Mental Illnesses Neglected and Rising

When someone has a fever/flu that persists they usually go to a doctor for the treatment. Similarly, when someone suffers a severe injury or has a heart attack, they will immediately rush to the hospital. Unfortunately, when someone is suffering from a mental illness, from depression to schizophrenia, they will often hide it or seek treatment from ‘peer baba’.

Mental diseases is not treated the same as other physiological illnesses, and coupled with the increasing stress of daily live including inflation, unemployment, etc, there is an increasing impact on the mental well being of Pakistanis. Very often increased stress results in psychosomatic complaints that appear physical e.g., pain in arms and chest, asthma, fainting, but are actually a result of psychological reasons. All these mental illnesses, like other physiological sickness, can be treated if professional help is taken for treatment. Considerable advances have been made in modern medicine to treat everything from depression to panic attacks.

 A WHO report indicates that according to epidemiological studies carried out in Pakistan, between 10-16% of the population suffers from moderate psychiatric illnesses, in addition to over 1% suffering from severe mental illnesses. Another WHO report claims that between 46-66% of women i.e. almost half of all women in Pakistan, and 15-25% of men suffer from anxiety and depression. In rural areas over 60% women were affected compared to 25-30% women in urban counters. Relatively mind mental illness like depression, although they can often lead to a much lower quality of life or even suicide, can often lead to moderate to severe mental illness. Professional treatment needs to be sought early in the illness to improve the prognosis of the disease.

At the policy front, the National Mental Health Program was formulated in 1986 and is part of the general health policy of the country. It involves incorporating mental health in primary health care, removing stigma which is attached with mental diseases, caring for mental health and substance abuse in the country. There has been limited progress on these excellent policies. A new Mental Health Ordinance emphasizes 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 was legislated, it has not been meticulously implemented. Given that there are only 4 mental hospitals and less than 800 psychiatrists and psychologists combined in a country of 175 million (about 1 per 250,000 persons), it is not difficult to understand the challenges that lie ahead.

Mental health is a much neglected area of public health in Pakistan, with a severe shortage of service facilities sectors. While the systematic issues that plague health services in Pakistan are shared by all health areas, mental health services are even worse than for other health issues because of the deep stigma and discrimination that mental health patient face. This not only leads to mental health patients often being isolated from society and sometimes from their families, but also causes people who have moderate or mild mental illnesses not to accept or seek treatment until their condition gets exacerbated. Even when treatment is sought, it is often through traditional healers, and the limited demand of professional mental health services has also resulted in very limited service availability in the private sector.

Unfortunately, many of us believe that living with stress, anxiety, depression, panic attacks, compulsive behaviours, psychosomatic pains and illnesses or a variety of other symptoms are simply what life is all about. These complaints are no different from fevers, broken bones, high blood pressure or other problems that life sometimes throws at us but we do seek treatment for these. We do not hide these symptoms, or live in shame, or pretend there is no problem.