Pakistan's mental health legislation, rooted in the 2001 Mental Health Ordinance, predates the UN Convention on the Rights of Persons with Disabilities (2006) and lacks full alignment with rights-based frameworks. Following WHO–OHCHR guidance, a gap analysis identified five major domains — institutional, capacity, resources, legal, and cross-cutting challenges — explaining why legislative provisions have not translated into practice. A digital assessment tool based on these findings has been developed and will be shared with provincial governments for review to ensure reforms are contextually informed and practically achievable.

A 3-day mhGAP refresher training was held in Kohat (April 6-8, 2026) for primary care physicians to strengthen mental health service delivery. Supported by Deutsche Gesellschaft fur Internationale Zusammenarbeit and International Medical Corps, the training reinforced clinical skills, improved adherence to mhGAP guidelines, and enhanced coordination among healthcare providers.' Despite challenges like workload and time constraints, the workshop helped strengthen referral pathways and sustain quality MHPSS services in the district.

The Ministry of Planning, Development and Special Initiatives set up a Mental Health, Strategic Planning and Coordination Unit (MHSP&C Unit) on 14th April, 2025, with the support of the German Federal Ministry for Economic Cooperation and Development (BMZ) through Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) and their partner International Medical Corps in Pakistan. Since then, the MHSP&C Unit has provided technical support to health departments of Khyber Pakhtunkhwa, Balochistan and Baltistan to implement MHPSS Services.