Mental illness: it’s not our problem


Pakistan’s attitude towards mental health is frightening


Pakistan’s perspectives on mental illness have yet to shape up or gain momentum enough for it to be taken seriously. This area of wellbeing rarely gets the attention it requires, and when it does get attention, it is the sort of attention that cannot possibly help.

To put it into perspective: can you remember the first time you hurt yourself as a child? You may have heard the stories and bear the scars, but the likelihood is that you can’t think back to a physical injury or ailment with precise memory. However, if one was to ask you of your first clear memory of being humiliated, it is likely that you could remember significant details down to the hotness of your cheeks and the sweatiness of your palms. The simple fact is that we remember emotional trauma and it stays much longer than a physical wound.

Mental health in numbers

The situation is made worse by the fact that hospitals all over the country do not get nearly enough funding to continue running these departments. Only 0.4% of the country’s health expenditure is devoted to mental health. Around 11% of that figure is handed over to hospitals that focus on mental health. Pakistan currently has only five mental hospitals to deal with a population of 193 million and their problems.

There’s no real emphasis placed on mental health in Pakistan. Despite the obvious fact that we deal with physical ailments and injuries in a much easier fashion as compared to emotional trauma. Despite the magnitude of the problem, mental health continues to remain stigmatised in the country. Going to a psychologist or a psychiatrist almost always gets a person labelled crazy or insane. We can gauge how problematic the situation is from the fact that the term “mentally ill” is used more so as a slur than anything else.

Not enough research

The key to solving Pakistan’s mental health problem largely lies in research. Any kind of mental illness needs contextual solutions that take into account the regional and national scenario at play. The solutions that can work in New York, USA, will potentially fail in Karachi, Pakistan. The cultures, languages, ethnicities, etc come together to build a dynamic context — that context can only be addressed through further research.

While private hospitals like the Agha KhanUniversityHospital have indulged in different projects for research, it is not nearly enough. By and large there remains a dearth of any kind of research work when it comes to this arena. Why does this matter? Simply because medical professionals are not prepared to deal with patients in an effective manner. Due to this, we have increased incidence of depression, schizophrenia and suicides. Several cases of mental illnesses going wrong have even made it to the news. And there have been some clustered instances of students committing suicide due to their results and due to not getting adequate help in time. The number of people attempting suicide is on the rise but our hospitals aren’t equipped to deal with it. Even the largest of Pakistan’s hospital have failed to develop any form of counseling groups and support systems.

What we’re dealing with is a continuously developing pandemic that will not cease its detrimental path of destruction unless some serious steps are taken. A study conducted in 2000 by Hussain, Creed and Tomenson, effectively proved that there is a higher prevalence of depressive disorders in Pakistan. Their work showed a 57.5% prevalence of depressive disorders in women and 25.5% of the same in men. A person’s tendency for depression multiplied several folds if they were having trouble with finances, had a higher number of children and a lower level of education. Pakistan has a higher level of mood disorders than any other developing nation also because a much higher proportion of the people go through social adversity on a constant basis.

Troubled training and broken policies

It’s no secret that doctors in Pakistan are not trained in behavioural sciences properly. There are cases where a doctor will prescribe a patient time with religious scriptures instead of advising them on actual medication that is vital for their health. Additionally, the doctors aren’t trained in proper techniques of informational care. Since they can’t provide proper information in a reasonable manner to patients and attendants, it leads to disagreeable instances where the doctors are beaten up or malpractice suits are brought when no one is at fault. The lack of proper counselling regarding hospitalisation and the disease result in stress, anxiety and the lack of compliance with treatments, thus further exacerbating the disease.

There are no policies or resources in place to help the victims of domestic violence, terrorism, and natural or man-made disasters. Even the police is not mentally trained to deal with any terror-related assaults that may take place.

Mental illness infrastructure

Resources and outlets that can help people suffering from a mental illness are few and far in between. There is absolutely no support system present for families that are dealing with a loved one’s issues either. There are no suicide or mental help hotlines available in Pakistan. No form of support groups or group counselling sessions exist at large. There are cases where mentally ill people were chained in basements or rooms for decades because of the social stigma AND the unavailability of proper healthcare. This also includes the less than sympathetic treatment of mentally ill patients by doctors.

The unfortunate fact is that many of these problems are resolvable and can be taken care of if the right kind of focus is given to them. Mental health issues are often such that they can be maintained and managed if they cannot be completely cured. However, the approach that we’ve taken to these problems as a country shows that the situation will only continue to worsen with time. Pakistan is a country whose people are battered and bruised because of their everyday lives. Real steps need to be taken to address this problem.

At present what’s needed isn’t just a large and significant boost in financial resources, but also several movements aimed at raising awareness about these issues amongst the masses. Even if Pakistan is to build the largest facilities to tackle any number of mental health problems, none of it will matter unless they are able to effectively ensure that the public knows getting help is a real option.

It’s high time we started taking the mental health issues in this country seriously; we’re quite literally en route to becoming a band of madmen.

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Luavut Zahid writes about all the injustices she sees, whether they're directed towards people, or the planet. She can be found writing about crisis response and disasters just as easily as she'll pen a piece about the mistreatment of women and minorities. She can be reached at: [email protected], and she tweets at: @luavut. Ali Sajid Imami is a doctor by training, a computer scientist by trade and a researcher and social activist by passion. Ali spends most of his time awake and staring at various screens. He tweets at @doctor_no.