A secret plague rages within the overcrowded confines of Pakistani jails. Approximately 80% of female inmates experience mental health disorders, often obscured by overcrowded facilities and systemic negligence. Despite the prevalence of security concerns and crime statistics in the media, the psychological welfare of these women remains an often overlooked aspect of the nation’s criminal justice system.
The figures depict a dire situation. Research reveals alarmingly elevated prevalence of mental health disorders, including severe depression, post-traumatic stress disorder, self-injurious behaviour, and psychosis among incarcerated women. A 2013 study conducted at Kot Lakhpat Jail in Lahore revealed that female convicts had a higher prevalence of mental disorders and depression than their male counterparts. Moreover, research carried out in Karachi identified prevalent symptoms, including insomnia (19%), irritability (17%), and stress (16%). The United Nations Office on Drugs and Crime reported that 36% of Pakistani female inmates engaged in self-harm during incarceration.
Poverty, lack of access to education, and social exclusion are all socioeconomic factors that keep people in jail, meaning that victims of domestic violence are disproportionately imprisoned. The harsh conditions of prison make people even more vulnerable than they were before. Lack of access to basic needs, unsanitary conditions, overcrowding, and most certainly sexual violence all create an environment conducive to mental decline. Biological problems accrue. Women prisoners in Pakistan report high levels of prior sexual violence (around 30%), and a significant minority experience new incidents of sexual violence during detention. Despite these risks, there are only 24 female medical or psychosocial staff serving all incarcerated women nationwide, severely limiting reporting and support.
Thirty-five-year-old Aisha (pseudonym), a mother of two, is currently incarcerated at Kot Lakhpat Jail for an offence she maintains she did not commit. She was isolated from her children and placed in an environment of hopelessness and violence after being arrested on allegations of theft. Aisha, who was already struggling with depression as a result of years of conjugal violence, experienced a rapid deterioration in her mental health while confined. In a private letter to her sister, she disclosed, “I am unable to sleep at night.” “The memories endure, and I am concerned for my children.” There are no individuals present to engage in dialogue, and no one is expressing concern. Aisha’s narrative, despite its anonymity, encompasses the experiences of other women incarcerated within Pakistan’s criminal justice system.
Mandatory mental health screenings upon entry into the prison system are crucial to identify and treat those in need
The provision of mental health care in correctional facilities is inadequate. Not all regions offer fundamental medical or psychological health services. Extended judicial delays adversely affect mental health and detain defendants before trial. Inmates are more susceptible to mistreatment in overcrowded correctional facilities. Kot Lakhpat Jail houses 188 women under trial. This suggests that the judicial system requires reform and that sentences need revision.
The mental health crisis in women’s prisons extends beyond the inmates themselves. Children whose mothers are incarcerated often experience profound emotional and psychological distress. Separated from their primary caregivers, they may face stigma, poverty, and a lack of social and emotional support, hindering their development and prospects. Some stay with their mothers, and some do not, as their mothers do not want them to be exposed to the malicious environment. Thus, the prison walls have a lasting impact on these children.
Addressing this crisis requires a multi-pronged approach. Essential policy changes include establishing separate facilities for non-violent offenders, expediting legal proceedings, and increasing investment in mental health services within prisons. Mandatory mental health screenings upon entry into the prison system are crucial to identify and treat those in need, i.e., standardised mental health assessments (e.g., SRQ-24, Hamilton Scale) at intake and periodic follow-up. Educating prison staff on gender-sensitive approaches, trauma-informed care, and suicide prevention will ameliorate the situation. Furthermore, rehabilitation programmes that provide vocational training, education, and post-release support can help reduce recidivism and promote successful reintegration into society.
Some provinces have initiated steps—Punjab, for example, has begun deploying psychologists to women’s prisons—but coverage is inconsistent and insufficient. Notably, specific data on facilities like Multan Women's Jail is lacking. Further studies are urgently needed to assess the unique challenges inmates face in these facilities and develop targeted interventions.
The mental health crisis in Pakistan’s women’s prisons is a moral imperative that demands immediate attention. Without intervention, these institutions risk becoming graveyards for women’s mental health, perpetuating a cycle of trauma, despair, and societal neglect. It is time for policymakers, healthcare professionals, and the public to acknowledge this forgotten crisis and work collaboratively to create a more humane and just system that prioritises the mental well-being of all its citizens, including those behind bars.