Aim To identify mental health needs in local communities, and provide and evaluate nurse-led services to promote community mental health in Karachi, Pakistan.

Method Using an action research approach, mental health nurses implemented activities to promote mental health and psychiatric rehabilitation in 15 urban communities in Karachi. The activities were planned and implemented in collaboration with a community-based social welfare organisation.

Findings Community mental health interventions were implemented by a multidisciplinary team including nursing educators and postgraduate nursing students. Positive transformation of the mental health of clients in the community was found.

Conclusion The challenges in identifying, diagnosing and rehabilitating clients with mental health needs in the community in Pakistan is acknowledged, and the benefits of enhanced support for clients and their families provided by community mental health nurses are described.