Dr. Noor Mohammad: "How are you?" is perhaps one of the most frequently asked questions in our everyday lives. We ask it almost automatically-to a colleague, a friend, a child, a parent. But how often do we stop to listen when the answer is, "I am not okay"?

For millions of people, that simple sentence may carry anxiety, depression, loneliness, trauma, exhaustion or a struggle that is invisible to everyone around them. Yet mental health remains one of the areas where society is often quicker to judge than to listen.

This year`s World Mental Health Day, observed on 10 October, carries a particularly powerful message: "Lived experiences heard: real voices, real change." The World Health Organization (WHO) is calling for a fundamental shift in the way mental health systems are designed. People who have lived through mental-health conditions should not merely be asked to tell their stories; their knowledge and experience should help shape the policies, services and decisions that affect their lives.

This matters enormously for Bangladesh.

The latest WHO assessment of Bangladesh`s mental-health situation reports that 18.7% of adults-nearly one in five-experienced a mental-health condition according to the 2019 national survey. Women were more affected than men, with prevalence reported at 21.5% compared with 15.7%. The burden is not simply a medical issue. Poverty, inequality, violence, disasters, displacement and other social and economic pressures can all affect mental well-being.

Perhaps even more troubling is the gap between need and care. Earlier WHO analysis estimated that more than 90% of adults with mental-health conditions did not receive treatment. That means that behind the statistics are millions of people who may be struggling without professional support, sometimes without even being able to tell someone what they are going through.

And stigma makes the situation harder. A person with depression may be told to "be strong". A young person experiencing anxiety may be dismissed as being overly sensitive. A mother under severe psychological stress may be expected simply to endure it. Someone living with a serious mental-health condition may be labelled, isolated or feared rather than supported.

We cannot build a healthier society this way.

Mental health is not only the responsibility of psychiatrists, psychologists or hospitals. It belongs in primary health care, schools and universities, workplaces, families and communities. It belongs in conversations about poverty, gender, disability, ageing, youth, emergencies and social protection. WHO`s recent work in Bangladesh also emphasizes the need to strengthen mental-health prevention and care as part of the wider health system and to make investment in mental health a public-health and economic priority.

But there is another change we need to make, perhaps the most important one.

We need to stop designing mental-health services only for people and start designing them with people. Someone who has experienced depression knows barriers that may not appear in a policy document. A young person who has sought counselling knows what makes a service welcoming-or frightening. A caregiver knows where the system breaks down. A person who has lived through a mental-health crisis knows what dignity, choice and support really mean.

Their experiences are not anecdotes to be heard once a year. They are expertise.

This is at the heart of the 2026 WHO message: meaningful engagement means going beyond listening. It means involving people with lived experience in planning, decision-making, service design, implementation and evaluation.

For Bangladesh, that could mean creating stronger peer-support networks; making mental-health services more accessible through primary and community care; involving young people and caregivers in program design; strengthening mental-health support during disasters; and ensuring that people seeking help are treated with dignity rather than stigma.

It also means changing the language we use. Instead of asking, "What is wrong with you?" perhaps we should ask, "What happened to you? What are you experiencing? What would help?"

On World Mental Health Day 2026, let us therefore make a simple commitment-not merely to talk more about mental health, but to listen differently.

Let us listen to the young person who says they cannot cope. Listen to the mother who says she is exhausted. Listen to the survivor of violence. Listen to the person living with depression. Listen to the person returning from a disaster. And, most importantly, let us give them a place in the decisions that shape their care.

Because mental-health reform is not only about building more services. It is about building more humane services.

And perhaps real change begins with the simplest question of all:

"How are you-and would you like me to really listen?"

 Executive Director, Population Services and Training Center (PSTC)