A trained psychotherapist with over a decade of experience, Sanaa Ahmad has a BSc in Psychology from the McGill University and a MSc in Mental Health and Psychological Therapies from QMUL (Barts and the London School of Medicine). Currently she is serving as Senior Manager Programmes (Mental Health) at the British Asian Trust (BAT). Through her experiences prior to BAT, she worked in the UK supporting individuals who had issues with drugs and alcohol, mental health issues and violence to sustain positive change. She also interned with Solace Women’s Aid, an organisation offering free advice and support to women and children in London to build safe lives. Sanaa has acquired strong clinical experience in working with BAME communities, women, and especially youth in very difficult circumstances. She led individual therapy sessions as well as support groups to help these women with their mental health and quality of life.

Since 2018, Sanaa has led the British Asian Trust’s transformational, multi-stakeholder programme to improve the mental health of over 40,000 people in low-income areas of Pakistan. She has been instrumental in establishing the first ‘Mental Health Coalition’ in Pakistan through this programme. The Coalition brings together organisations and experts for a more focused, collaborative approach across the sector.

In October 2024, the British Asian Trust in partnership with The Mir Khalil-ur-Rehman Foundation (MKRF), launched a nationwide campaign ‘Milkar’ to address mental health issues in Pakistan. The 12-month mental health campaign aims to spread vital mental health awareness and lead to sustainable and systemic change across the country. In an exclusive interview with You! Sanaa talks about mental health issues and highlights the key points of ‘Milkar’ campaign. Read on…

You! What are the aims and objectives of ‘Milkar’ campaign?

Sanaa Ahmad: The ‘Milkar’ campaign is a joint venture between Mir Khalil-ur-Rehman Foundation (MKRF) and British Asian Trust (BAT). BAT has worked for over 12 years on the issue of mental health. Unfortunately, the issue remains neglected and underfunded in Pakistan, often surrounded by stigma and a lack of awareness. Initially when BAT started working on mental health, it was a topic less spoken of. However, post-COVID, there has been a global shift towards greater emphasis on the importance of this issue, as the pandemic had led to a surge in mental health cases worldwide. MKRF, with a track record of highlighting social issues in Pakistan through advocacy campaigns and utilising Geo’s strategic reach, aims to raise awareness and drive meaningful change.

We believe that this partnership of an NGO and a channel dedicated to creating an attitudinal and behavioural shift in mental health can bring real impact. We have worked on the campaign setup for one year also with the support from of the Pakistan Mental Health Coalition (PMHC), experts in the field, and a technical advisory board, including Zafar Masud, CEO of Bank of Punjab, and Zafar Mirza, former Health Minister and WHO leader, the project aims to bring positive change in society where mental health’s concept changes from a stigma to an issue which can be cured with care and treatment. We want to emphasise the need for investment in mental health services and to strengthen the healthcare system in Pakistan.

The essence of ‘Milkar’ is about bringing together diverse perspectives and expertise to change the mental health landscape in Pakistan. The campaign’s tagline, ‘Aao Baat Karein’ (Let’s talk), encourages people to open up about mental health issues, break the silence, and address topics like substance abuse, domestic violence, maternal mental health, and relationship problems - issues that often go unspoken and contribute to the high prevalence of mental health issues in the country.

You! What steps have you taken so far to address the mental health crisis in Pakistan?

SA: We have brought together a panel of experts, including Dr Rubina Qidwai, Dr Ayesha Mian, Dr Usman Hamdani, Dr Yasmeen, Dr Shaista and many others to help us shape the campaign. We are also conducting research to create culturally relevant and relatable messages about mental health. A baseline survey has already been conducted to assess the state of mental health in Pakistan. Given the country’s diverse population, we have ensured that our messages are tailored to various groups, including women, youth, and those from lower-income backgrounds, each of whom may experience different mental health challenges.

Our research has revealed that 1 in 5 school-going children in Pakistan is struggling with mental health issues, but this data only represents those attending school. Pakistan also has one of the highest rates of out-of-school children, including street children, who are a highly vulnerable and traumatised group. They are subjected to physical abuse, sexual abuse, substance misuse, and child trafficking.

You! Has the baseline survey helped you in understanding the state of mental health in Pakistan?

SA: We partnered with Gallup to conduct the baseline survey. The baseline survey has helped us understand the state of mental health in Pakistan. It also ensures that our campaign accurately reflects the diverse demographics of the Pakistani population, including educational, gender, and socio-economic factors. This survey has been instrumental in identifying the terminology we should use. According to the World Health Organization, one in four people in Pakistan will experience mental health issues at some point in their lives. However, the data remains weak, and there are only around 900 licensed psychiatrists in the country, underscoring the lack of mental health professionals and regulation.

