Most people do not notice mental illness, which ends up affecting both their personal and professional lives. Those that do realise something’s amiss, hesitate in seeking help, given the stigma that is associated with mental illnesses in Pakistan, according to Rabia Manzoor, a clinical psychologist at Aga Khan Health Unit in Islamabad.
There are 800 psychiatrists and psychologists in a country of 175 million people, roughly translating to one physician per 200,000 people. There are are just four mental hospitals.
World Health Organization says 10-16 per cent of Pakistanis suffer from moderate psychiatric illnesses, with 1 per cent suffering from severe mental illnesses. With the ratio of severely-ill patients to doctors at 2,000:1, there are nearly not enough psychiatrists and psychologists in the country.
People themselves do not make it easy. Patients, especially those in rural areas, lack awareness. Moreover, they avoid seeking up because of the social stigma attached to a person who visits a psychologist or a psychiatrist.
Sharing a case history, Manzoor said that she recently came across a woman who was suffering from chronic stress and depression. “She refused to visit me, saying that she was not ‘mad’.”
She added incidents of domestic violence, honour killing and physical abuse contribute to mentall illnesses. “The victims feel helpless and hopeless, which increases frustration and anxiety in them, leading to mental illness,” she said.
Factors such as the deteriorating law and order situation, sky rocketing inflation, unemployment, prolonged power/gas load shedding among others do not help the matters either. Women and children in particular are being deeply affected by it, according to Manzoor.
Qudsia Mehmood, a consultant psychologist said people in Pakistan prefer seeking help from pirs (faith healers) instead of seeking professional help.
“There are very few hospitals where there is a vacancy for a clinical psychologist,” she said. Stress, Mehmood said, may manifest itself in the form of aches, asthma and fainting among others; if otherwise unexplained they might actually be indicative of an underlying psychological condition. Left untreated, many people get worse.
Between 46-66 per cent of women and 15-25 per cent of men suffer from some form of anxiety or depression. In rural areas, over 60 per cent women are affected compared to 25-30 per cent women in urban areas.
The national mental health programme, which is a part of the general health policy of the country, involves incorporating mental health in primary healthcare, removing the stigma which is attached with mental illnesses and caring for mental health. Little has been done though.
A mental health ordinance passed in 2001 emphasises on 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 has been legislated, it has not been implemented.
Published in The Express Tribune, August 8th, 2011.