Mental Health In Pakistan- Stigmatized, Stereotyped, and Treated with Cultural Insensitivity
A large chunk of Pakistani households believes that mental health is not an issue that ought to be highlighted on a daily basis. It is often surmised by them as a myth, an excuse, and perhaps, a shame. In Pakistan, more than half of the population (62.84%) live in rural areas with lower social statuses and poverty compounded by illiteracy. The dwindling literacy rates and rising penury lead people to seek convenient and cheap treatment from hakims, pir babas, traditional/spiritual healers, Unani (Greco-Arab) healers, bonesetters, herbalists, and quacks. Nonetheless, an extensive population still seeks qualified professionals’ help for physical diseases, such as diabetes and hypertension; however, less significance is given to psychological health.
The question is why the elite class is hesitant in seeking help for mental health issues? Well, the answer is quite simple, if one denied the existence of something, it would be impossible to look out for its solution. It is due to the lack of general awareness in society regarding psychological issues and the outdated beliefs of older generations regarding it being a subject of shame. Above it, the stigma associated with mental disorders has led people to think that they would be considered “abnormal” or “mentally handicapped” if they ever thought about seeking help. Even if vocalized, more than often, it is termed as melodrama and attention-seeking stunts by the family and friends.
The orthodox beliefs of the traditionalists suggest that a person feels anxious or depressed perhaps because life ostensibly did not pan out the way they wanted or probably because they are ungrateful towards the Nth number of blessings they seem to possess. Patients are frequently stigmatized as “mad” and “crazy”, mental disorders are stereotyped, and mental ailments are negatively associated with soi-disant ‘pir babas’ and ‘hakims,’ resulting in the lack of access to mental healthcare institutions. Another profound impediment to mental health in our country is the cultural belief system, which causes mental illnesses to be connected with supernatural powers, labelling them as black magic, witchcraft, and possession. Around 53 % population of Pakistan inculpates their conditions to evil spirits.
Traditional and cultural considerations tend to obstruct the progress of mental health in Pakistan. The foremost reason is the discrimination among patients with schizophrenia and psychosis by labelling them as violent and destructive. Secondly, it is thought by many that if they would go near these patients, the evil spirits may end up possessing them as well. Thirdly, many feel that the ideal place for people with mental diseases are shrines, where they are physically harmed to get rid of the black magic and possessions. These misconceptions increase the taboo around mental disorders, exacerbating the suffering of already sick patients who are not only facing the symptoms of their illnesses but are also subjected to the prejudice of society.
These traditionalist elements often claim that ‘anxiety’ is nothing but a feeling of being ‘stressed.’ Similarly, ‘depression’ is merely a feeling of being ‘sad’ that does not require external intervention. However, being anxious is not equivalent to being stressed, as anxiety is typically characterized by a “persistent feeling of apprehension or dread”. Unlike stress, anxiety persists even in the absence of stressors. On the same lines, sadness is a human emotion that individuals oftentimes experience during their lives. Nonetheless, like other emotions, melancholy is fleeting and disappears with time. On the other hand, depression is a chronic mental condition that can negatively impact social, occupational and other consequential areas of functioning. Its symptoms can perpetuate for a longer duration if left untreated.
A concerted effort is required to break down these taboos and to begin constructively dealing with mental health. There is the need to talk about mental health without stereotyping it, to dissociate the stigma attached to psychological disorders from people’s minds. It is significant for people, communities, and stakeholders to work together to lead the mental health advocacy campaigns to promote the human rights of persons with mental disorders and reduce stigma and discrimination. It is vital to encourage people to acknowledge the problem and seek help from professionals since nearly all mental conditions can be treated effectively with the combination of medications and therapy to minimize the symptoms and individuals to function independently.
According to the World Health Organization, mental illnesses account for more than 4% of the overall disease burden in Pakistan, with women bearing a disproportionate share of the burden. It has also been discovered that 24 million individuals in Pakistan require psychiatric treatment, although there are only 0.19 psychiatrists for every 10,000 people. Pakistan is lagging way behind with the low level of readiness, which will eventually result in our country trailing behind others nations and, overall, a weak health infrastructure that would be ineffective for ensuring the mental health of its population.