WORLD Mental Health Day this year carries a compelling message. The theme, ‘Lived experiences heard: real voices, real change’, challenges a practice in which patients are passive recipients of care rather than people whose experiences can improve it. The message is particularly relevant to Pakistan, which launched its National Mental Health Policy 2026-2035 earlier this month. The policy promises to bring treatment closer to communities, an encouraging development in a country where some 32.4m people need mental healthcare and access to services remains desperately limited. However, expanding treatment is only part of the challenge. Patients must also have a voice in determining what kind of care they receive, how they are treated, and whether services meet their needs. Otherwise, even well-intentioned reforms risk overlooking the people they are supposed to help.
A Pakistani woman’s experience, highlighted by the WHO this week, illustrates why this matters. Sania suffered depression as a teenager but later came to understand how social circumstances could shape psychological distress. She questioned whether problems rooted in discrimination, insecurity and restricted freedoms could be addressed through medical treatment alone. Her subsequent work helped bring the views of people with mental health conditions into discussions surrounding Pakistan’s new policy. Her experience raises an important question: what happens when a woman suffering from anxiety lives in an abusive household, or a young man battling depression cannot find work? Medication and counselling may be necessary, but they cannot remove the pressures contributing to their distress. For poorer households, even travelling to a distant clinic can mean losing a day’s wages. In Pakistan, where families often make decisions on behalf of vulnerable loved ones and mental illness carries shame, protecting patients’ right to make choices about their care is particularly important.
The recently concluded Islamabad mental health summit promised greater community participation and closer monitoring of improvements to mental healthcare. Those commitments now require action. Provincial governments should ensure that people who have experienced mental illness, along with caregivers, are represented in bodies overseeing mental health services. Hospitals must strengthen safeguards for informed consent, create confidential channels for complaints, and protect patients against degrading or coercive treatment. The authorities should also publish figures on patient complaints and how they are resolved. Community-based care should allow people to remain connected to their families, education and livelihoods wherever clinically appropriate. Equally important, patients must be involved in evaluating whether these services actually work. Pakistan has spent years discussing the stigma surrounding mental illness. This World Mental Health Day, it should begin listening to those who know the system’s flaws first-hand.
Published in Dawn, October 10th, 2026
