Capital lacks psychiatric care for children

CADD minister says govt plans to build neurosciences centre at PIMS soon

ISLAMABAD: Even as tough competition in studies and incidents of terrorism continue, there is no child psychiatry department in public sector hospitals of the federal capital to deal with the mental and psychological disorders among children.

Recently, in response to a question posed to State Minister for Capital Administration and Development Division (CADD) Dr Tariq Fazal Chaudhry, he had told the Senate that currently there were no specialised healthcare facilities for treating psychological or psychiatric issues among children in the capital.

However, he hastened to add that they were looking to set up a Centre for Neurosciences (NCS) at the Pakistan Institute of Medical Sciences (Pims).  For this, a Project Concept-I will be sent to CADD and the Planning Ministry once the consultants — who will be hired for the centre — are finalised.

Apart from treating children, the proposed centre will consist of an adult and paediatric neurology, psychiatry, and neurosurgery departments.

At the moment, children can only receive psychiatric care at the outpatient department of Pims. While an age-wise record of patients at the department was not readily available, on average three to four children are seen at the OPD every day.

According to the data presented before the Senate, around 56,598  patients were treated at the outpatient department for various mental and psychological problems from 2013 to 2017. Of these, around 1,053 were admitted for treatment.

At least 12,614 patients visited the hospital’s OPD in 2013-14, 12,744 in 2014-15, 14,978 in 2015-16, and 16,262 in 2016-17.

Other government hospitals in the capital, such as the Federal Government Services Hospital (Polyclinic), the National Institute of Rehabilitative Medicine (Nirm), Capital Hospital, and the Federal General Hospital do not have specialised psychiatry services — not even for adults.  The Nirm only offers psychological services to both children and adults.

Experts say the child and adolescent psychiatry is the application of specialist medical practice to mental illnesses and psychological disorders in children and young people up to 18-years-of-age and needs to be applied by specialised child psychiatrists.

There are important differences between the practice of child and adult psychiatry says Ayesha Minhas, the head of the Child Psychiatry Unit at the Benazir Bhutto Hospital.

“Compared to adults, child mental health includes a different range of disorders. Assessment of family functioning is the key factor in the formulation of a treatment plan; (Disruptive behaviour in a child often accompanies disturbed family relationships),” Minhas said.  “It emphasises a multi-disciplinary approach,” she explained, adding that they use more psychological than physical treatments and use less in-patient care.

“Because of these differences in perspectives of assessment and management, it is important to provide specialist health care for children, separate from adult clinical services,” she explained.

She added that it was important that such centres liaise with schools since children face a lot of stress and other mental issues at schools — spending a considerable amount of their time there. But this is hampered by a severe shortage of child psychiatrists in the country. “We started child psychiatry services at the Institute of Psychiatry in BBH in 2006,” Minhas said, adding that the number of patients has steadily increased since and today stood around 2,500 patients annually under 18-years-of-age.

Asked about the most common problems children face, she said that Neurodevelopmental Disorders, followed by Behaviour disorders are top of the list.

Children also report emotional disorders such as anxiety and depression. “We also have referrals from schools regarding educational difficulties,” she said. The centre has a huge catchment area and patients from places such as Islamabad Gujar Khan, Chakwal, Kashmir, and even Haripur come for treatment as there is no other specialised facility for the children.

Published in The Express Tribune, December 11^th, 2017.