Depression in women and Mental Health Services in Karachi, Pakistan - Do we need to address the gap?

Karachi is the largest city of Pakistan with population of 18,000,000. Out of it 59.19% are 18 years and older. Synthetic estimation was done with the help of researches which indicate that 2,533,110 women are suffering from depression in the city of Karachi. A majority of these women have a low level of education, a high number of children, lack support from their families and lack access to treatment options due to few mental health workers (only 44 psychiatrists, who must cater to the needs of not only men and children of Karachi but also patients of other cities of province sindh and Balochistan as well). For adult depressed population there is only one psychiatrist available for 82,312 depressed patients. At present there are about 184 psychiatric beds in Karachi. Pakistan's Health budget is 1% of GDP and Mental Health Budget is 0.4% of GDP, but this allocation is insufficient and people have to depend on almost complete out of pocket expenditure for all kinds of mental health treatments. High cost of treatments, poverty, economic dependence, and mobility dependence of women and stigma keeps the utilization of available mental health services low and further adds to the loss of productivity and misery for themselves their families, and society over all. WHO has recommended integration of mental health into primary health care as the most viable, affordable method to reduce treatment gaps yet General Practitioners lack information on mental health diagnosis and hence fail to treat or refer the patients.