“We need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in” — Desmond Tutu

THERE is much talk of a ‘mental health crisis’ in Pakistan currently. Campaigns for ‘raising awareness and reducing stigma’ have been launched, encouraging people to talk about and seek help for mental health issues. There is a call for increased funding, upscaling mental health services and integrating mental health into primary care. These are all important and mental health definitely needs to be prioritised. But it is also equally important to reflect on what is driving this mental health crisis in Pakistan and what can be done about it.

The mental health crisis is not merely a health issue. It is a reflection of how power, inequality, and governance intersect to shape the emotional lives of millions of Pakistanis. The crisis is not a natural disaster but manmade — the outcome of 78 years of brutalisation of the people through social and economic injustice, political instability and structural poverty.

Pakistan’s history is defined by political turbulence. For almost half of its existence, Pakistan has had direct military rule and an indirect one even when there is a façade of civilian government. The events of the last three years, the stolen mandate, state violence and oppression, emasculation of the judiciary and parliament have all but eroded what little public trust there was in state institutions. This has serious psychological consequences. Pakistanis live in a permanent state of uncertainty. Political chaos is fuelling collective anxiety, cynicism, and a loss of civic sense. Fear and distrust have become national emotions.

For millions of Pakistanis, psychological suffering is inseparable from economic hardship. Rising inflation, unemployment and collapsing purchasing power has turned everyday life into a test of survival. When families cannot afford school fees or electricity bills, when people feel they cannot make ends meet, when savings evaporate overnight, mental distress is the natural outcome. Poverty is not only material deprivation; it is psychological violence inflicted by an unequal system.

Over 60 per cent of Pakistan’s population is under 30 years of age. What should be a demographic dividend has become a demographic crisis. Young people face shrinking opportunities, high unemployment, and an outdated education system disconnected from labour markets. Merit is sacrificed for nepotism and favouritism; hard work is replaced by connections. A society that denies its youth opportunity also denies them hope. No wonder every other young person wants to leave the country.

For millions of Pakistanis, psychological suffering is inseparable from economic hardship.

This suffering is not a ‘test of God’; it is political. The failure to provide social justice, address poverty, provide basic necessities, to control corruption — by neglecting social development — represents a deliberate abdication of state responsibility. The emotional cost is borne silently in our homes and workplaces across the country. This is criminal.

Among the many silent tragedies, Pakistan is the tragedy of suicides. The World Health Organisation estimates that between 13,000-20,000 people die by suicide each year and 10-20 times more attempt suicide, mostly by young people, under the age of 30 years. Poverty and unemployment stand out as major causes. This in a country that was created in the name of Islam, whose central tenet is social justice. We need to ask ourselves why then is the prohibition on suicides not having its deterrent effect in a country with 97pc Muslims.

This silence is strategic. To confront the mental health crisis would be to confront its root causes — poverty, inequality, corruption, and misgovernance. Instead, individuals are told to be patient, to pray, or to endure. Endurance, in this context, is not resilience; it is resignation. There is no greater insult than to label the silent suffering of Pakistanis as ‘resilience’. People have no choice but to struggle on.

Addressing the mental health crisis in Pakistan requires far more than setting up clinical services, increasing the number of psychiatrists and psychologists, setting up crisis helplines or offering interventions through apps or digital platforms. It demands a reordering of political and economic priorities. This means addressing the root causes of the mental distress of the population. We need truly representative governments, not one that is imposed on us. We need to curb corruption, which has eaten into the moral fabric of our society. We need to declare a national emergency in education in the country. Why are 25m children out of school in Pakistan? What is the future for them? We can spend billions of dollars over four days in a ‘war’ with one of our neighbours but cannot provide universal health coverage to our people.

Nearly one in three Pakistanis are estimated to be in need of mental healthcare. Yet, there is no separate budget for mental health and mental health spending is estimated to be less than 0.5pc of the national health budget. Whatever little is there, is eaten up by corruption and mismanagement. Access to psychiatric care remains confined to a few major cities, where it is largely unaffordable for the vast majority.

