Sindh’s mental health gap leaves communities unsupported

For someone battling depression, anxiety, or another mental health disorder, finding help in Sindh can be as difficult as living with the illness itself. Where a person lives can determine whether a specialist is within reach—or whether they have to struggle without one.

Mental-health specialists are concentrated in just 10 districts of the province, while the remaining districts have no reported specialist services. With around 140 mental health professionals serving Sindh, access to psychiatric and psychological care remains severely limited outside major urban centres.

The shortage is compounded by the absence of a provincial mental health policy for the past five years. Experts say the lack of a comprehensive policy has also contributed to inadequate data, making it difficult to determine the true scale of mental health disorders or assess services required across the province.

Dr Karim Khawaja, Honorary Chairman of the Sindh Mental Health Authority, said more than 30 per cent of Pakistan’s population suffers from depression and other mental and psychological disorders. He said there were around 600 mental health professionals across Pakistan, including 140 in Sindh, but those in Sindh were available in only 10 districts.

“The remaining districts do not have these specialists,” he said, highlighting the geographic gap in mental health care. People living outside these districts may have to travel to larger cities for diagnosis and treatment, creating another barrier for families already facing financial difficulties and other social pressures.

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The problem is particularly significant as mental health disorders are believed to be increasing across Pakistan. According to experts, the number of people suffering from mental health disorders has increased by around 15 per cent over the past five years, while more than 30 per cent of the population is estimated to suffer from depression and other psychological disorders.

But the absence of reliable provincial data makes it difficult to establish the scale of the problem in Sindh.

Professor Dr Muhammad Iqbal Afridi, Distinguished National & Meritorious Professor (HEC), said one in every three people in Pakistan, compared with one in every five globally, suffered from some form of psychological illness. "Depression is increasingly being reported among men and women, with domestic conflict and other social pressures contributing to psychological problems among women," noted Dr Afridi.

Young people are also facing growing pressures. Professor Afridi said Pakistan’s economic situation, unemployment, terrorism and uncertainty about the future were affecting their mental health. He also pointed to increasing exposure to ice and other addictive substances, as well as excessive use of digital platforms.

Professor Wajid Ali Akhunzada, President of the Pakistan Psychiatric Society, said one in every four young people and one in every five children in Pakistan suffered from some form of psychological illness. He confirmed that the country faced a severe shortage of psychiatric specialists and needed greater investment in mental health services.

Experts say Sindh needs a policy framework covering prevention, early diagnosis, treatment, referrals, specialist training, and data collection. Better data could help identify districts with the greatest need and guide the deployment of additional mental-health professionals and facilities.

For many in Sindh, the hardest part of fighting a mental-health disorder may be finding someone qualified to help. Until care reaches beyond major cities, too many people will be left to struggle in silence, with help out of reach when they need it most.