When people have a fever that persists, they usually go to a doctor and seek treatment. Similarly, when they suffer a severe injury or a heart attack, they will immediately rush to the hospital. Unfortunately, when they suffering from a mental illness, from depression to schizophrenia, they will often hide it or seek treatment from pirs and other religious figures.
Mental illness is not treated the same as other physiological illnesses, and coupled with the increasing stress of inflation, joblessness, load shedding, etc., there is an increasing impact on the mental well-being of Pakistanis.
Quite often, increased stress results in psychosomatic complaints that appear physical e.g. pain in arms and chest, asthma, fainting, etc., but are actually a result of psychological reasons. All these mental illnesses, like other physiological illnesses, can be treated if professional help is sought.
Considerable advances have been made in modern medicine to treat everything from depression to panic attacks and schizophrenia.
A WHO report indicates that according to epidemiological studies carried out in Pakistan, between 10 percent and 16 percent of the population suffers from moderate psychiatric illnesses, in addition to over one percent suffering from severe mental illnesses.
Another WHO report claims that between 46 percent and 66 percent of women – almost half of all women in Pakistan – and around 15 percent to 25 percent of men suffer from anxiety and depression.
In rural areas, over 60 percent women were affected compared to 25 percent to 30 percent women in urban centres.
Relatively mild mental illness like depression can often lead to a much lower quality of life or even suicide and often result in moderate to severe mental illnesses.
Professional treatment needs to be sought early to improve the prognosis of the disease.
At the policy front, the national mental health programme was formulated in 1986 and is part of the general health policy of the country. It involves incorporating mental health in primary health care, removing stigma which is attached with mental illnesses, caring for mental health and substance abuse in the country.
There has been limited progress on these excellent policies. A new mental health ordinance was passed in 2001. The new ordinance emphasises the promotion of mental health and prevention and cure of mental illnesses. The ordinance protects the rights of the mentally ill and promotes awareness and mental health literacy. Although the ordinance was legislated, it has not been meticulously implemented. Given that there are only four mental hospitals and less than 800 psychiatrists and psychologists combined in a country of 175 million (about 1 per 250,000 persons), it is not difficult to understand the challenges that lie ahead.
Mental health is a much neglected area of public health in Pakistan, with a severe shortage of service facilities and staff in both the public and private sectors.
While the systemic issues that plague health services in Pakistan are shared by all health areas, mental health services are even worse than for other health issues because of the deep stigma and discrimination that mental health patients face. This not only leads to mental health patients often being isolated from society and sometimes from their families, but also causes people with moderate or mild mental illnesses to not accept or seek treatment until their condition becomes exacerbated.
Even when treatment is sought, it is often through traditional healers, and the limited demand for professional mental health services has also resulted in very limited service availability in the private sector.
Unfortunately, many of us believe that living with stress, anxiety, depression, panic attacks, compulsive behaviors, psychosomatic pains and illnesses, or a variety of other symptoms is simply what life is about. These complaints are no different from fevers, broken bones, high blood pressure or other problems that life sometimes throws at us – but we do seek treatment for these. We do not hide these symptoms, or live in shame, or pretend there is no problem. The most important thing for people to realise is that mental illness is like any other illness – it requires treatment from trained professionals – and can be cured or managed. The worsening state of mental well-being in Pakistan can only improve when people seek out adequate treatment on a timely basis, and support the provision of more qualified mental health services.
