Peanuts for mental health

Mental disorders account for more than four per cent of the total disease burden in Pakistan, says a study.

It is estimated that 24 million people in Pakistan are in need of psychiatric assistance. However, allocated resources for screening and treatment of mental health disorders are not enough to meet the increasing needs.

According to the WHO data, Pakistan has only 0.19 psychiatrists per 100,000 inhabitants, one of the lowest numbers in WHO Eastern Mediterranean Region, and in the whole world. Mental illness and violence are often seen as inextricably linked, creating a harsh stigma for patients and, at times, an uncomfortable environment for psychiatrists.

Religious bigotry and violence have become a concern in the practice of psychiatry. Ouster of the heretics carries serious consequences for psychiatric patients in the form of further discrimination and religion/spirituality is one of the methods to deal with this chaos. Religious experts also sometimes behave as if, and speak as if; they have frequent and ongoing hallucinatory experiences. Most patients consider faith and spirituality as important aspects of their lives and want their doctor to hold a spiritual conversation in the clinics because it helps them understand their illnesses in a different context. Norms and practices which define women as inferior to men which impose control on women are present everywhere in our families, social relations, religions, laws, schools, text books, media, factories, offices. The legal system favours men and economically powerful classes. Laws pertaining to family, marriage and inheritance are very closely linked to the patriarchal control over property. Traditional patriarchy in Pakistan introduced laws in supposed accordance with Shari’a on discrimination, inequality and exploitation of psychological strength. For this reason, poverty, inequality, violence and social fragmentation are not good for outcomes in schizophrenia which is a chronic brain disorder with symptoms of delusions, hallucinations, trouble with thinking or concentration, and a lack of motivation.

The exact prevalence of schizophrenia in Pakistan is not known, which makes the incapacitating illness difficult to combat. Pakistan’s top court has ruled that schizophrenia does not fall within its legal definition of ‘mental disorders’, whatever clears the way for the execution of a mentally ill man convicted of murder caused by incoherent or illogical thoughts, bizarre behavior and speech, and delusions or hallucinations. Despite massive economic burden of mental diseases and a clear connection between mental and psychological illnesses, mental health has always been a low priority in Pakistan. Pakistan’s public health budget is less than one percent of the country’s GDP and mental health does not even have a separate budget.