Pakistan’s vulnerability to climate change has added a devastating dimension to the mental distress of its population. The 2022 floods displaced over 30m people, destroying homes, livelihoods, and communities. It was replayed in the recent floods in Punjab and KP. Many survivors continue to experience post-traumatic stress, anxiety, and depression — yet mental health remains absent from national disaster response and recovery plans. A nation’s true strength is measured not by the size of its economy or its armed forces, but by peace of mind of its citizens. Until Pakistan learns to prioritise the mental well-being of its people as a central pillar of its policies, our crisis of the mind will remain, silently but unmistakably, of our own making.

The writer is a consultant psychiatrist.

[email protected]

Published in Dawn, November 1st, 2025

By Akhtar Hussain Sandhu

The PAK-AFGHANdialogue held at Istanbul could not be successful as desired by both the countries, Pakistan’s federal minister, Mr. Atta Tarar, revealed the news through his statement on 29 and then 30 October. Both agreed to continue the ceasefire and further talks to deal with the terrorist groups existing in Afghanistan. This gathering in Istanbul was a continuation of the talks concluded in Doha (Qatar), which had resulted in a ceasefire between Pakistan and Afghanistan. The Taliban leaders acknowledged the open secret that the incumbent regime in Afghanistan is sponsoring the terrorist activities in Pakistan. Yet the Pakistani delegation showed the world that Pakistan is a pacifist state seeking an effective action against the terrorist groups within Afghanistan. The dialogues were at the verge of failure but both sat again and concluded agreed points of meeting on 6 November 2025. If transit trade remains blocked, then Pakistani pressure will sustain otherwise weapons will be imported through Karachi by Afghanistan. Hopefully, tension will dwindle down soon because the Afghan delegation did not repeat the Durand Line and other issues in the last meetings. National Mobilization Front, a dissident group in Afghanistan, has declared if India support Taliban, they would support the Sikhs and Khalistan movement in India. Moreover, very important leaders of TTP have been killed by the Pakistani forces that shows the commitment to eliminate the terrorists from the Pakistani soil.

Pakistan moved only one major agenda item, that Afghanistan should not support the Tehrik-i-Taliban Pakistan (TTP) and other terrorist groups that have been launching suicide attacks against the military and civilians in Pakistan. This is the same demand that the Talibans had already promised in the Doha agreement. Now, in the recent talks organized in Istanbul, the Taliban leaders confessed the presence of the terrorists of Tehrik-i-Taliban Pakistan (TTP) and other banned terrorist organizations in Afghanistan, which are being sponsored and facilitated by the Taliban regime. Pakistan had closed Chaman, Torkham, and other borders.

No transit trade is allowed, and repatriation of the so-called Afghan refugees is in progress. Hundreds of trucks are parked due to the persistent security concerns by Pakistan over the terrorist attacks facilitated by Afghanistan. All the terrorist organizations of Baluchistan, KPK, and Punjab are involved in immoral, illegal, and un-Islamic activities with the help of the Taliban regime. They must know that state affairs don’t not function on religious basis but on ‘National Interest.’ Therefore, Afghanistan will have to respect international laws and cosmopolitan ethics.

Afghanistan is working as the Indian proxy that Pakistan cannot tolerate at any cost. Turkey and Qatar played a sincere role in bringing the Talibans and Pakistan to the table, but the Indian-backed Kabul regime did not let the talks end with a positive result. The agreement was approaching a successful end, but Kabul, through the delegation, tabled a new demand for Pakistani help if the USA attacks. This was an immature gesture because Istanbul talks were a part of the agenda already concluded at Doha, in which no such point was a part of the agenda. The facilitators of the Muslim countries were surprised by the support of the terrorists and the erratic behavior of the Taliban delegation.

Significantly, the point of Islamic laws and Shariah propagated by the Talibans is worth discussing that since the skirmishes started on the Pak-Afghan borders or even before, the so-called advocates of Shariah have been hiding behind the falsified narrative and utter lies constantly. They adopted the same lies during the meeting at Istanbul, but were embarrassed when the Pakistani delegation presented undeniable proof and argued in the form of audio and video recordings. The real followers of Islam do not tell lies, do not kill innocent people, do not desecrate and mutilate human corpses, and do not conspire against Muslims with the help of non-Muslim state.

