Lack of awareness, stigma key inhibitors in seeking help for mental health issues

Islamabad : The stigma attached to mental health is not as pervasive in societies that are individualistic and nonjudgmental in nature. Although some level of stigma still prevails in the west, but in highly judgmental societies like ours, lack of awareness and education, along with misattributions around mental and psychological problems based on our folk wisdom, compound the sense of inefficiency or inappropriateness to report any kind of mental or psychological illness.

It was in these words that Yasir Masood Afaq, the founding director of House of Wellness (HOW), set out to describe the factors that contribute to stigmatization of mental health issues in Pakistan. HOW is a psychological care and drug addiction treatment facility where trained counselling and clinical psychologists render services through intensive outpatient and inpatient treatment for a range of adjustment issues and severe mental ailments. The facility devises customized treatment programmes to meet each client’s emotional and psychological needs, covering a broad spectrum of disorders.

“If we consider the process of mental illness development, stigma is a key factor that inhibits people from reporting the signs and symptoms of their mental illness right at the outset. It is an established statistic that on the average, people wait for up to 10 years to report their psychological or emotional problems, and this delay adds to the intensity or complication of the problem,” continued Afaq, who holds a Master’s degree in Psychology with a distinction from the National Institute of Psychology, Quaid-i-Azam University, has done his MS in Clinical Psychology from IIU and is currently pursuing his PhD from NUML. As a mental health practitioner, what is the major source of stigma attached to mental health issues, ‘The News’ asked Afaq. Responding, he said, “When we talk about mental illnesses, the deeply embedded perception in our society that relates any psychological issue to mental retardation inhibits people from admitting and reporting their condition, which is the first step to seeking help.”

Indeed, lack of mental wellbeing is, in no way, synonymous to the person requiring to be admitted to a mental hospital, as is the common belief. “Unlike extreme psychotic disorders, mental health issues include minor or moderate level of maladjustments and emotional problems of any nature and severity. However, the social disapproval attached to any kind of confessions made by a person who is suffering from a mental or psychological illness prevents it from being reported,” Afaq pointed out.

“How much of a role does a patriarchal society play in aggravating the situation? Are women at a disadvantage when it comes to seeking help for a mental illness,” Afaq was asked. “Interestingly, mental health is perhaps the only subject where even patriarchy doesn’t help men. In a patriarchal society, mental, psychological or emotional illnesses are considered as a sign of weakness that leaves men at a more disadvantageous end to seek help. Women are not at a disadvantage, except for the lack of access to a mental health facility,” he stated. Afaq then talked about the extreme dearth of experienced and qualified professionals in this field. According to official statistics, there are only 400 mental health practitioners managing the entire population of Pakistan. “The psychiatric wards of DHQs in small cities and even main hospitals in our major cities are totally deplorable and in a pathetic state due to being resource-starved, not only in terms of treatment, equipment and methodology but also professional expertise,” Afaq regretted.

When responding to a question on how stigma gets in the way of treatment, and whether stigma is always social or can come also from within the person having mental issues, Afaq said, “A person’s self-image is a social construct. Yes, stigma is social as well as personal. It is overlapping in being personally social and socially personal. If a person is living alone on an island, he will not feel any social stigma, but in the world we live in, social stigma is a part and context of self-image,” he explained. Afaq termed lack of awareness as the number one challenge in seeking help, with the second inhibitor being stigma.

Living in times marked by social media campaigning, the best way to achieve any breakthrough is to break barriers by raising awareness, talking about sensitive health issues, and relentlessly challenging the stigma attached to mental illnesses. “We must use all channels for this purpose, be it social or traditional media, drama, stage, community level engagement or any other platform. Youth must particularly be at the centre of all awareness and advocacy campaigns as the onset of numerous mental illnesses usually takes place around adolescence,” Afaq stated in conclusion. The House of Wellness has been conducting pro bono sessions on drug abuse in various educational institutions in the twin cities as well as Peshawar. Its website (www.houseofwellness.pk) is a platform for youth to raise their voices about mental health issues. Now is perhaps the best time to make a start.