EVERY World Mental Health Day arrives with a theme, a hashtag, and a flurry of panels. This year’s call to centre the voices of people with lived experience deserves more than a single day. It requires an honest accounting of whose voices have shaped our mental health agenda, and whose have been absent from it.

In clinical practice, one learns that people rarely describe their distress in the language of diagnosis. Recent events shape, and at times fortify, age-old dogmas. A young woman laments that recent allegations of sexual assault on a university campus have reinforced the view for her parents that places of learning are not safe for girls and that she must rethink her dreams. A teenage boy says he has not cried since he was nine, because he learned early what crying would cost him. A man in his 40s says he cannot tell his family he has stopped sleeping, because the word ‘depression’ would be heard as weakness, or worse, as madness. None of them is describing a disorder alone. Each is describing a world, and a mind adapting to it.

Mental health does not reside only within individuals. It is shaped by homes, classrooms, workplaces, streets, and the narratives a society sustains about who may be safe, who may be vulnerable, and who may speak. Pakistan ranks near the bottom of global gender parity indices; millions of girls remain out of school. When women fear pursuing an education, or when their aspirations are quietly renegotiated, the consequences extend well beyond the economic. They appear as hopelessness, chronic anxiety, and a constriction of possibility. Boys raised to equate emotion with weakness and dominance with worth bear a different burden: silence, aggression turned inward or outward, and........

© Dawn