There are trainings you complete, and there are trainings you carry with you. The 9th cohort of the Problem Management Plus (PM+) Training of Trainers in Quetta, Balochistan belongs firmly in the second category.
A Region We Had Been Trying to Reach
Quetta had been on our list since last year. Every time we tried to plan a training there, the same question came up. How do we conduct this safely? Balochistan’s security sensitivity is not a small detail on a map; it is a lived reality that shapes almost every decision an organization makes before stepping into the region. So, the plans kept getting pushed. Not because the need wasn’t there, the need was one of the strongest across all our regional sites, but the path to meet that need was not simple.
This year, instead of waiting for the path to become easier, we decided to build a new one.
Choosing a Different Way In
The decision to adopt a hybrid model was not made lightly. It meant redesigning a training format that had worked reliably in fully in-person settings and trusting that it could still hold its depth and quality when split across physical presence and virtual delivery. It meant more planning meetings, more contingency thinking, and honestly, more uncertainty than we were used to.
Under the leadership of Prof. Dr Asad Tamizuddin Nizami, the plan took shape. The team would travel to Quetta to conduct an inception meeting in person at the Balochistan Institute of Psychiatry and Behavioural Sciences. We would meet all 46 participants face to face, understand the local context directly from stakeholders, and then hand off the core training to be delivered online from the Institute of Psychiatry, Rawalpindi Medical University.
What made this plan work was Prof. Asad taking the time out of his own busy schedule to travel with us all the way to Quetta. His presence was more than symbolic. It was genuinely encouraging for the whole team, and it made a lot of things go smoothly that could easily have gone wrong. His experience and calmness under pressure set the tone for how the entire visit unfolded.
The clearest lesson in leadership from that day was watching how a time-bound plan can be executed effectively when the person leading it is fully present and engaged.
Every part of our Quetta visit: the travel, the inception meeting, the stakeholder engagement, was completed in under 24 hours. That kind of execution does not happen by chance. It happens because someone at the front is willing to move at the pace the situation demands and bring the team along with him.
The Part That Stays with Me
Choosing to go to Quetta despite the known security concerns was not a small ask of the team. It would have been easy to justify staying back and running everything remotely from the start. Nobody would have questioned that decision. But the team chose otherwise. They chose to show up in person for the parts of the process that mattered most for building trust: the first meeting, the first handshake, the first real conversation with the people we would be training.
That choice says something about the kind of commitment this work demands. It is one thing to believe in expanding mental health services on paper. It is another to walk into a region carrying that belief, knowing the risks, and doing it anyway because the people on the other side deserve access to quality care regardless of where they live.
That team included Ms Maham Abid (Project Manager), with Ms Noor Fatima, Ms Rabeya Tariq, Ms Asma Muzaffar, and myself, Hassan Raza Ali. Looking back, I do not think I fully appreciated in the moment what it meant to have this particular group of people on that trip. Each of them showed up fully, handled the uncertainty of the day with composure, and carried out their part of a tightly timed plan without losing sight of why we were there in the first place.
The People Who Made Us Feel Safe
One of the most meaningful parts of the Quetta visit was meeting the stakeholders at the Balochistan Institute of Psychiatry and Behavioral Sciences. Prof. Hazrat Ali, Director of the institute, and Prof. Ghulam Rasool, Founding Director of BIPBS, welcomed us with warmth. They took the time to sit with us, to put us at ease, and to encourage us in a way that gave the whole team a real sense of confidence and validation. In a region to which we had carried so much apprehension, their hospitality provided a safe and secure environment that made the inception meeting possible in the first place.
What stayed with me even more than their welcome was their story. In the short time we spent with them, we learned how they had started and built the mental health system in Balochistan, often from very little, in a context far more difficult than most of us have had to work in. Hearing that firsthand was humbling. It put our own hesitation about traveling to Quetta into perspective and left us genuinely inspired by what dedication over the long term can accomplish, even in the most under-resourced and challenging environments.
Learning to Train Differently
Back in Rawalpindi, the real experiment began. We needed to deliver a training online that we had only ever done in person, to a group we had only met once. There was no established playbook for this within our project.
It required us to rethink our pacing. We needed to be more intentional about engagement. We could not read a room the same way virtually and needed to lean more heavily on structure to keep 46 participants connected and motivated across the sessions. It was uncomfortable at times.
But discomfort is often where the most useful learning happens.
This training taught us a great deal about how flexible our model can be when the situation demands it.
The Numbers That Mattered Most
At the end of the training, we conducted competency assessments through roleplays, the same rigorous standard we hold every cohort to regardless of format. The results were satisfactory, though not quite as strong as what we typically see from our fully in-person cohorts. That is not surprising given everything this cohort had to work around, and it is okay. It was part of the learning that came with trying something new and gives us something concrete to think about as we move forward. Specifically, how can we refine the hybrid model for future cohorts?
What Quetta Taught Us
Every training teaches you something about the intervention itself. This one taught us something about ourselves as a team. It taught us that access to mental health training should not be limited by geography or by the difficulty of reaching a place. It taught us that innovation in project delivery is sometimes born not out of convenience but out of necessity, when the usual way forward is simply not available.
Most of all, it reminded me that behind every cohort number and every completion report, there are people who made a deliberate choice to show up for this work under circumstances that asked more of them than usual. That is not something I want to reduce to a statistic.
Quetta is done now, but I won’t stop thinking about it anytime soon. It has quietly become one of the trainings of which I am most proud to have been part.
Written by Hassan Raza Ali (IoP).
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