‘We fear the rain’: unveiling silent toll on mental health and integration of mobile health services for psychosocial support to flood-affected rural communities of Pakistan

Climate-induced floods disproportionately affect vulnerable rural communities within Pakistan due their immediate and long-term impacts on mental health. Over time, the community narrative around rain, mostly considered as God’s blessing, has shifted to fear and uncertainty, exacerbating flood-related trauma and anxiety. With excessive damage to infrastructure, disrupted health facilities, socioeconomic inequities and limited access to relief and emergency services, these remote communities are often neglected and remain deprived of basic psychological aid. This paper presents the integration of community-based mobile health services to deliver mental health and psychosocial support in six high-risk districts of Sindh and Balochistan, and provides policy and practice recommendations. Lived experiences of flood affectees have been highlighted to amplify community voices in transforming mental healthcare systems for underserved populations.