“Silent Struggles: Pakistani Communities and Mental Health in the UK”
In a small café in Birmingham, a group of young men laugh loudly as they sip tea and scroll through their phones. Beneath the surface, however, at least one of them is carrying a weight he has never spoken about — sleepless nights, constant anxiety, and a creeping sense of isolation. In the community he grew up in, “mental health” is rarely discussed. To admit to depression, or to see a therapist, is still considered shameful.
For many Pakistani migrants and their families in the UK, mental health remains a silent struggle. Despite the resources available through the National Health Service, stigma and cultural barriers mean that countless people continue to suffer in silence.
The hidden burden
Rates of depression and anxiety are often higher in migrant and minority groups, driven by multiple pressures: financial stress, language barriers, racism, and the challenges of living between two cultures. Women, in particular, often carry the heaviest load. Many are juggling childcare, household responsibilities, and in some cases, caring for relatives back in Pakistan. Some are isolated by limited English skills, unable to access the support networks that might help them cope.
Young people face a different pressure. They live in a world where conversations about mental health are increasingly open, yet at home the subject may remain taboo. A student in East London describes it bluntly: “I can talk about anxiety with my university friends, but I would never bring it up at home. My parents wouldn’t understand — they’d tell me to just pray and move on.”
Stigma and silence
The stigma surrounding mental health in Pakistani communities is powerful. Mental illness is often seen as weakness, a lack of faith, or a family disgrace. Families may worry about reputational damage, especially when it comes to marriage prospects. As a result, many hide symptoms, turning instead to prayer, traditional remedies, or the advice of community elders.
Religion itself is not the problem. Faith and spirituality can be an enormous source of comfort. The difficulty comes when faith is used to silence medical needs rather than complement them. An individual experiencing panic attacks or postnatal depression may be told to “pray harder” rather than being encouraged to seek counselling or medication.
Barriers in the system
Even for those who want help, the path is not easy. Access to NHS mental health services is notoriously stretched, with waiting times for counselling often running into months. Language barriers compound the problem: therapy delivered only in English may not resonate with someone who is most comfortable speaking Urdu or Punjabi. The lack of culturally aware counsellors also means that some patients feel misunderstood or judged.
For new arrivals, the problem is even sharper. Migrants on temporary visas may not even realise they have the right to access mental health services. Those who come from professional or middle-class backgrounds may feel embarrassed at the idea of opening up to a stranger about problems they were taught to keep private.
Stories from the ground
In Luton, a mother of three recalls the isolation she felt after giving birth: “I cried every day, but I didn’t tell anyone. My mother-in-law said it was just weakness, that every woman goes through it. I only realised later it was postnatal depression.”
In Manchester, a young man in his twenties describes being torn between cultures: “At uni, everyone talks about therapy. My friends say I should go, but at home my dad would think I’d gone mad. He’d worry what people back home would say about us.”
These voices are not unique. They reflect a pattern repeated in Pakistani communities across the country.
Breaking the silence
Encouragingly, things are beginning to change. Community-led projects are opening safe spaces where people can talk openly about stress, depression, and trauma. Mosques are starting to host workshops on wellbeing, with imams speaking about the importance of seeking medical help alongside prayer. Younger Pakistanis, exposed to wider cultural conversations, are more willing to challenge the stigma and advocate for therapy.
Charities and grassroots organisations are also stepping in. Peer-support groups in cities like London and Birmingham allow women to meet in informal settings, share their struggles, and learn about available services. Bilingual helplines and community mental health workers are helping to bridge the gap between professional care and cultural understanding.
What needs to change
To truly address the issue, both the health system and the community itself need to shift. The NHS must ensure that counselling is accessible in languages people understand and that staff are trained in cultural sensitivity. Shorter waiting times, more outreach in Pakistani-majority neighbourhoods, and stronger partnerships with community organisations would make a real difference.
At the same time, community leaders — from imams to councillors — need to speak openly about mental health, helping to dismantle stigma. Families must learn to treat depression, anxiety, and other conditions with the same seriousness as physical illness. And younger generations, already pushing the boundaries of silence, can play a key role in reshaping attitudes.
Looking ahead
Mental health is not just a personal issue; it is a community issue. When silence dominates, the costs ripple outwards: broken families, lost potential, and worsening health. By bringing the conversation out of the shadows, Pakistani communities in the UK can begin to heal.
As one community organiser in Birmingham put it: “We don’t need to choose between faith and treatment. We can have both. The important thing is that no one suffers alone.”