The world is mostly witnessing ‘war diplomacy’ while the Talibans always adopted ‘terrorism economy’ and ‘violence diplomacy’, which means to use terrorists as bargaining chips or tools. As compensation, they beg money from different countries. Pakistan knows this false show and the Taliban’s nuisance value; therefore, on the demand of money for the settlement of the terrorists far away from the Durand Line, Pakistan simply refused to pay. Pakistan had already mortified and crushed their arrogance, haughtiness, and fake image of being warriors within a few hours. Even Pakistan seems ready to revise the false curricula of Pakistan Studies and history in which the marauders are glorified.

Pakistan shared the stance vividly that if any terrorist attack in Pakistan is linked to the Afghan areas, Pakistan would hit Kabul and other main cities of Afghanistan. The engagement policy of General Asim Munir has stamped how Pakistan’s Law Enforcement Agencies would react to the anti-Pakistan conspiracies. On the failure of the Istanbul talks, the Talibans threatened to attack Islamabad, although they lack an air force which means they will use terrorists and suicide attacks. The terrorists must be clear that Islamabad will retaliate fiercely and protect the borders and ensure the security of the civilians.

However, Pakistan must repatriate the Afghan refugees as soon as possible. We hear that some of the policemen are taking bribes to show that the Afghans either have been repatriated or disappeared somewhere. The soil of Pakistan is more sacred than any other neighboring land, and the people of Pakistan are more important than anyone else on the earth; therefore, the state must take stern actions against the terrorists, traitors, corrupt officials, smugglers, terrorists and their sympathizers. Pakistan right now enjoys a soft image, effective establishment, and powerful military leadership at the international level. Therefore, this is the right time to root out the anti-Pakistan extremist elements and terrorism from the country.       

