“When will our new car arrive, Baba?” said a 17-year-old, just one week before attempting suicide. This heartbreaking question reflects more than one family’s suffering; it points to a broader crisis affecting millions of people worldwide. According to the World Health Organisation (WHO, 2022) and global health estimates, the prevalence of mental health conditions is approximately 15% in the United States, 14% in Canada, and around 14% in India and Pakistan.
Pakistan is currently facing one of the worst cost-of-living crises in its history. While policymakers often discuss inflation and taxation solely in economic terms, far fewer recognise that these policies are also shaping the nation’s mental health. Mental health is often viewed through a purely medical lens, yet a growing body of evidence suggests that economic policy, particularly taxation and income inequality, plays a significant role in determining psychological wellbeing.
Caught in a cycle of status anxiety, middle-income households endure the relentless pressure of climbing the socioeconomic ladder through persistent effort
Mental health statistics and research consistently show that psychopathology is increasing worldwide due to multiple factors. But the prevalence of mental health conditions in certain countries is showing a similar pattern compared to others. According to Richard Wilkinson, the British social epidemiologist and co-author of The Spirit Level, countries with greater economic inequality are consistently experiencing poorer health outcomes. This pattern is also evident from the WHO World Mental Health Report (2022). Income inequality intensifies social comparison, insecurity, mistrust, and chronic stress across society. Consequently, high levels of economic disparity create fertile ground for both physical and mental health problems to flourish.
The impact of economic disparity is not limited to a single socioeconomic class. However, the middle class is uniquely vulnerable. Caught in a cycle of status anxiety, middle-income households endure the relentless pressure of climbing the socioeconomic ladder through persistent effort. When this pressure is combined with a modern workplace culture inherited from the Global North, the result is an increasingly unsustainable way of living. Living in chronic stress creates a domino effect, contributing to the development of physical illnesses such as cardiovascular diseases, diabetes, and chronic pain, alongside mental health challenges like mood disorders, anxiety disorders, and personality disorders.
Iinvisible Wounds Of A Polycrisis: Why Children Need Mental Health Support Now
Considering the history of Pakistan, where we were dealt a difficult hand, we are currently on the verge of going very sick as a nation. Pakistan has already endured decades of political instability, economic uncertainty, and repeated financial crises
If economic disparity is not addressed by the effective implementation of tax laws, then in the years to come, the Pakistani population is likely to face multiple physical and mental health issues. It is high time for the government to reconsider its implementation policies and systems
And even if Pakistan truly wishes to achieve sustainable economic growth, strict and fair tax implementation is no longer optional; it is a necessity. A sick, burnt-out workforce cannot sustain institutions in the long run. Moreover, when wealth is not fairly redistributed or taxed, the state’s capacity to invest in healthcare, education, and social protection also goes down, and national institutions remain trapped in a destabilising loop of “becoming and unbecoming”.
Hence, Pakistan still has the opportunity to choose prevention over cure. If Pakistan wants to thrive as a sovereign nation, it must recognise that tax policy is both healthcare policy and revenue policy
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