Figure amounts to 0.02 psychiatrists per 100,000 people
Rawalpindi
The Institute of Psychiatry, WHO Collaborating Centre for Mental Health Training and Research at Benazir Bhutto Hospital hosted an auspicious gathering of the leading professionals in the field of mental health today for celebrating the World Mental Health Day observed on October 10 around the globe.
Head at the Institute Professor Fareed Aslam Minhas served as host and in attendance were Professor Emeritus and founder of the Institute Professor Malik Hussain Mubbashar, Founder of Armed Forces Institute of Mental Health Brigadier (r) Mowadat H. Rana, TV anchor and writer Amaar Masood, Head of MNCH Professor Shamsa Zafar and doctors, psychiatrists, and psychologists of the Institute along with mental health professionals of the twin cities of Islamabad and Rawalpindi.
World Mental Health Day is observed on the 10th of October every year with a vision of raising awareness of mental health issues around the world. This year’s theme is ‘Dignity in Mental Heath-Psychological & Mental Health First Aid for All’.
The basic idea of the seminar was that as part of our daily lives, we may inevitably encounter individuals who have experienced traumatic sufferings. Learning the basic principles of psychological first aid (PFA) will help us provide support to these individuals, and importantly to know what not to say.
According to organizers, the World Mental Health Day provides an opportunity for all stakeholders working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people around us and worldwide.
After recitation from the Holy Quran, Professor Minhas took the stage and welcomed the distinguished guests. He started the discussion drawing on his insights from his own clinical experience of working with mental health patients. He enlightened the audience about the basic theme in the humanitarian context.
He informed the audience that four out of five mentally ill persons do not get mental health care. He alluded to how the population in Pakistan of 180 million people is rapidly growing for which the health budget is one per cent, which is the lowest in region. Of this budget, only 0.4 per cent goes to mental health. There are a total of 350 psychiatrists in the entire country that amounts to 0.02 psychiatrists per 100,000 people, he said.
He reminded the audience that the work done at the Institute of Psychiatry is a fraction of the tip of the iceberg and needs to be extended to the community in rural areas. Genetic problems become multiplied with natural calamities and the scale goes even further beyond control, he said.
He then moved on to give an introduction to the Psychological First Aid (PFA) Guide. It is evidence based modular approach to reduce initial distress. It is not meant only for professionals and that it is not professional counselling. The main principles revolve around ‘Look’, ‘Listen’, and ‘Link’, he explained to the audience.
He then alluded to Mental Health Services Research in humanitarian context which included a 2-year course formulated with the help of international collaborators and comprised of four modules. People trained through these courses are available now to mentor others in our nation. He informed the audience about the Problem Management Plus as an advanced version of PFA, for which a pilot study spanning across Swat, Peshawar and Institute of Psychiatry, BBH was in progress.
Professor Minhas said training for students at RMC, other health professionals in RMC and allied hospitals along with professionals from other educational institutions are in the pipeline. There should be active collaboration with the national disaster management cell, to effectively counter problems, he said.
Professor Muwaddat Hussain Rana began his lecture with an illustration of how the newborn despite his 100 billion neurons is completely dependent, and how through looking, listening, and linking in the society, the neurons interact with one another to develop into the brain of successful human beings. This is what PFA is all about, he said.
He explained that a trauma always has a ripple effect and impacts even those who merely hear about it. At extreme end of this ripple stand the mental health professionals. Yet, there are those who are going to be clinically affected. Those most vulnerable for this are the marginalized people, the injured, the needy, those on the extremes of age, female gender, those in the midst of the trauma, those who experienced childhood adversities, etc, he said.
The concluding address was delivered by the guest of honour, Professor Malik Hussain Mubbashar. He spoke of his journey as a young boy visiting a mental asylum called “Giddu Bandar” in the 1950’s. His family bought tickets to enter the asylum and witnessed humans locked up like animals behind bars, some of them naked, both men and women. Their symptoms served as a means of entertainment for the visitors. They were served rotten fruit as a treat for their “performance”. There, I decided to dedicate my life for the welfare of mentally ill, he said.
On returning to Pakistan after specialising from England, I realised that there are no jobs for psychiatrists. Nobody felt the need. My commitment to my vision was unshaken and when refused a place in any hospital, I setup my table and chair under a tree under the hot July sun. The medical professionals refused to fraternize with me, refused even to shake hand. I tolerated abuses of the most abominable kind. It was those sacrifices that led to psychiatry developing in Pakistan, he said.
Poverty, mental illness, and illiteracy are the unholy triad, he said. I started going to rural areas in 1985, to counter this. I used to travel and sought to educate people; in schools and in mosques, telling them about mental illness. I went to faith healers as well, he said.
Prof. Mubbashar spoke about the success in 1986 getting support for psychiatry from Zia Ul Haq and getting an article entitled Revolution in Mental Health published in the lancet. He lamented that those community efforts are dying. School mental health needs to be revived. Being future custodians of mental health, you must visit faith healers in order to educate them. War is too important for soldiers alone, he reminded the audience, and thus mental health is too important for psychiatrists alone. When ‘Mental Health for All’ becomes a practical reality then situation for mental illnesses will change, he said.