Therapy on the assembly line

The Covid-19 pandemic brought about significant changes in workplace dynamics and made mental health issues a real concern. The need for workplace therapy has increasingly arisen in Pakistan, where factory workers are often besieged by precarious working conditions. The practice of workplace therapy will be institutionalised in post-pandemic Pakistan factories, and the questions raised are those of cultural sensitivity particularly because of the country’s socio-cultural norms, religious influences, and economic disparities.

Although workplace therapy has the potential to become a transformative intervention, its success hinges on the congruence with local cultural and economic context. In Pakistan, mental illnesses are often not understood, and stigma against mental illnesses is strong. Stigma is mentioned in research as being the reason why 75 per cent of Pakistanis like to refrain from seeking help only when they are diagnosed with a mental health problem. The idea of workplace therapy institutionalised such discussions so that they can become more normalised in workplaces with vulnerable factory workers. Nevertheless, tolerance to therapy is not simple – many workers may think therapy is incompatible with religious or traditional coping strategies. For instance, workers might choose prayer or family support as a first resort to the exclusion of professional intervention, requiring integration of therapy services with existing support systems that are culturally sensitive.

Workplace therapy has tangible benefits like improving mental well-being as well as productivity. Research indicates mental health interventions can cut absenteeism and improve job performance by up to 25 per cent. Therapy can help factory workers who are overcoming post-pandemic stressors. However, there are limits to how such programmes can be designed when taking into account literacy levels, language barriers, and socio-economic constraints. Closer gaps will be bridged through group therapy sessions focusing on local dialects and headed by culturally competent therapists.

Another potential solution to dealing with mental health is AI-driven mental health apps that offer confidential support in Urdu or regional languages. Adaptability to the hierarchical and patriarchal culture of many Pakistani factories is also critical to the success of workplace therapy. Psychologist Emily Armstrong told HuffPost that male-dominated work environments may not be open to having those conversations around mental health, even more so for women. In fact, Zafar and Malik (2021) found that only 12 per cent of female factory workers feel comfortable sharing some personal challenges in workplace settings. By integrating therapy programmes within a holistic health and wellness approach, we can combat resistance by framing mental health support as an employment productivity tool rather than a personalised intervention.

Finally, it must also be economically feasible. Pakistan's factory owners make their living on razor-thin margins. Production comes first, and worker well-being is a low priority. Workplace therapy might be considered a nonessential expense, but it's something that companies seem willing to offer. Nevertheless, there is evidence that for every dollar spent on mental health, the return on productivity gains is four times. To increase adoption, the government could provide subsidies or tax incentives for mental health programmes to give factory owners the incentive to see workplace therapy as a long-term investment, not a short-term cost.

The selection and training of therapists extend to that of cultural sensitivity. Therapists must be acutely aware of the socio-economic realities factory workers live under. This, Hussain et al (2020) suggest, can increase the likelihood of trust and credibility that might otherwise be difficult to achieve between therapist and client due to the power dynamics in place in such a relationship. In addition, accepting the workers depending on their religious beliefs while integrating Islamic counselling practices can strengthen acceptance by the users.

However, workplace therapy is challenged by implementation difficulties, especially in informal factories that employ almost half of Pakistan’s labour force. In many of these workplaces, mental health programme institutionalisation is further complicated by the absence of structured human resource departments. This gap can be filled by delivering mental health services directly to workers using community-based initiatives such as mobile therapy units or partnerships with local NGOs. Now, similar initiatives have prevailed in other developing countries and these scalable models can be adapted in the case of Pakistan, particularly.

Additionally, the post-pandemic context has elevated workers' stress levels in that most work from home while wrestling with job insecurity and financial hardships. The results of studies have shown that during the pandemic, 68 per cent of Pakistani factory workers reported having experienced increased anxiety. Workplace therapy helps teach resilience and is a creative way to help cope. However, workers must believe confidentiality is very important because they might lose their jobs by admitting they have mental health problems. Trust building in therapy programmes requires clear policies and (anonymised) reporting mechanisms.

Workplace therapy also relies on strong leadership commitment for its integration. To break this stigma, factory managers must be champions of all mental health initiatives and must lead by example in open communication. Leadership training in emotional intelligence, and awareness around mental health, can enhance our supportive workplace culture. Labour unions colluded with can improve the implementation and acceptance of therapy programs in factories with union representation. However, institutionalising workplace therapy is promising but not a silver bullet. To improve workers’ mental health, it’s important to address systemic problems such as working in bad conditions, low wages, and long working hours. Any workplace therapy we do should work alongside broader reforms to improve overall worker well-being. An approach that maximises the effect of interventions provides a holistic one bringing mental health support along with implementation of physical safety measures and fair labour practices. Workplace therapy can improve worker well-being and productivity if it addresses mental health stigma, designs culturally and economically appropriate programs, and is supported by strong leadership. But success hinges on the inequality of understanding the social and cultural nuances of Pakistan and active collaboration among factory owners, workers, therapists, and policymakers. A properly planned and culturally sensitive implementation of workplace therapy has the potential to transform Pakistan into a powerful tool to build resilient, thriving factory communities.

The writer is a graduate of Warwick Business School.