-CJ Nisar’s recent visit to a psychiatric hospital has once again brought the plight of psychiatric patients in the limelight
ISLAMABAD: Although the plight of psychiatric patients has largely remained absent from public debate, the Chief Justice of Pakistan (CJP) Mian Saqib Nisar’s recent visit to a state-run psychiatric hospital in Lahore was able to shed a little light on the plight of psychiatric patients.
The CJP expressed concerns over the state of affairs and blatant mismanagement. Pakistan Today decided to go beyond the headlines and hullabaloo to report what life really is in scores of private ‘rehabilitation centres’ in the twin cities of Islamabad and Rawalpindi.
Many rehabilitation centres that offer treatment for drug abuse, psychiatric disorders, alcohol addiction, stress management, and other mental ailments are located in the twin cities. Many of them are situated in rented or owned houses in densely populated residential areas like Chak Shahzad, Bani Gala, Khana Pul, Ghori Town, Satellite Town, Chaklala, Khyaban-e-Sir Syed and CDA sectors.
It is normal practice for these rehabs offer different ‘packages’ ranging from 1000 rupees a day to as much as 10,000 a day. The packages depend on the financial capacity of the patient’s guardian and offer facilities like a separate room, better food and an individual caretaker.
Interestingly, the number of psychiatric patients in these rehabs is far less than drug addicts, a majority of whom hail from Khyber Pakhtunkhwa (KP). The number of heroin and hashish (charas) addicts outnumber alcoholics and psychiatric patients in every single rehabilitation centre Pakistan Today visited.
Psychiatric patients are involuntarily interred by either their parents, friends, children or spouses. Patients suffering from depression, schizophrenia, bipolar disorder, suicidal thoughts and a history of self-harm are admitted to these rehab centres on the recommendation of a psychiatrist as most government and private hospitals are devoid of psychiatric wards.
These rehabilitation centres make money by taking advantage of poor governmental regulations, lack of check and balance by the concerned governmental bodies, and the lack of rehabilitation facilities at government hospitals.
In the capital’s territory, these rehabilitation centres are issued licences from the Ministry of National Health Services, Regulations and Coordination (NHSRC) and in provinces, the provincial health regulatory bodies are the ones who issue these licenses.
Furthermore, before the issuance of a license these rehabs have to register themselves in pursuance of the Companies Ordinance, 1984.
“The menace of drug addiction is on the rise for the past many years. In the past, a majority of addicts were from poor, working-class segments of society. However, now I have many patients who belong to well-to-do families. The most worrying aspect is students of elite schools and colleges who turn to drugs like heroin and hashish,’ said Dr Naveed, a psychotherapist with 8 years of experience in the field, while talking to Pakistan Today.
Operating in tiny rented houses in suburban areas, these rehabilitation centres provide services to both psychiatric patients and drug addicts at exorbitant prices. The staff hired at these rehabilitation centres are under-qualified and paid poorly. However, the most suspicious thing is that the in-patient facilities they offer are neither registered with the social welfare agency nor the health directorates in their respective provinces.
Up till 2001, the Lunacy Act of 1912 regulated both the medical treatment meted out to psychiatric patients in Pakistan and the rehabilitation centres—both in private and public sector—came under its purview. It took 54 years to replace the outdated, colonial-era legislation with Mental Health Ordinance 2001 that aimed to bring about the necessary changes that took place in mental health practices over a century.
The new legislation was applicable all over Pakistan and carried provisions related to mental health care, voluntary treatment for such illnesses, and dealt in detail with the installation and outs of involuntary admission in severe cases. Additionally, provisions related to appeals against involuntary detention was also provided which was, however, rarely used.
The state of affairs in KP and Balochistan are such that both provinces have yet to pass mental health regulating acts, even after a lapse of seven years since the 18th amendment.
“The situation of mental health is hopeless in Pakistan. There is already scant awareness about various mental ailments. The social stigma and ostracism that follows a diagnosis, exact a huge cost to an individual. There is much need for awareness and acceptance. Proper laws, their legislation and most importantly their implementation will improve things for such individuals, as well as, the society,” said CDA Hospital Islamabad’s Psychiatry Head Dr Anwaar-ul-Haque.
