The contemporary economic breakdown of Pakistan and its consequences on the mental health of inflation-stricken nation

Over the past seven decades, Pakistan has grappled with recurring episodes of political instability that have invariably led to severe economic and financial crises in the country. Recent months, however, have brought unprecedented challenges to our nation's economic stability. A dramatic surge in fuel prices, soaring electricity bills, abrupt hikes in sales taxes, and the relentless impact of the COVID-19 pandemic have coalesced to create a perfect storm. With a population of approximately 231 million, Pakistan is teetering on the brink of what could be a historically catastrophic economic breakdown. The nation's mental health is now at stake, given the sharp spikes in inflation and the resulting financial hardships faced by its citizens.

Many studies have shown positive association between financial constraints and onset of mental health problems.¹ Similarly, multiple suicide cases of young people have been reported in the past few months due to poverty, joblessness, and inflation in different cities of Pakistan.² These dire circumstances are particularly concerning given that mental healthcare services remain limited, and mental health concerns are often stigmatized, preventing individuals from seeking help.

The economic crisis extends its damaging effects to vulnerable populations, including children growing up in impoverished households. Such circumstances can give rise to a host of emotional, social, and intellectual problems that may hinder their transition into productive adulthood. Adding to the complexity, nearly 40% of Pakistan's population lacks health insurance, which creates another significant barrier to accessing mental health services.³

Although, in Pakistan, mental health services are included in the Sehat Sahulat Program, which is a health insurance scheme for underprivileged citizens. However, it's important to note that mental illness is often not fully covered by insurance under this program, and government spending is considered the major source of financing for affordable healthcare. The budget allocation for mental health services is crucial, and there is a need for a particular focus on low-resource districts to avoid patients and their families having to travel to tertiary care hospitals in better-resourced districts of Pakistan.⁴ With the recent skyrocketing inflation and the contemporary wave of political turmoil in the country, the GDP rates are dropping drastically day to day, with a figure of 5% in the last few years and the foreign reserves of the country are also replenishing expeditiously. According to an economic survey report 2023, the value of the rupee has been depreciating persistently at a rate of 24% since the year-to-date against the rate of the dollar, which is appraising up to 17%, the fact which is convincing International Monetary Funds to continue the legacy of their grants and loans to the country making the situation further complicated.^{5, 6} Pakistan is facing the worst economic crisis in history up until now with the inflation rate being 24.76%, which is affecting the whole nation terribly.⁶ According to different economic surveys, the rate of joblessness has been reported at up to 31%, which creates a sense of uncertainty and hopelessness among the well-educated and qualified younger bloodline of the nation and is correlated to the augmenting suicidal rates. Each year 130,000–270,000 people commit suicide in Pakistan, and the leading cause of these suicidal deaths is the lack of health facilities provided to the traumatized people of the nation. These cases are more prevalent in the younger generation, which forms a major part, that is, 65% of the country's population.⁷ The percentage of different mental health-related disorders, including depression and anxiety, is reported at around 10%–16%, and the main culprit behind this entire fiasco is narrated as the frequent change of political regime in the country, the last wave of devastating floods, and the deleterious effects of COVID-19.⁶

Additionally, it is significant that medical coverage and psychiatric services are within an arm's reach to help ameliorate the economic downturn effects on psychological well-being.

Tasmiyah Siddiqui: Conceptualization; methodology; validation; writing—review and editing. Ayesha Saadat: Conceptualization; methodology; visualization; writing—original draft; writing—review and editing. Rooja Zubair: Conceptualization; methodology; writing—original draft; writing—review and editing; validation. Shafaq Taseen: Writing—review and editing; writing—original draft; validation; conceptualization.

The authors declare no conflict of interest.

We, the authors of this study, affirm that this manuscript is an honest, accurate, and transparent account of the study being reported, that no important aspects of the study have been omitted, and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.