Curing the cause

Curing the cause

“Psychological knowledge should put itself at the service of society. Where the wellness of the few does not depend on the suffering of the rest. Where the achievements of some do not require the neglect of others” — Ignacio Martin-Baro MENTAL health is often presented as an individual problem. We tend to think of depression, anxiety or trauma as conditions within a person’s mind, to be treated through medications or therapy (or both). While these interventions are important, they are only part of the story. In countries grappling with poverty, inequality, violence and political instability, psychological distress is not only an individual issue but a social and political one as well. In Pakistan, discussions around mental health are mostly focused on ‘raising awareness, reducing stigma, closing the treatment gap by training more psychiatrists, psychologists and counsellors’. While essential they do not fully answer a fundamental question: what happens when the social conditions themselves generate psychological suffering? ‘Liberation psychology’ offers a compelling perspective. Developed by the Jesuit priest and social psychologist Ignacio Martín-Baró in El Salvador during the civil war of the 1970s and 1980s, liberation psychology was framed on a radical premise that psychology cannot be separated from the realities of oppression, injustice and inequality. On the other hand, conventional psychology focused on the individual, helping him/ her to adapt to unjust social conditions instead of questioning or transforming them. Liberation psychology does not reject therapy or clinical care. Rather, it asks us to widen our lens. If communities experience chronic poverty, displacement, discrimination, conflict or violence, then improving mental health also requires addressing these structural realities. Liberation psychology encourages us not simply to ask ‘what is wrong with this individual?’, but rather ‘what has happened to this person and what conditions continue to produce this suffering?’ Several Latin American countries have demonstrated how this broader perspective can shape mental health responses. In Colombia, decades of armed conflict left millions displaced and traumatised. Community-based psychosocial programmes were developed that combined mental health support with truth-telling, collective memory and rebuilding social trust. Mental health was connected with reconciliation and community healing rather than simply treating individual symptoms. In Chile, following the Pinochet dictatorship, psychologists worked with human rights organisations for survivors of torture and political violence, recognising that trauma was inseparable from justice, acknowledgement and accountability. Recovery involved not only counselling but also restoring dignity and recognising historical harms. In the 1980s, Brazil’s psychiatric reform movement challenged institutional models of men­­tal healthcare, shifting away from isolated psychiatric hospitals towards community mental health centres. It recognised that social inclusion, employment, family support and community participation are integral to psychological well-being. Liberation psychology is relevant for Pakistan, where millions live under economic insecurity, climate disasters and violence. These examples demonstrate that mental health interventions are most effective when they engage with the social realities. Mental health should not remain confined to hospitals and clinics in major cities; it should become part of schools, primary healthcare, disaster preparedness, workplaces and local governance. This perspective is particularly relevant for children and young people. Research consistently shows that adverse childhood experiences — including violence, neglect, poverty and displacement — have lifelong consequences for mental and physical health. Preventing childhood trauma therefore requires more than expanding counselling services. It requires safer schools, stronger child protection systems, social protection and policies that reduce violence in homes and communities. Liberation psychology is highly relevant for Pakistan, where millions live under economic in­­security, unemployment, climate disasters, gend­er-based violence, displacement, sectarian tensi­ons and political uncertainty. Millions are struggling to meet basic needs. Young people face an uncertain future, with limited employment oppo­r­tunities. These are not merely economic statistics; they are psychological stressors. A farmer who loses his crops due to recurring floods, a young graduate unable to find work despite years of education, or a woman experiencing domestic violence — their condition cannot be understood solely through the lens of mental illness but rooted in lived experiences shaped by social structures. Similarly, suicide prevention in Pakistan cannot rely solely on crisis interventions or psychiatric services. Social exclusion, poverty, unemployment and barriers to accessing support all contribute to suicide risk. Addressing these underlying determinants is as important as improving clinical care. Liberation psychology also reminds professionals to reflect on whose voices mental health policy is shaped. Too often, interventions are designed by experts in urban centres with limited engagement from the communities they seek to serve. Participatory approaches that involve people with lived experience, community leaders and marginalised populations produce solutions that are more culturally grounded and sustainable. None of this diminishes the importance of psychiatrists, psychologists or evidence-based treatments. Pakistan urgently needs more mental health professionals and better access to quality care. But if we focus exclusively on expanding clinical services while ignoring the conditions that produce widespread distress, we risk treating symptoms while leaving the causes untouched. Perhaps the greatest lesson liberation psychology offers is that psychological well-being is inseparable from human dignity. People flourish not simply because they receive therapy, but because they feel safe, valued, connected and hopeful about their future. Healing is not only about changing individuals; it is also about changing the conditions in which they live. Martin-Baro’s work ultimately cost him his life. In 1989, he along with five fellow Jesuit priests were assassinated by the Salvadoran military because of their advocacy for social justice. Yet his ideas continue to influence mental health professionals and community practitioners across Latin America and around the world. The writer is professor emeritus, psychiatry, Aga Khan University. mmkarticle@gmail.com Published in Dawn, August 21st, 2026