You! How does the campaign address the stigma surrounding mental health?

SA: Media can play a pivotal role in shaping public perceptions of mental health. As this is a media-driven campaign, we aim to utilise Geo’s extensive reach through their television channels, social media, print, and digital platforms. Through this campaign, we aim to promote understanding and reduce stigma by encouraging open conversations about mental health issues, including workplace well-being, school-based mental health, and parenting practices.

You! What is the duration of this campaign?

SA: This is a year-long campaign that was launched in October 2024, with content starting to roll out in November and continuing throughout the year. However, we recognise that addressing mental health challenges in Pakistan requires constant efforts beyond this timeline. The first year is focused on creating awareness, encouraging conversations, and engaging policymakers, parents, and youth to prioritise mental health. Geo is our initial partner; our long-term goal is to involve other media outlets and stakeholders as well to amplify the impact of the campaign.

You! What are the plans for rehabilitation and treatment?

SA: Rehabilitation is a crucial aspect of addressing mental health. Psychiatrists primarily provide medication, while psychologists offer therapy and counselling. For severe mental illnesses, medication may be necessary, but for mild to moderate issues, therapy or community support can be effective. In Pakistan, joint family systems can serve as a natural support network, but the lack of awareness often prevents timely recognition of mental health issues.

To make rehabilitation accessible and effective, we need scalable and sustainable solutions. This includes establishing a national helpline, integrating mental health professionals into public and private hospitals, and training community health workers, teachers, and managers to provide basic mental health support. Early recognition of symptoms such as sleep disturbances, psychosomatic symptoms, or behavioural changes can significantly improve outcomes.

You! Do you agree that caregivers often neglect their own mental health while taking care of others?

SA: Caregivers are often overlooked and are deeply affected by mental health issues within families. Most individuals, especially women in Pakistan are caregivers to their families- elderly, a special needs child, someone with a disability. Our society puts a lot of emotional pressure on such caregivers. A lack of awareness and lack of support for such caregivers can affect the individual they are taking care of as well as themselves. Our holistic approach should provide systemic care to patients as well as their families and caregivers.

By integrating counselling and mental health services into broader healthcare frameworks, we can address the interconnected nature of physical and mental health, ensuring a holistic approach to well-being.

You! What kind of services ‘Milkar’ is providing besides raising awareness?

SA: As our content reaches audiences, those in need of support can access free helplines, free clinics, and paid services. We have been working on creating a services directory, with a vetting process in place, to educate people and make them aware of where they can seek help. As part of the campaign, we will also be educating people on what standards and qualifications to look out for when they are seeking professional help so we endorse the importance of good quality care and push for more regulation when it comes to mental health services.

This year-long campaign will also help us identify areas requiring greater focus, determine where funding should be allocated, and design programmes and projects in collaboration with the government.

You! What role is the government playing in this initiative?

SA: The British Asian Trust has always prioritised working in collaboration with the government to create scalable and sustainable solutions. Collaboration is essential for addressing mental health issues effectively. We have conducted numerous awareness sessions with government representatives. For instance, we have met with key figures such as Dr Azra Pechuho (Health Minister of Sindh), Barrister Murtaza Wahab (Mayor of Karachi) and Dr Kareem Khawaja, (Chairperson of the Sindh Mental Health Authority) who have endorsed the campaign and shown their support.

In the previous administration, members of the Pakistan Mental Health Coalition and I were part of President Dr Arif Alvi’s working group on mental health. While engagement with the current government is ongoing, we are confident that with media involvement and increased public discourse, both federal and provincial governments will take an active interest in supporting mental health initiatives. Mental health is a relatable issue, as many people either experience it themselves or witness it within their communities. This shared understanding can drive meaningful action and hopefully ‘Milkar’ we can all create a healthier Pakistan.

WHAT IS MENTAL HEALTH?

Mental health is a state of mental well-being that enables people to cope with the stresses of life, realise their abilities, learn well and work well, and contribute to their community. It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in. Mental health is a basic human right. And it is crucial to personal, community and socio-economic development.

Mental health is more than the absence of mental disorders. It exists on a complex continuum, which is experienced differently from one person to the next, with varying degrees of difficulty and distress and potentially very different social and clinical outcomes.

Mental health conditions include mental disorders and psychosocial disabilities as well as other mental states associated with significant distress, impairment in functioning, or risk of self-harm. People with mental health conditions are more likely to experience lower levels of mental well-being, but this is not always or necessarily the case. (Reference: WHO)

The writer is a staff member. She can be reached at sheheronline@gmail.com