Stigma and mental health problems in a Pakistani context

In western countries it is quite normal for people to visit a psychiatrist. The topic itself creates images of a comfortable sofa popularly known as “The Couch” with the patient opening his or her heart to the psychiatrist in the belief that here is one person who will resolve all the emotional and mental problems faced by the patient.

Here in Pakistan it is quite a different ball game altogether. First of all, there is a dearth of psychiatrists in the country. According to latest available reports, there are believe it or not about 15 million people, which is one in four people in Pakistan, suffering from some form of mental illness or the other but for this huge number only 400 trained psychiatrists are in the field to offer treatment. There are also a few mental health units in teaching and general hospitals.

Not only is there a paucity of psychiatrists but even the patients are reluctant to get in touch with one, given the stigma mental health problems carry in the country. Here the word ‘Pagal’ defines such people stamping and stigmatizing them before friends, relatives and coworkers, making life unbearable; and the treatment, instead of helping, just glorifies the problem and creates more problems than it solves.

This means that many people do not seek help, and 90% of those needing treatment cannot access support. This has become worse for many people since the outbreak of Covid-19 pandemic and the devastating floods, which were also historical in their magnitude and capacity for destruction.

The greatest beneficiaries of this situation are the faith healers who are doing a roaring business and are much more organized and popularized by their followers to attract those with mental illnesses. If you travel the length and breadth of the country the tall claims of these miracle workers are stamped on every wall and every corner of the country.

Just like you have family doctors in developed countries and even in Pakistan you have family faith healers in large numbers across the country. With the tag line “Baba” these have served these families for generations and are almost worshipped by them. In all family events they enjoy a prominent position and if they are really well entrenched even decide who gets married to who and who does not.

Growing insecurity, pervasive poverty, political uncertainty, genetic factors and a lack of economic opportunity all pose a significant risk to mental health in the country. They also pose a grave danger to the family of the mentally disturbed individual. Only recently, there have been more than one incident in Karachi alone where whole families have been torched to death or slaughtered by the lone mentally deranged member of the family.

It is a taboo to talk about mental health problems in Pakistan as almost in many other countries in the world. Affected persons are accused of practicing witchcraft or being afflicted by evil spirits. Mental illness is that rare diseases where society holds patients accountable for their illnesses.

Hostility in society increases as several mental illnesses are accompanied by odd or aggressive behaviour. People who act in this way are likely to face hostility and scorn. Many societies still use electroshocks, beatings, or incarceration as common reactions to aggressive, out-of-control behaviour, or even severe depression. Short cuts that leave lasting and destructive impressions on not only the patient but his near and dear ones as well.

I visited a psychiatrist recently. No I assure you nothing serious. Just a chat to discuss some minor issues. He was very professional and helpful. Only thing I missed was the famous couch shown in Hollywood movies. Well psychiatry is in its infancy in Pakistan.

Just wait and see it develop. Once our psychiatrists get the recognition they truly deserve I am sure they will be offering couches that will beat the set of Mughal-e-Azam and give their clients that deep seated comfort which loosens their thoughts and tongues to reveal their deepest secrets for satisfying results, resulting in top of the line treatment.

Copyright Business Recorder, 2024