate is likely grossly underreported due to inadequate reporting systems and the historical criminalisation of suicide.

For every life lost, countless others suffer in silence. For many, societal pressures, familial expectations, and financial challenges heighten their vulnerability to suicide.

For instance, my research on maternal suicide in Pakistan illuminates the profound distress women in particular face—trapped in cycles of physical and emotional abuse, poverty, and helplessness—that ultimately propelled their suicide attempts.

These factors, combined with poor mental health literacy and limited access to care, create a dangerous environment where help seems out of reach. Understanding such risk factors for suicide within Pakistan’s unique context is crucial, as they can serve as worthy intervention targets.

Equally important, empathetic and non-stigmatising dialogue is vital for facilitating early detection and intervention; ultimately, preventing suicide. However, conversations about suicide are rare, and those who speak up face shame, isolation, or complete disregard.

Pakistan’s intricate social and religious fabric often frames suicide as a moral or spiritual failing, rather than a public health crisis that needs our attention.

Compounding this, until December 2022, attempted suicide was illegal under Section 325 of the Pakistan Penal Code, punishable by up to a year in prison, a fine, or both, dissuading individuals from seeking the help they so desperately need.

While Pakistan has made progress by decriminalising attempted suicide, legislation alone is insufficient.

To effect meaningful change, we must keep the conversation about suicide prevention alive well beyond World Mental Health Day by prioritising mental health literacy and raising awareness in schools, workplaces, and communities. Importantly, this education should actively dismantle the stigma that prevents individuals from seeking help.

Language plays a critical role in destigmatising suicide.

How we talk about suicide—whether with compassion or stigma—shapes the discourse and influences pathways to prevention. For instance, instead of framing suicide as a "mistake" or "sin" (as in "khudkushi galat hai" or "khudkushi gunah hai"), we should focus on support and understanding.

Saying, "I’m here for you, and together we can explore ways to get you the care you need," removes judgment and offers a pathway to help. Framing suicidal thoughts as failures often contributes to stigma and can further isolate those already in pain.

Similarly, using terms like "committed suicide" can reinforce harmful associations of crime or sin, while shifting to neutral language like "died by suicide" helps remove blame and shame from the conversation. These small yet significant shifts in our language can greatly impact how individuals experiencing suicidal thoughts feel about seeking help and how others perceive their struggles.

Suicide myth-busting is crucial for encouraging individuals to seek help and enabling others to provide support.

Research shows that beliefs in suicide myths impact one’s willingness to offer help to those experiencing distressing thoughts.

Thus, debunking common myths about suicide and teaching people how they can approach conversations about it should also be a part of the efforts to improve mental health literacy.

One of the most common myths is that asking someone about suicide may unintentionally "put the idea in their head." In reality, asking someone directly about suicide provides an opportunity for communication, which is often a relief for individuals who wish they had someone to confide in.

Discussing suicidal thoughts can reduce the likelihood of suicide if handled with care.

Community leaders, such as imams and teachers, who play an influential role in shaping societal attitudes, should be engaged in efforts to promote compassionate, rather than punitive, responses to suicide. Their voices can help shift harmful narratives that cast mental health struggles as moral failings and encourage more supportive responses.

On this World Mental Health Day, let’s pledge to change the narrative surrounding suicide. On this World Mental Health Day, let’s commit to changing the narrative surrounding suicide.

By prioritising mental health literacy and challenging the harmful beliefs that perpetuate stigma, we can create an environment where open discussions about mental health are encouraged and supported year-round.

Suicide is preventable, but it requires our collective, sustained effort to drive meaningful change. The time for action is now, because, for too many in Pakistan, tomorrow may be too late.

Support for you or someone you care about:

Reaching out to someone about your feelings and thoughts can be lifesaving. There are actions you can take to ensure safety of yourself or your loved one during a crisis.

1. Umang Pakistan: Call 0311-7786264 for 24/7 mental health support available throughout Pakistan. This helpline is confidential and offers assistance in Urdu, English, and all regional languages, including Sindhi, Punjabi, Pashto, and Balochi.

2. Taskeen helpline: Call 0316-8275336 from Monday to Saturday between 11 AM and 11 PM or chat with their 24/7 chatbot for confidential mental health support. You can also book a free online distress screening or a well-being screening with Taskeen through the helpline, chatbot, or WhatsApp.

The writer is a PhD student at Yale University and a global mental health researcher. She currently leads several projects focused on suicide prevention in Pakistan.