Vol. 2 No. 1 (2026)

Conceptual Insigths and Critical Reflections

Learning Inside the System: What Community-Based MHPSS Practice in Pakistan Teaches Us About Global Mental Health {peer reviewed}

Published 28-04-2026 — Updated on 25-06-2026

  • Sumbal Gilani

Sumbal Gilani
University of Glasgow

Abstract

In this paper, the author argues that the pedagogical innovations called for in global mental health (GMH) education are not waiting to be designed, in many cases, they have already been built, refined through iterative practice, and rendered largely invisible in the international literature as a consequence of the structural epistemic inequities through which GMH knowledge is produced and circulated. Responding to the call by Karadzhov (2025) for contextualised, collaborative and future-oriented approaches to GMH competency development, this paper draws on the author’s extended practitioner experience in Pakistan to propose a model termed system-embedded pedagogy, an approach in which professional formation happens inside live service delivery systems rather than in preparation for them. This paper is a reflective practitioner case study, drawing on programme documentation, supervisory records, and institutional reports from four MHPSS initiatives in Khyber Pakhtunkhwa, Pakistan (2016-2026). Four cases are examined through an explicit pedagogical lens: the I Support My Friends peer support programme for adolescents; sports-based mental health programming; the establishment of community child protection systems and district child protection units (DCPUs); and the Child Protection Van (CP Van) outreach model. Each case is mapped onto a recognised pedagogical mode, service and experiential learning, reflective supervision, peer-led and collaborative learning, and embodied contextual learning, to illustrate what these approaches look like when they are operationalised within a functioning, resource-constrained, community-anchored system. The paper advances three interconnected arguments: that GMH academic curricula must reposition field experience from a supplementary requirement to the organising spine around which theoretical instruction is structured; that reflective supervision must be explicitly taught as a core pre-service competency rather than assumed to develop with postgraduate experience; and that the practice knowledge generated in LMIC systems constitutes a substantive contribution to the global GMH pedagogical evidence base, not a contextual footnote to it.

Keywords

global mental health, pedagogy, experiential learning, MHPSS, Pakistan, competency development, community psychology, decolonial training, peer support, child protection

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Author Biography

Sumbal Gilani

Sumbal Gilani is a Clinical Psychologist and Mental Health and Psychosocial Support (MHPSS) Specialist with over thirteen years of experience working across humanitarian, public health, and clinical settings in Pakistan. She currently serves as Child Protection Officer (MHPSS & Prevention) at UNICEF Pakistan, Khyber Pakhtunkhwa, where her work focuses on psychosocial programming in conflict-affected and climate-displaced communities. She is an Honorary Affiliate at the University of Glasgow's School of Health and Wellbeing, a BPS Chartered Psychologist (CPsychol), and a Duke-NUS Global Mental Health Fellow (2026). Her career spans UNICEF, WHO Pakistan, the Khyber Pakhtunkhwa Health Department, academic teaching at NUST Islamabad and the University of Peshawar, and private clinical practice. Her research is shaped by a practitioner-researcher identity forged in some of Pakistan's most underserved and crisis-affected contexts.

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