Mental health is a state of well-being in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community, as defined by WHO. It goes without saying that mental health is important for sustainable social and economic growth. All over the world, mental health policies are designed to promote mental health.
However, when it comes to Pakistan, the situation is rather dismal. Psychological problems and mental illnesses are on the rise in the country due to lack of awareness and inadequate support system in terms of psychiatric services and resources. It is estimated that mental health problems affect 1 in every 4 people in Pakistan – over 50 million people. In the whole country, there are fewer than 400 psychiatrists – one for every 125,000 people. And there are only 480 psychologists which paints a very gloomy picture. According to a recent study, economically, there is very little investment in Pakistan on mental health care. The total mental health budget merely stands at the 0.04 per cent of the total health budget in Pakistan. No wonder, the mental health care system is not compatible to its growing challenges. And one of the biggest challenges is creating awareness regarding mental health which has always been a constant struggle in our country. Unfortunately, people are afraid of talking about their mental health issues because of the stigma attached to the subject. However, slowly and gradually people are accepting these issues as something that can be treatable.
The good news is that there are non-governmental organisations that have been working diligently to create awareness and promotion of mental health in Pakistan since the past many years – ‘Kazim Trust’ is one such non-profit organisation. Established in 2008, the organisation is dedicated to creating awareness about people with ADHD (Attention-deficit/hyperactivity disorder) and Learning Difficulties (LD) in Pakistan and to also help these individuals learn differently in a safe environment, where they are encouraged to progress and gain full confidence in order to live a sound and cheerful life.
Recently, I visited Kazim Trust’s office, situated in Saddar, Karachi, and was quite inspired by the unique way this Trust works. It solely runs on self-help basis and it does not take any funds, aids or donations. The founder Mr Kazim Anwar, a well-known businessman, is a philanthropist who believes in giving back to society. He formulated a plan and laid the foundation of Kazim Trust in a bid to build a community in which children and adults with ADHD and learning difficulties possess the academic, social and emotional skills that would enable them to succeed in all spheres of their lives.
During my visit, I got to meet the very talented Ambreen Ali, a clinical psychologist, and her dedicated team. Ambreen has been working with the mental health sector for the past 4 years. She has extensive training and experience in counselling, behaviour therapy, play therapy, cognitive behaviour therapy, eidetic therapy and psychotherapy. Describing the philosophy of Kazim Trust, Ambreen says, “The Trust’s ideology revolves around the concept of ‘empowering minds that learn differently’ through a triadic approach that involves children, parents, and teachers, and which focuses on improving the gifted individual’s life. We encourage children and adults with ADHD and LD, not to simply follow traditional academic paths, but to pursue other mediums and creative avenues such as sports, music, and entrepreneurship.”
While talking about the different kinds of therapies and trainings given to children, Ambreen informs, “Neuro-developmental disorders are lifelong conditions that can be managed with treatments that are right for the individual. The treatment programme consists of several therapies that includes psychotherapy, remedial therapy, and speech therapy, behavioural therapy including ABA, Cognitive behavioural therapy, trauma therapy, occupational therapy, parental counselling and social skills training. With time and proper help, the individual is able to manage the challenges.”
“There’s a wide spectrum when it comes to how severely an individual is affected by a learning difficulty and understanding the difficulty on a case-by-case basis. The treatment plan may take time, no appropriate deadline can be quoted as it depends on the severity of the case and varies from individual to individual,” she adds.
What is your mechanism of creating awareness? To this end, Ambreen explains, “We use different platforms to tap the right audience or anyone who needs help. Therefore, accessing the value of social media (like Facebook, Instagram and LinkedIn), we are able to get connected with people, conduct live sessions, workshops in different schools, and we do television appearances, radio shows, annual conferences all these mechanism helps us reach to the masses. We cater to every class. Since the Trust works on self-help basis, the fee structure has been purposely kept nominal as compared to market rates. However, for low – socio economic class, we conduct free workshops, summer camps, training programmes to cater to parents, individuals, teachers and students to learn and help others.”