Paris (Imran Y. CHOUDHRY) :- Former Press Secretary to the President, Former Press Minister to the Embassy of Pakistan to France, Former MD, SRBC Mr. Qamar Bashir analysis : The recent summit hosted by President Donald Trump, with Egypt’s Prime Minister beside him, carried moments that went beyond protocol. When Trump extended an affectionate greeting to Prime Minister Shehbaz Sharif, it was more than a warm gesture—it symbolized a historic shift in U.S.–Pakistan relations. That moment showed how Islamabad’s civilian leadership and its military command under Field Marshal Asim Munir had moved from the margins of suspicion to the heart of Washington’s strategic calculus. This closeness did not emerge overnight. It had been cultivated in the months before America’s devastating strike on Iran’s nuclear facilities, when Pakistan’s leadership first engaged with Trump in serious dialogue. Since then, Pakistan has become central in persuading the Muslim world and wealthy Arab capitals to support Trump’s ambitious 21-point Gaza Peace Plan.
What followed at the summit underscored the depth of this bond. While European leaders, presidents, and prime ministers from around the globe sat on the sidelines, Shehbaz Sharif was invited by Trump to take the podium and publicly offer praise. No other leader was given such a platform. Trump, clearly pleased, remarked that the true achievement of the summit was not only the signing of the Hamas–Israel agreement but the dawn of a new era of friendship, reconstruction, and hope for Gaza. In a further gesture, Trump mentioned Field Marshal Munir by name, praising his leadership and role in regional stability. It was a recognition that carried consequences far beyond the hall, signaling to the world that Pakistan was no longer merely a participant but an indispensable partner in shaping the future of the Middle East.
The political consequences at home are equally profound. A country that only recently teetered on the brink of economic collapse now finds itself under the protective shield of Washington’s goodwill. Trump’s personal embrace of Pakistan’s leadership, combined with the IMF’s readiness to release fresh funds and the global media’s acknowledgment of reforms, all but ensures that Shehbaz Sharif’s government will complete its five-year term. Bloomberg’s recent report, which placed Pakistan as the second most improved emerging economy in terms of sovereign default risk, has become an anchor for this perception of stability. It suggests that regime change, once a lingering fear, is no longer an imminent threat.
For the opposition led by Imran Khan, this represents a near-terminal blow. PTI, once a movement with momentum, now appears fractured, riddled with blame games and leadership rifts. International recognition of government performance compounds the decline of PTI’s appeal. The likelihood of Khan’s return to power grows slimmer with each passing day, not only in this term but perhaps in the next electoral cycle as well. Continuity, not disruption, now defines the political horizon.
Bloomberg’s endorsement is more than a headline. Between June 2024 and September 2025, Pakistan’s sovereign default probability fell by as much as 2,200 basis points. From being ranked among the riskiest economies in the world, Pakistan rose to the second-best performer among emerging markets, behind only Turkiye. The turnaround was achieved through strict fiscal discipline, compliance with IMF conditions, timely debt repayments, and reforms that improved investor confidence. To lenders and investors, the message is clear: Pakistan is no longer a default story but a recovery story. To citizens, it signals hope that the worst may be behind them.
Yet beneath this optimism lies a more complex reality. The improvement in sovereign risk is significant but does not tell the whole story. Pakistan’s growth for FY25 was revised upward to 3.04% after industrial output rebounded, while third-quarter growth came in at 2.4%. These figures are encouraging but modest, reflecting stabilization rather than a boom. Inflation, which had once spiraled above 30%, cooled dramatically to just 4.1% by late 2024, allowing the State Bank to cut policy rates from a suffocating 22% down to 12%. This drop, however, owes as much to global commodity relief as it does to policy discipline.
Investment has shown some sparkle: the Special Investment Facilitation Council pushed foreign direct investment up by 16% in one month, IT exports rose 32%, and the Karachi Stock Exchange doubled in a single year. Exports rose by 10% to $30.64 billion in FY2024, though a persistent trade deficit remains, fueled by costly imports of petroleum and machinery. Most recently, a $1.2 billion IMF agreement reached in October 2025 has shored up liquidity, while the 2025–26 budget ambitiously targets 4.2% growth.
These data points reinforce Bloomberg’s narrative to an extent. Inflation is under control, growth is stabilizing, investors are returning, and credit risk has narrowed. Yet deep challenges persist. Job creation remains weak, and official data is thin. Small and medium enterprises, which form the backbone of domestic employment, still face crushing costs from energy tariffs, taxation, and financing constraints. Structural reforms in governance, energy, and taxation continue to lag. Pakistan’s revival, while real, is fragile—dependent on external goodwill and vulnerable to global shocks.
What makes the Bloomberg recognition consequential is its convergence with Trump’s embrace. Together, they create a powerful narrative dividend: Pakistan is not only stable, but strategically indispensable. For Washington, Islamabad’s role in rallying Muslim and Arab states behind the Gaza framework is invaluable. For Pakistan, the dividend is survival and the chance to thrive under international endorsement. IMF funds flow more smoothly, investors take notice, and international media highlight the recovery rather than the collapse. Confidence breeds confidence, and the government’s legitimacy is strengthened at home.
But overreliance on narrative is dangerous. Recognition from Bloomberg or praise from Trump cannot substitute for deep economic transformation. If oil prices spike, if U.S. interest rates rise, or if domestic reforms stall, the narrative could unravel quickly. Investors are patient only as long as reforms continue; corruption or complacency could break the cycle of confidence. Pakistan’s future cannot rest solely on symbolic endorsements. It must be built on durable change that translates into jobs, thriving businesses, and improved living standards.
The outlook is both promising and precarious. If Pakistan can maintain fiscal prudence, expand exports, exploit its mineral wealth, and modernize its economy, this Bloomberg moment may be remembered as the beginning of a genuine turnaround. With Washington’s backing, the country enjoys a rare window of stability that could last five to ten years, enough time to set the foundation for durable prosperity. But history offers harsh lessons: moments of reprieve squandered, opportunities lost to complacency or discord.
The challenge now is not to mistake recognition for resolution. Trump’s embrace and Bloomberg’s endorsement are powerful signals of global confidence, but unless they are matched by tangible improvements in jobs, trade, and technology, they will remain fleeting headlines. Pakistan stands at a turning point, its reprieve fragile but full of possibility. Whether this moment becomes a renaissance or a relapse depends not on the applause abroad but on the reforms at home.