Mental Health Resources in Pakistan

One of the most common sayings about health is' Health is Wealth'. It is a true saying but over here, it is not specified as to which health is wealth. When we talk about health, we can categorize it into four types, i.e. physical, mental, emotional, and spiritual. The first three are interconnected and dependent on each other, while the fourth one is a very different case because it is related to one's beliefs and faith. However, it can still affect one's mental and emotional health.

When someone is suffering from any type of physical ill health we consult a general practitioner, a hakeem, or a homeopathic doctor. To get help for spiritual ill health we refer to maulvis or alims, etc. All these types of health professionals are easily available. Mental and emotional health are strongly linked to each other because our emotions are controlled by hormones or chemicals produced by the brain and any malfunction in the brain can lead to an increase or decrease of these hormones or chemicals, leading to emotional and mental ill-health.

The scenario over here is that on the one hand, we can find all types of doctors, clinics, and hospitals to treat physical distress but what about mental and emotional health?

In the western world or developed countries, they pay a lot of attention to mental health, and as a result, they have teams of psychiatrists and psychologists associated with hospitals as well as working individually. Patients do not feel stigmatized when they seek help for their mental issues or receive any kind of help from psychiatrists or psychologists.

At times only talk therapy works and sometimes group therapy is helpful. On occasion, medicines are also prescribed.

Let us talk about our own country, Pakistan, where there are scores of medical colleges that have established separate psychiatric departments. However, in most cases, they lack manpower. Still, the majority of the hospitals do not have any psychiatric wards or departments. The psychological healthcare system is woefully deficient in our country, Pakistan. And due to poor management and stigma accessing psychological help is considered taboo. There are hardly any clinics, institutions, or hospitals where drug users or alcoholics can receive treatment. Only the rich can avail treatment for these problems.

Mental health is most neglected in Pakistan. 10%-16% of the population suffers from mild to moderate psychiatric illness, the majority of whom are women. In our homeland, only one psychiatrist is available for 10,000 adult citizens suffering from any type of mental illness whereas one psychiatrist is available for four million children who are suffering from mental health issues.

The lack of mental health facilities for children is an important issue that should be dealt with as quickly as possible. We should take a look at it in various institutions viz-a-viz in schools across the country. There are schools in major cities where physical health care might be available but no counseling or counselor is available for mental health issues being faced by the young, who undergo issues like peer pressure, body shaming, problems related to studies or grades, and even separation or demise of the parents. These issues leave a deep scar on the mind of youngsters, leading to the development of individuals with deep-seated mental health issues. The same is the case in colleges and even in universities where physical health monitors refer the students to psychiatrists or psychologists who are expensive and are sometimes not skilled enough to help these young adults to become mentally healthy individuals who can easily lead a successful life with no repercussions.

Only four major psychiatric hospitals exist in Pakistan, resulting in only a small number of patients suffering from mental disorders being given treatment. The lack of mental health professionals has created a vast gap leaving more than 90% of the people with simple common disorders untreated. Depression (6%) schizophrenia (1.5%) and epilepsy (1-2%) are major mental disorders in Pakistan.

 Overall depressive disorders and anxiety is 34%. We are not going to go into detail about the number of mental health sufferers in various provinces and cities across Pakistan or when and where any psychiatric hospital was established. However, two mental health institutions are mentionable over here. One is the Fountain House, established in Lahore in 1971, which has extended its services in rural areas. From being a small institution, it is now a major mental healthcare institution in Punjab where patients from other provinces also visit for treatment. The second such institution is in Sindh near Hyderabad, commonly known as Giddu Bander. Its actual name is the Sir Cowasjee Jehangir Institute of Psychiatry (SCJIP). It was established by a philanthropist Parsi family before the creation of Pakistan. Before the establishment of Fountain House, it was the largest of its kind in Pakistan and is more than 150 years old. The Sindh government has decided to affiliate it with Liaquat University of Medical and Health Sciences (LUMHS) Jamshoro.

A major problem that is being faced in Pakistan is that many psychiatrists who receive training and education in this field leave Pakistan for greener pastures, leaving Pakistan lacking in psychiatric professionals when patients, as well as the country, should have benefited from their expertise. It is also important to create better incentives for these professionals to avert brain-drain scenarios.

The British Asian Trust launched in 2007 is taking interest in providing solutions to improve both clinical and non-clinical services available to people with mental health problems. Pakistan needs to address this problem with urgency and provide mental healthcare and support to patients.

Note: Initially published in the Perspective Magazine @PerspectiveMags in April 2022