Over the last three years, the British Asian Trust partnered with local Pakistani organisations IRD, Sehat Kahani, Taskeen and Aga Khan University to deliver a sustainable model for low-cost mental health support in Pakistan that addresses the historical lack of resources and understanding of the mental health in the country.
Currently, 1 in 4 people (50 million people) in Pakistan are affected by mental health issues such as depression & anxiety but only 0.4% of the national health budget is allocated to mental health. Almost 90% of people in need of treatment in Pakistan have no access to any kind of support and there are fewer than 500 psychologists and 400 psychiatrists for the population of 216 million people.
To address these systemic issues, programmes that promoted access to mental health services for the poorest, were undertaken by several British Asian Trust and CareTech Foundation partners. Interactive Research & Development (IRD), an organisation committed to building healthcare infrastructure in Pakistan established a model to screen clients and provide lay counselling services and referrals at the community level. Furthermore the British Asian Trust, CareTech Foundation and the other donors also partnered with IRD to open the Pursukoon Zindagi Wellness Centre at The Indus Hospital in Karachi, offering free mental health counselling and regular structured group sessions and support groups. Sehat Kahani, an all-female telemedicine organisation provided outreach combined with online mental health provision in far flung rural clinics. Taskeen, a mental illness prevention non-profit focused on delivering a multi-channel campaign to raise awareness and reduce stigma of mental health across the country. When the COVID-19 pandemic hit last year, the British Asian Trust worked with its partners to pivot their programmes to respond to the crisis. IRD took their lay counsellors onto helplines so that they could respond to the anxiety exacerbated by the pandemic, Sehat Kahani expanded its telemedicine reach, and Taskeen incorporated messaging related specifically to mental health and COVID-19. Additionally, to address the need for remote mental health support, Aga Khan University piloted an online model for equipping parents with support and skills on ‘parent-mediated therapy’ to support children and young people with mental health issues that had lost access to therapy due to COVID-19.
The programme has resulted in the successful delivery of mental health related messaging to 10.3m people, including 270,000 people in low-income urban communities and 725,506 people reached through the COVID-19 proactive mental health helpline and SMS messaging. Improved access to support has been provided to over 63,000 people, through access to quality and appropriate support.
The need for the programme was identified by UK based British Asian Trust and its partners the CareTech Charitable Foundation and COSARAF Foundation who along with other donors have contributed £1M GBP to the programme and also helped establish a Mental Health Coalition, improving coordination and best practice in the country. Additionally, the British Asian Trust and its partners engaged key stakeholders, including the President of Pakistan and the Pakistan Cricket Board to leverage their influence to raise awareness around mental health, mental health policies and national quality standards.
Ongoing and future support will be focused on expanding the reach of the programme to a further 28 communities in Pakistan, building a greater local presence, and building further regional and institutional partnerships to support delivery and implementation of the mental health agenda.
Our Chair and Chief Executive of CareTech plc, Haroon Sheikh, said:
“We are thrilled to be a part of this innovative and much-needed programme with the British Asian Trust. While important and significant strides have been made in addressing the mental health crisis in Pakistan, there is still more work that needs to be done, especially as we begin to exit the COVID-19 pandemic and begin to return to normalcy. More people than ever will need to know where they can go for help and trust the services they are receiving. We look forward to working with the British Asian Trust further on this programme in the future.”
Our CEO, Jonathan Freeman MBE, said:
“It is fantastic that the CareTech Foundation has been able to play its part alongside the British Asian Trust in bringing about what I hope will be the beginning of a revolution in the way mental health is treated in Pakistan. Most importantly, this is a programme designed and led by Pakistani organisations for the good of the Pakistani people. Only through local voices, knowledge and support can change be delivered with meaningfully and for the long-term. ”
The Status of Mental Health In Pakistan and Covid-19
The aftermath of COVID-19 lockdowns in Pakistan will only exacerbate the already existing problems. As reported in an abstract from the British Medical Journal in 2020, fear and social stigma linked with COVID-19, many individuals in the community hide their disease and do not access healthcare facilities in a timely manner, job insecurity caused by workplace social restrictions have caused increased financial and job security stress whilst panic caused by the unavailability of essential protective equipment, particularly masks and sanitisers has led to a variety of mental health issues, including depression, anxiety, panic attacks, psychotic symptoms and even suicide, being reported.
Despite the steps made these past three years, the British Asian Trust acknowledges that they want to reach more people and that the systems established need to be maintained to remain successful and address mental illness issues long term.
Jonathan further commented on the matter:
“This is not about quick fixes but I am confident that the programme will come to be seen as a significant catalyst for major long-term positive change in Pakistan – and beyond.”
Richard Hawkes, Chief Executive of the British Asian Trust, added:
“We have been delighted to partner with the CareTech Foundation on this mental health programme. We, at the British Asian Trust, want to create a transformative change in mental health in Pakistan including the availability and quality of services, care, and a positive shift in attitudes towards mental health issues in Pakistan. We are delighted at how quickly we were able to collaborate with delivery partners and pivot out programmes to respond to the mental health needs during this current pandemic.”