Shedding light on some of the issues being faced by parents of their mentally challenged children, Ambreen elucidates, “Parents of children with special needs go through psychological, emotional, spiritual and physical trauma throughout their lifetime. There are various problems faced by parents such as acceptance. It is too painful for most parents to accept that their child is not normal. Most parents live in a state of denial for many years. Secondly, the social stigma attached to mentally challenged children make parents vulnerable. Many parents do not attend public gatherings as they fear that people will make cruel remarks about their child.”
“Helplessness of the parents comes both from a lack of knowledge and a lack of information about the resources available. Many a time parents from low income group find it difficult to take care of their mentally challenged children. They are not aware of the assistance provided by particular institutes who cater to children with special needs,” elaborates Ambreen.
What kind of problems does your organisation face while dealing with parents? “Don’t ask,” replies Ambreen with a sad smile. “We face different kinds of issues such as when parents are in denial, or one partner, may be the father or the mother, is not ready to cooperate to understand the process of therapies that the child is in need of. Sometimes when the child starts to show sign of progress, parents start expecting a lot and want their child to progress way too quickly, which is sometimes not feasible as it depends on the capacity and severity of the case. In all such cases we offer Parent counselling sessions to make parents confident as well, so that they can help their child progress at the same time.”
For Ambreen, working for this organisation has been the most satisfying experience of her life. “I have been working here for the past 3 years, started my journey as clinical psychologist now working as Service Head. The thing that I love about my job is the environment in which ideas are cultivated, openly discussed, appreciated and implemented with the help of team. The team culture at our work place is the one that makes me feel like home. The philanthropist ideology of the Trust – spreading mental health awareness and serving humanity selflessly without any discrimination gives me a peace of mind and inspiration to do more. We are offering online sessions and in fact already facilitating many of our clients online from different cities. We plan to achieve even more in near future,” shares Ambreen.
“Parents are a child’s first and best teachers. So, I would like to advise the parents to show your children that life can be fun and difficulties can be catered, be their loudest cheerleader, focus on their abilities and not their weaknesses, be honest with yourselves and get them the right kind of help. Motivate them, don’t be afraid. Empower yourselves and your children as well, because with love, support and trust they can achieve anything in this world. Help them grow and prosper. Be proud of them,” concludes Ambreen.
Subha was just 7 years old when she arrived at Kazim Trust back in March 2014. She was experiencing severe reading, writing, and spelling challenges and also found it very difficult to focus on a task for a prolonged period. At the start of her time with Kazim Trust, Subha would not want to join the sessions with our staff but after a short period of time with some mentoring and guidance, she adjusted well with our team. As we got to know her better, we discovered that Subha was struggling extremely hard to cope with the growing pressure of academic and social life at her local school.
Today, Subha has made remarkable progress as her spelling skills have improved and she is much more confident with her speech. Even though there are still areas for improvement, Subha with the help of the dedicated staff at KT is seen to try harder and is more self-motivated and also has started writing as well. “I’ve seen a lot of change in my daughter’s behaviour. She’s now overcoming her learning and reading issues. The psychologist and remedial therapist who are working with Subha are both wonderful people and have helped her come a long way. Thanks to their guidance, my life is easier and stress-free. I can now handle my child in a much better way and I can see a very bright future for her,” says Subha’s mother.
*Hasan, (real name withheld), was an aggressive teenager and did not like to socialise. He was extremely hyperactive. He had a problem understanding emotions and showing his own emotions. Also, he had been struggling in his academics and relationship; could not communicate effectively. Consequently, he had difficulty in having a healthy relationship with his siblings. As such, he did not have any friends either. As a teenager, life was getting tougher for him.
When Hasan was brought to Kazim Trust four years ago, he must have been 13 years old. Our therapists observed him and evaluated him for attention deficit hyperactivity disorder (ADHD). He struggled with the various symptoms and functional impairments that a child would with ADHD. After relentless service provided by the therapists at the Trust, a gradual change was observed in Hasan’s behaviour. He started coming out of his shell. The intense behaviour therapies given to him changed his life for good. He became more focused and was able to manage his shortcomings. Hasan started getting good grades, and now he is a student of the first year (commerce). He is more confident because of his improved academic results. His developing skills show that he is going to go places.
Erum Noor Muzaffar is the editor of You! magazine. She can be contacted at [email protected]