A mental health policy must reach the exam hall

By Ahsan Ilyas Butt

On 1 October, Pakistan launched a new National Mental Health Policy (2026–2035). Nine days later, World Mental Health Day took as its theme “Lived Experiences Heard: Real Voices, Real Change”. Few groups in this country have more lived experience to share, or are asked less often, than the teenagers who sit our board exams.

The scale of the challenge was laid out at the Islamabad summit where the policy was unveiled. The World Health Organization estimates that 32.4 million Pakistanis need mental healthcare, yet only about five per cent can reach it. The country has roughly 0.19 psychiatrists per 100,000 people; high-income countries average around seven. A gap that wide cannot be closed by specialists alone, which is why the policy rightly looks to primary healthcare, communities and schools.

Schools are where this policy will be won or lost, and nothing in a school year is as loaded as exam season. For months, a teenager’s worth is quietly converted into a number. A single sitting can seem to decide which college, which stream, which future. Coaching centres sell first-attempt success. Relatives ask “Kitne numbers aaye?” (“How many marks did you get?”) before they ask how the child is. Then results arrive, publicly and instantly, often on a phone, sometimes before any adult has had a chance to be in the room.

The cost is not abstract. Dawn reported in August 2025 that a 15-year-old girl in Upper Dir, who had scored 1,010 out of 1,200 in her matric exams, died by suicide, reportedly because she found the result unsatisfactory. No single result explains a death. But a society in which 84 per cent can feel like a verdict has a problem the exam board cannot see and the school is not equipped to hear.

What can be done before the next exam season? Three steps need no new law.

First, put help where the pressure is. Every roll-number slip and result notification should carry the number of a staffed, toll-free student helpline, and every district should keep a trained counsellor on call through exams and results. The health ministry has already named school psychologists among its workforce priorities; Classes 9 to 12 should be first in line.

Second, change how results arrive. Announce them at hours when schools, counsellors and families can respond, attach a short message of support to every result, and stop treating a list of toppers as the only story a board has to tell.

Third, train the adults. One teacher in every school should learn psychological first aid, and every parent meeting should begin with a simple lesson: ask how your child is before you ask what they scored. Much of what a frightened teenager needs is free: a night’s sleep, a calm dinner table, an adult who listens before judging.

None of this is utopian. The Pakistan Medical and Dental Council has ordered annual mental health screening for about 22,500 medical and dental students, along with faculty and staff, and told colleges to set up primary mental health care centres. If it can be done for aspiring doctors, it can be done for the far larger number who sit board exams every year.

The harder question is who pays, and who answers for it. The federal government has asked the provinces to endorse the policy within 45 days, which is roughly mid-November, and has promised a costed implementation plan within a year. Education is largely a provincial subject, so provincial education departments, not just health departments, must sign on, with budgets, targets and public reporting attached. Otherwise this becomes one more policy that lives on paper.

World Mental Health Day asked governments to listen to lived experience. In Pakistan, those experts are already in the exam hall, pens in hand, and they are rarely asked what would help. Ask them. A mental health policy that cannot be heard there has not really been heard at all.

BBA student at Sukkur IBA University