02/09/2026
Research Article Analysis Series
Article No. 3
Title: The Migrant Hazara Shias of Pakistan and Their Social Determinants for PTSD, Mental Disorders and Life Satisfaction
Authors: Sara Rizvi Jafree, Syed Mujtaba Hasnain Nadir, Qaisar Khalid Mahmood, and Syeda Khadija Burhan
Journal: Journal of Migration and Health
Published: 2023
Overview
This study explores the mental health and overall wellbeing of Hazara Shia migrants living in Quetta, Pakistan. The Hazara community has endured decades of targeted violence, sectarian persecution, discrimination, social exclusion, and economic hardship. Against this backdrop, the researchers examined how these experiences affect psychological wellbeing, post-traumatic stress disorder (PTSD), and life satisfaction.
The study surveyed 251 Hazara Shia adults using internationally recognised assessment tools that measured:
• PTSD symptoms
• Common mental health disorders
• Community support
• Household stability and satisfaction
• Job satisfaction
• Financial security
• Overall life satisfaction
Key Findings
The results reveal a community facing significant psychological challenges.
High Levels of Psychological Distress
A large proportion of participants reported symptoms associated with poor mental health:
• 70% experienced excessive worry.
• 77% worried about their health.
• 70% reported feeling fearful.
• 70% felt hopeless about the future.
• 70% experienced loneliness.
• More than half (51%) reported thoughts of ending their lives.
These findings suggest that psychological distress is widespread within the community.
Groups Most at Risk
PTSD symptoms were particularly high among:
• Women
• Unemployed individuals
These groups appeared to be especially vulnerable to the combined effects of insecurity, economic hardship, and social pressures.
The Importance of Community Support
One of the study's strongest findings was the protective role of social support. Individuals who reported weak connections with:
• Ethnic or national communities,
• Religious communities, or
• Other social groups,
were significantly more likely to experience mental health difficulties.
The findings highlight how social networks and a sense of belonging can act as important buffers against psychological distress.
Factors That Improve Life Satisfaction
Using structural equation modelling, the researchers found that life satisfaction was positively associated with:
• Household satisfaction (β = 0.25)
• Community support (β = 0.26)
• Financial security (β = 0.11)
• Job satisfaction (β = 0.13)
In other words, people tended to report higher levels of wellbeing when they felt supported by their community, financially secure, satisfied with their work, and comfortable in their home environment.
Major Barriers to Wellbeing
Participants identified three main challenges affecting their quality of life:
1. Fear of violence, discrimination, and targeted attacks.
2. Obstacles to education and employment, including language barriers and limited opportunities.
3. Poverty, food insecurity, and difficulties meeting basic household needs.
The study also found that many households were struggling financially:
• 65.3% had difficulty paying utility bills.
• 35.1% had sold personal belongings to survive.
• 27.9% reported going without meals.
• 19.9% relied on welfare organisations for support.
Overall Conclusions
This research provides one of the first detailed examinations of the wellbeing of Hazara Shias in Pakistan. The findings suggest that prolonged exposure to violence, discrimination, social isolation, and economic deprivation has had a profound impact on the community's mental health and quality of life.
While security remains a major concern, the authors argue that improving safety alone will not be enough. Meaningful improvements in wellbeing will also require efforts to address poverty, expand educational and employment opportunities, strengthen social inclusion, and improve access to mental health services.
The study calls for coordinated action from government institutions, civil society organisations, community leaders, and international stakeholders to support the long-term wellbeing of the Hazara Shia population.
Strengths of the Study
The research has several notable strengths:
• It is among the first quantitative studies focused specifically on Hazara Shias in Pakistan.
• It uses internationally validated tools to assess PTSD and mental health.
• It combines statistical analysis with participants' personal experiences, providing a more complete picture of their lives.
• It identifies practical social and economic factors that can inform policy and humanitarian responses.
Limitations
The authors acknowledge several limitations:
• Participants were selected through convenience sampling rather than random sampling, limiting how widely the findings can be generalised.
• The research focused only on Hazara Shias living in Quetta and may not reflect the experiences of Hazara communities elsewhere.
• Individuals who are highly isolated and do not engage with community centres may face different, and possibly more severe, challenges than those captured in the survey.
• Safety concerns and low participation rates restricted the size of the sample.
Recommendations for Future Research
The authors recommend further studies to:
• Better understand the needs of women and unemployed Hazara Shias, who appear to face higher PTSD risks.
• Examine su***de and self-harm in greater depth.
• Explore the experiences of Hazara communities outside Quetta.
• Assess the effectiveness of community-based mental health and social support programmes.
• Evaluate the long-term impact of policies aimed at improving security, employment, education, and social integration.