Pakistan can no longer ignore its mental health epidemic
https://arab.news/vmc7c
Mental health disparities exist around the world, with a pervasive epidemic of mental health illnesses that has crept into every segment of society for years. But during the current pandemic, the decades of neglect and underinvestment in addressing mental health issues has truly come to the forefront.
There is constant news and imagery of death, misery, uncertainty, stock markets crashing and an impending recession. More and more people are being laid off from jobs and the ones who have jobs are not certain how long they’ll be able to hold on to them.
Loved ones are dying, mostly in isolation, with no final goodbyes-- buried without ceremonial rites while people have been advised social distancing. It’s a somber time for everyone.
COVID-19 has created a major global mental health challenge, and Pakistan is not spared its psychological impact. According to one estimate, around 50 million people in Pakistan are already suffering from mental health disorders, including depression, anxiety, substance abuse, post traumatic stress disorders, bipolar disorders and schizophrenia.
Over 20 million children require trained help from mental health practitioners, according to Dr Ayesha Mian, Chairperson of the Department of Psychiatry at the Aga Khan University (AKU)-- and there are nowhere near enough paediatric psychiatrists in the country.
In Pakistan, anxiety is the eighth most common health problem that causes disability, whereas depression accounts for 44.6 percent of the total disease burden for mental illnesses.
The Lancet Commission on Global Mental Health and Sustainable Development reports that people who previously coped well are now less able to cope because of the multiple stressors generated by the pandemic and the deluge of constant information on social media.
The exponential numbers that will require professional help for their mental health needs due to the ubiquitous influence of COVID-19 is beyond imagination. This should be an eye opener for the government and healthcare policymakers in Pakistan, who are allocating very little money for mental healthcare.
The reality is that not everyone will catch the virus and a vast majority will survive with few symptoms-- but many are going to be psychologically impacted and suffer from varying degrees of post traumatic disorder.
Old people are vulnerable due to loneliness and isolation and not being able to meet and interact with their families. Young children and adolescents are confined within their homes with no interaction with their peers and with limited avenues for recreation. Those who are losing their loved ones have to deal with the complexity of grieving alone.
The exponential numbers that will require professional help for their mental health needs due to the ubiquitous influence of COVID-19 is beyond imagination. This should be an eye opener for the government and healthcare policymakers in Pakistan, who are allocating very little money for mental healthcare.
Dr. Mehreen Mujtaba
Women are increasingly being subjected to domestic violence; substance abuse seems to be on an increase according to various reports. The ministry of planning estimates that 12.3-18.5 million people in the county will lose their jobs and livelihoods in the aftermath of the coronavirus outbreak.
Whether it’s temporary or permanent, unemployment can lead to stress, anxiety, depression and other mental health challenges. The uncertainty related to COVID-19 is adding to the angst. So far, seven suicide cases due to the lockdown related economic recession have been reported in various newspapers.
These are all raising alarm bells in a country standing on the precipice of a mental health disaster.
A healthcare system that truly caters to mental health illness is woefully lacking in Pakistan and it is a pity that the country has limited political will and priorities for mental health. This unfavourably influences the quality of care provided to people suffering from mental health issues. Societal taboos surrounding seeking counselling and mental health treatment are still deeply embedded within the people’s psyche.
Over the years, subsequent governments have failed to prioritize public health on their agendas, which must encompass the entire spectrum of health and well being, including mental health. Pakistan’s mental health policy was last revised in 2003-- seventeen years ago-- and the allocated mental health budget is 0.4 percent of total health expenditure, with only five hospitals in the country catering to mental health illnesses.
The healthcare system’s response in Pakistan is not adequate to meet current challenges and major focus needs to be shifted to this area without further ado. We are in the middle of a catastrophe, where more and more people will no doubt require medical help for their emotional well being.
Free of cost telemedicine (tele-psychiatry) facilities should be provided at basic and tertiary healthcare facilities alongside all major hospitals. The political commitment to mental health must improve, and policies and legislative infrastructures to provide integrated healthcare must be developed to help those who need it most.
– Dr. Mehreen Mujtaba is a freelance consultant working in the areas of environment and health.
