Mental health: Dare to think

From children who are marginalised to the mothers who have seen trauma to adults who resort to violence because of the battles that rage within them, mental health, and its challenges in Pakistan, remain both a taboo and a subject mired with misconceptions and mysteries. We will come to some of the misconceptions in just a bit, but let us start with our attitude that needs to change. Mental health challenges, just like any other health crisis, personal or collective, are a serious business and should not be the fodder of our jokes. It’s time we recognise that it is highly offensive to make fun of anyone struggling with a mental ailment, just as it is extremely inappropriate to make fun of a cancer patient or someone who is battling a heart disease. It’s time we stopped using the ‘R’ word or terms that demean those who are fighting some of the biggest battles of their lives with everything that they have.

Now, let us come to some common misconceptions present in our society. In the light of the Peshawar tragedy, there was some discussion about psychiatric support and counseling, which is a step in the right direction. But there is a common misconception that mental health problems emerge only after a traumatic event. We believe that it is the loss of some kind, personal or collective, that triggers these crises. That is simply not true. The reasons may include personal loss but the factors can also be genetic, age related or biological. Second, we also believe that mental health is somehow a kind of a touchy-feely subject that has no clinical basis and those who practise this profession are somehow less rigorous than other clinicians. Once again, there is no truth in that as well. The clinical and biological basis of mental health is grounded in scientific research and while the complexity of the problem is indeed enormous, this does not mean that it is somehow outside the domain of scientific scholarship. Finally, and perhaps, closest to my own interests, is this misconception that there is no room for technological innovation in this sphere and it is best left to psychiatric counselors. Not only is this idea incorrect, it is also a reason a lot of our understanding is shrouded in decades-old local customs and practices that are both outdated and dangerous. It is also a lost opportunity, for our scientists, engineers and innovators, to contribute to one of the most underappreciated health problems of society.

Mental health challenges, like many other diseases, are strongly influenced by local environment, immune system and socio-cultural factors. There is, therefore, a substantial need to come up with solutions, from early diagnosis, to better case management, to follow up and cure, that understand the local culture, customs and resources. There is an even bigger need for us to bridge the gulf that exists between innovators and clinicians to identify the problems and think collectively about focused solutions. In my interactions with students and staff at universities and research institutions, I found plenty of activity on problems faced by Nasa and Cern but nothing that focused on the plight of those who are struggling to find the strength to live for even one more day. The clinicians were also looking to the greener pastures in the West to come up with solutions and had written off interacting with local scientists and innovators. This needs to change, both from the top-down and bottom-up. While some may argue that expecting the government to do anything is like beating a dead horse, but we cannot give up. We have to demand and expect leadership, both in the private and the public sector, to help fight our demons. There are successful examples, such as the Saving Brains initiative from Grand Challenges Canada, that is creating both a global awareness and providing grant support all across the world to innovative ideas that can change the tide. The BRAIN initiative from the US government is also a step in recognising that understanding the brain and its function and malfunction is the next frontier.

Our own next frontier lies in changing our attitudes.

Published in The Express Tribune, January 27^th,  2015.

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