Professionals stress on need to include mental healthcare at primary level

Severe shortage of psychiatrists, lack of incentives for serving in rural areas cited as major reasons.

ISLAMABAD:

In Pakistan, mental healthcare is limited to tertiary care hospitals due to which residents of rural areas have to travel long distances to see a psychiatrist.

To encourage the integration of psychiatric treatment in primary healthcare and to address service gaps between different regions in the country, a three-day international conference of the Psychiatric Society, began at a local hotel on Friday. Health professionals from 45 countries and 500 from across Pakistan are participating in the conference.

Talking to The Express Tribune, Dr Asima Khan, chief psychologist at Pakistan Institute of Medical Sciences, said the conference was a platform for training doctors and health professionals working at the community level to detect and treat mental illness.

Dr Khan believes that lack of willingness among health professionals regarding working in rural set-ups is a major hurdle in providing mental healthcare at primary level. Medical students should know how to address mental health issues, she said. “It is important to develop a referral system so that patients seeking mental health treatment could be transferred to hospitals for better care.”

A key factor for lack of ethics in medicine is the absence of ethical role models in training institutes, she added.

William McGhee, professor of Psychiatry from Loma Linda University, USA, told The Express Tribune that there was a severe shortage of psychiatrists in Pakistan due to which they were unable to provide services at primary healthcare setups.

While quoting statistics from the World Health Organisation’s Mental Health Atlas 2011, he said there are 380 psychiatrists in Pakistan for over 187 million people, which means there are are less than two psychiatrists for 1,00,000 people.

McGhee said the prevalence of psychiatric disorders in the country is 58 out of 1,000, but these figures should not be considered accurate because many cases remain unreported. He believes there was an increase in mental health issues after the devastating earthquake in 2005 as a result of which a large number of people suffered from post traumatic disorders.

He said more psychiatrists were needed in the country and they should be given incentives to work in rural areas. A large number of rural women suffer severe depression due to customs like karo kari, swara and early marriages, he stated. “They also lack education and basic healthcare facilities,” McGhee added.

Highlighting the importance of physical activity, Dr Batool Kazmi, sports psychiatrist from USA, said sports could improve mental health.

Published in The Express Tribune, December 29^th, 2012.