Central Asian Nations Rank Low in Global Mental Health Index

Mental health remains a significant challenge across Central Asia, with populations reporting high levels of distress and rising rates of self-harm. According to the Mental State of the World survey, Uzbekistan ranked 74th out of 82 countries on the Mental Health and Wellbeing Index, scoring 54.5 points. Kazakhstan followed at 76th (52.3), Kyrgyzstan at 79th (51.2), and Tajikistan at 80th (51.2). The global average stands at 63 points, suggesting that, on average, people around the world feel mentally stable and active for about 21 days each month. Experts point to a range of factors driving poor mental health in the region, including anxiety, depression, fatigue, loneliness, and unresolved personal issues. A joint survey by the UN Population Fund (UNFPA) and YouGov, which included more than 14,000 respondents across 14 countries, found that 32 percent had experienced unplanned pregnancies and 23 percent were unable to start families when they wished. Financial hardship was the most frequently cited barrier to wellbeing (39 percent), followed by job insecurity (21 percent), inadequate housing (19 percent), and fear of war or pandemics (19 percent). A study published in BMC Public Health reported age-standardized suicide rates per 100,000 people in 2019 as follows: Kazakhstan at 18.05; Uzbekistan and Kyrgyzstan both at 8.28; Turkmenistan at 6.07; and Tajikistan at 5.32. By comparison, the global suicide rate that year was approximately 9 per 100,000. Despite its relative economic strength, Kazakhstan ranked 17th globally for suicide rate in 2020, with 18 deaths per 100,000 people, according to World Health Organization (WHO) data. UNICEF has also recorded a disturbing trend among the country’s youth: between January and August 2024, over 2,300 self-harm incidents were reported, including 128 involving children aged 5 to 18. Among adolescents aged 15 to 19, self-harm has become the leading cause of death. Uzbekistan, which received the highest score in the region, is expanding access to counseling services and training school psychologists. Meanwhile, Kyrgyzstan and Tajikistan are piloting community-based mental health centers. However, specialists warn that without broader social reforms, such as stable employment, affordable housing, and gender equality, both reproductive and mental health will continue to fall short of international standards. “True progress means giving people freedom to choose and live without fear,” the UNFPA report concludes. For Central Asia, this requires greater investment in rights, services, and long-term wellbeing.

Declining Birth Rates in Central Asia Tied to Crisis in Reproductive Freedom

Birth rates across Europe and Central Asia are falling sharply, accompanied by aging populations and the migration of young people in search of better opportunities. In response, many governments have introduced financial incentives to encourage childbirth. However, the United Nations Population Fund (UNFPA) warns in its State of World Population 2025 report that these measures address symptoms, not causes. The real issue, the report contends, is a crisis of reproductive freedom. The report, compiled in partnership with the polling agency YouGov, surveyed over 14,000 people across 14 countries, including Germany and Hungary. Its findings highlight a deep disconnect between people’s reproductive intentions and their lived realities: 32% reported experiencing an unplanned pregnancy, while 23% said they were unable to have children when they wanted. Among respondents over the age of 50, nearly one-third (31%) reported having fewer children than they had hoped. Economic insecurity emerged as the leading barrier to planned parenthood. Financial hardship was cited by 39% of respondents, followed by job instability (21%), lack of suitable housing (19%), and concerns over war, pandemics, or climate change (19%). Relationship-related issues were also significant: 14% said they lacked a partner, while 10%, mostly women, said their partners did not contribute enough at home. Although Central Asia continues to report fertility rates above the global average, the region is not immune to this trend. The report notes a steady decline in birth rates across much of Central Asia, including Kazakhstan, which is experiencing a multi-year downturn despite having one of the region’s higher fertility rates. UNFPA emphasizes that these patterns reflect underlying socio-economic constraints, not shifting cultural values. Rather than framing the issue as one of declining birth rates, UNFPA urges a shift in perspective from “why aren’t people having more children?” to “why can’t people have the families they want?” Reproductive freedom, the report argues, means being able to decide freely and securely when, and how many children to have. This requires stable employment, access to quality healthcare and housing, and genuine gender equality. UNFPA calls on governments, particularly in Eastern Europe and Central Asia, to focus less on raising fertility rates and more on protecting individual rights. Key policy recommendations include greater investment in public health systems, affordable housing, decent work opportunities, and stronger protections against violence and discrimination. “The real crisis is that millions of people can’t build the families they want, not because they don’t want children, but because they can’t afford to have them,” the report states. As The Times of Central Asia previously reported, four out of five Central Asian countries are currently experiencing declining fertility. The exception is Uzbekistan, where birth rates remain high and continue to climb. In 2023, Uzbekistan recorded a fertility rate of 3.4 children per woman, the highest in the region. It was followed by Tajikistan (3.1), Kazakhstan (3.0), and Kyrgyzstan and Turkmenistan (each at 2.7). Uzbekistan also posted the region’s highest number of births last year, approximately 962,000, representing a 14% increase compared to 2020. By contrast, Kazakhstan registered...