“UNDERSTANDING THE LIVED EXPERIENCES, SOCIAL DRIVERS, AND CHALLENGES AFFECTING YOUTH MENTAL HEALTH IN RURAL BALOCHISTAN: A QUALITATIVE STUDY.”

Abstract

Background: Mental health disorders contribute substantially to the global burden of disease, disproportionately affecting adolescents and young adults in low- and middle-income countries. In Pakistan where 64% of the population is under 30 years of age, youth mental health remains critically under-addressed, particularly in rural and underserved regions such as Balochistan. Stigma, limited-service availability, and systemic constraints further exacerbate unmet mental health needs among medical students, a group uniquely vulnerable due to academic pressures and exposure to distressing environments. Objective: This qualitative study aimed to explore the social drivers, challenges, and perceived mental health needs among undergraduate medical students in Loralai, Balochistan, to inform contextually relevant mental health support strategies for youth in rural Pakistan. Methods: A focus group discussion (FGD) with eight medical students from Loralai Medical College was conducted online using semi-structured guidelines and following COREQ standards. Discussions were held in Urdu and English, recorded, transcribed verbatim, and analyzed independently by two researchers using iterative thematic analysis supported by NVivo 12 Plus. Purposeful sampling was used, and ethical clearance was obtained prior to data collection. Results: Four overarching themes emerged: (1) Severe scarcity of mental health services, highlighting structural barriers and lack of accessible professional support; (2) High psychological stress among medical students, driven by academic burden, isolation, and exposure to traumatic community events; (3) Pervasive stigma surrounding mental illness and help-seeking, reinforced by cultural expectations and fear of judgment; and (4) Urgent need for mental health education and awareness, including training in stress management, communication, and coping strategies within medical curricula. Participants emphasized that the mental health of future physicians directly affects patient safety and clinical performance, and that post COVID-19 consequences further intensified communication gaps and psychological distress. Conclusion: Medical students in rural Balochistan face significant, multifactorial mental health challenges compounded by stigma, inadequate resources, and limited institutional support. Strengthening mental health awareness, integrating student-focused mental health education into medical training, and improving access to culturally sensitive services are essential steps toward improving youth well-being and future healthcare delivery. This study highlights the need for systemic interventions and highlights the value of student-led initiatives like SHAW Pakistan in driving mental health advocacy and support in low-resource setting