“I’m alright. I’m okay.”
We say it with such ease. Sometimes we mean it, sometimes it is simply the answer we have learned to give while carrying worry, fatigue, or loneliness we cannot quite put into words.
Behind a casual “I’m fine” may be someone trying hard to hold everything together, someone who needs to be heard but fears being judged.
When our body hurts, we seek treatment. But when our mind struggles, too many of us remain silent.
In Bangladesh, this resounding silence meets a deficiency of care. The 2018-19 National Mental Health Survey found that 18.7% of adults and 12.6% of children aged 7-17 experienced mental health conditions.
Reported treatment gaps exceeded 92% for adults and 94% for children. Behind these figures are people and families navigating distress with little professional help.
Resources remain painfully limited. A WHO-supported report published in 2025 noted that mental health received just 0.44% of Bangladesh’s total health budget in 2021, with two-thirds of that spending directed towards mental health hospitals. Care closer to home needs far greater investment.
We need services that people can reach, afford, and trust. Our experience points to three priorities.
- A multidisciplinary approach: Treatment should be customised for each individual’s conditions. For people with complex conditions, a multidisciplinary team of psychiatrists, psychologists, nurses, occupational therapists, and social workers should work together in a holistic manner with each medical professional providing their own unique insights for treatment and recovery.
- Comprehensive documentation: Continuity of care should be the standard. No one should have to begin their treatment from the very start at every instance. Confidential and secure records of treatment, medication, and progress can help families and medical experts make informed decisions.
- Family involvement: With the person’s consent, trusted family members can be important partners in care. They need practical guidance on how to listen, recognize warning signs, manage any crisis, and support everyday recovery.
Bangladesh’s mental health policies must translate into accessible services:
- stronger primary care;
- trained professionals;
- affordable treatment;
- Effective implementation of the Mental Health Act.
This cannot be a singular effort. The government, private sector, and civil society all have to act in concert.
And each of us can begin with a small act of kindness: Ask how someone is doing, then make time for the answer.
We owe people a world where “I’m struggling” can be spoken without shame and met with compassion, dignity, and care.
Zahida Fizza Kabir is a social entrepreneur and CEO at SAJIDA Foundation.
