by Onaiza Qureshi, MSc Global Mental Health candidate

 

Pakistan – home to approximately 182 million people of diverse races and religions who operate within limited access to healthcare, political acts of violence, and high levels of financial insecurity and social injustice. This environment is a breeding ground for mental health problems. The treatment gap for mental illness is expounded by the fact that Pakistan has a ratio of 2-3 psychiatrists per 100,000 of its population. Depression is the most prevalent mental illness and is the fourth leading cause of years lost due to disability in the country[1]^,[2]. Epidemiological reports around the country put the prevalence rates of depressive and anxiety disorders between 22% and 60% with incidence varying widely between urban and rural settings[3].

Among the many marginalized populations, the most vulnerable to depression are the females, the elderly, those from lower socio-economic groups and uneducated individuals[4]. The most dominant opinions about the causes behind depression appear to revolve around the social factors such as poverty, insecurity around terrorism and violence and population density. Moreover, factors such as marital status, interpersonal issues and financial worries were also quoted as leading to psychosocial stressors as a consequence⁵⁰. There is also a common conception that mental disorders are caused by supernatural forces and beings such as evil Jinns (evil spirits/genie created from smoke and fire), black magic, and possession or as a punishment by God for sins committed in the past[5] (Karim et al, 2004).

There is a strong culture of stigma against depressive disorders in Pakistan. A person suffering from mental illness will yield different degrees of reaction from his community depending on the severity of the depression and its symptoms. Since depression does not manifest outward in an obvious fashion or cause visible social problems, it tends to be neglected and missed in the population when compared to more visibly noticeable disorders like schizophrenia. It may be due to this reason that many people do not seek or access help for depressive disorders in this context.

A fully functioning and up to date mental health act exists in two of the largest provinces of Pakistan; however, there is a lack of implementation for the policy to protect the rights of people with mental illnesses. Although small-scale non-governmental organizations have been doing their part in trying to change the state of mental health in Pakistan, the government itself needs to take responsibility for putting mental health on the agenda for policy, planning and implementation before any significant changes can be made.

15 / 115 is the emergency number for Pakistan.

References

[1] Taj, R. (2015). Mental health in Pakistan. Routledge Handbook of Psychiatry in Asia, 103.

[2] Institute for Health Metrics and Evaluation. Pakistan. Extracted from http://www.healthdata.org/pakistan

[3] Ahmed, B., Enam, S. F., Iqbal, Z., Murtaza, G., & Bashir, S. (2016). Depression and Anxiety: A Snapshot of the Situation in Pakistan. International Journal of Neuroscience and Behavioural Science 4(2): 32-36.

[4] Mirza, I., & Jenkins, R. (2004). Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review. Bmj, 328(7443), 794.

[5] Karim, S., Saeed, K., Rana, M. H., Mubbashar, M. H., & Jenkins, R. (2004). Pakistan mental health country profile. International Review of Psychiatry, 16(1-2), 83-92.

 

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