Consider the phrase 'I am OK.' It is one of the most standard and automatic responses we hear when asking people, 'How are you?' It could be true, or it could mean, 'I don't know how I am feeling,' 'I don't want to trouble anyone,' or simply, 'I don't think anyone will understand.' Beneath that common response could lie enormous, deep cultural silence regarding one's emotional distress. I often observe that people do not always present their psychological distress as a mental health concern but through physical symptoms in the form of expressions such as 'man bhari hune', 'darr lagne', or 'haat khutta jhamjham garne', 'mutu jhaskine', 'tauku ghumaune', or 'jagar nalagne'. Sometimes the symptoms may manifest as emotional, social, and behavioural symptoms. Parents frequently mention concerns such as, 'sano sano kura ma jhijho manche', 'usko ama naaunjel phone gareko garei garcha chatpatincha mathi mathi garcha,' runcha', 'ma ta najameko bhaye hunthyo' and many more. Behind these complaints might lie a story that has yet to be heard or one that was silenced when attempted to be shared: 'You are grown up; you need to deal with friends on your own.' 'It's okay if the teacher scolded you; you must have done something silly,' or 'You used to score A+; why only an A this time?' When compared to the iceberg phenomenon, only a small portion is visible above the surface, while the much larger part remains hidden beneath it. The presenting problematic/challenging behaviours often carry an unexplored deeper meaning. For instance, a child who spends excessive time on screens and wakes up late for school may be called 'alchi' or 'phone ma jhundirahancha'. In reality, this could be his coping mechanism to distract from underlying suffering (for instance, there might be conflict between parents every day, bullying in school, or academic decline and so on). This does not mean encouraging excessive screen time but rather recognising that all behaviour is a form of communication. We must ask ourselves, 'What is this specific behaviour communicating?' At times, behaviour can be a form of communication, especially when a person does not yet have the words to express what they are experiencing. Therefore, active listening/responding to behaviour is an important skill rather than providing advice/suggesting/responding. This applies not only to children but to all groups. We tend to assume that 'things will pass' if we wait a few days, but days turn into months or years, and we fail to notice the signs until it is too late. We notice when a student stops attending school, grows concerned when a young person isolates, and seek professional help only when things get worse. Just as we do not wait for a physical illness or injury to worsen before seeking medical care, psychological difficulties deserve timely attention. Wounds of the mind may not always be as visible as physical ailments, but early warning cues should not be ignored. Also, not every mental health concern requires medication or hospitalization. Often, support can begin with a simple conversation: a non-judgmental parent, a supportive teacher/friend, a healthcare professional, or someone who knows when to refer or access a trained mental health professional. Every year as World Mental Health Day approaches, media channels, social feeds, and seminars feature clinical experts and NGO representatives. While their expertise is vital, it does not complete the entire picture. A clinical textbook can define a panic attack, but it cannot convey the experience of waiting in a crowded ward at Teaching Hospital, fearful of being seen entering the psychiatry department. While professionals prescribe supportive care, a teenager from Pokhara who survived a suicide attempt truly knows whether hospital staff treated her with dignity or judgement. A parent raising a neurodivergent child in Jumla, travelling long distances to get therapeutic services in Kathmandu, understands far better than policymakers whether local health posts provide actual care or if 'free psychosocial services' exist only on paper. These lived experiences are not merely sad personal anecdotes; they serve as the ultimate measure of whether our healthcare system functions in practice as it is claimed in drafts. Lived, authentic voices need to be heard. Nepal has made progress through helplines, social media campaigns, and open discussions about therapy among youth. However, displaying awareness banners in Kathmandu does not address the availability of services in rural regions. It offers little comfort to a mother struggling with postpartum depression in rural Dang if her condition is understood only through beliefs of possession (bhoot lageko) while accessible mental-health services remain out of reach.' We need mental health services designed not just for the people but with them. This brings us to the core theme of World Mental Health Day, 'Lived Experiences Heard: Real Voices, Real Change', which deserves more than a single day of discussion. We often find it difficult to truly listen to others, or we listen merely to respond, interrupting before they have even finished speaking. Have you noticed this phenomenon? This year's theme asks us to practice something that sounds simple yet is challenging to fulfil: the act of listening attentively to others' concerns and distress, allowing their experiences to be shared, and serving as an empathetic ear for those who need us. This October 10, instead of chanting another catchy slogan or printing another brochure, let us pause and ask: Whose quiet struggle are we ignoring? Is there something we see among us? Am I one among them? Is it the father quietly suffering from anxiety due to his child's behavioral challenges at school, expected to hide his pain because men are told to be strong? Or a child who admits to her parents that she does not feel like waking up tomorrow morning, only to be dismissed with, 'You have everything, why would you say that?' Or is it the underpaid teacher managing 50 stressed teenagers in a single classroom without guidance or psychosocial support resources? Real care doesn't start with grand speeches. It begins when we stop telling people to 'toughen up' and start listening with an open heart. 'Sometimes the most radical act of care isn't offering an answer, rather it is staying quiet, staying close, and refusing to look away.' Pokharel is a Clinical Psychologist at Kanti Children's Hospital's Child and Adolescent Mental Health (CAMH) unit under the CWIN-UNICEF project, and at Synergy Mind Clinic. She also serves as a lecturer at Kathmandu University for the Masters in Early Childhood Education and PGDE in Inclusive and Special Needs Education programs.