Mental setback

Pakistan’s healthcare system has for long ignored those suffering from mental health issues, with families also in too many cases attempting to disguise depression, severe emotional disturbances, schizophrenia or other challenges because of the social stigma attached to them. The fact that Pakistan’s 114 medical colleges only place one optional question on psychiatry on their final exam paper means that only a very small amount of the 14,000 doctors who graduate each year will have even a basic knowledge of mental health problems and how to identify or handle them. According to official figures, Pakistan currently has at least 50 million patients suffering mental health disorders while there is only one psychiatrist for even 100,000 people in the country. The ratio of expert medical care available is even lower for adolescents and children – a population extremely badly affected by the Covid-19 pandemic. Pediatric experts in the UK have recently warned that the impact on their mental health is so alarming, given weeks of forced isolation coupled with fear and a breakdown in routine, that they have sought some reopening of schools to enable children and young people to return to something that resembles normal life for them.

The WHO has already expressed concern about the 3.9 billion people under lockdown around the world in terms of their mental health. The organization also warns that in Pakistan the situation is aggravated by the lack of experts available to people facing isolation, the stigma, the inability to share feelings because of this stigma and that women and girls may be especially affected because they are unable to express their thoughts within families and are potentially cut off from friends or neighbours who could be a source of support. The increase in domestic violence has also been recorded around the world and obviously harms women facing it emotionally, mentally and physically, with few channels they can turn to for help. Women are also among the first within any workforce to be deprived of jobs and therefore finances and emotional wellbeing. The issue has largely been ignored. The Sindh government has set up a helpline for those who require support on mental health issues following the pandemic. This helpline, according to reports, is receiving an extremely large volume of phone calls such as similar helplines which exist around the world.

The established practices through which people cope with the death of a loved one have also broken down. In many cases, those who have died as a result of Covid-19 are buried in the presence of a few immediate family members, sometimes asked to wear PPE gear and accompanied by local administrative officials or graveyard managers dressed in a similar fashion. These factors add to the desperation created by isolation and fear and end up building a dangerous mental health situation. It has been taken too little note of in a country that lacks sufficient expert care in the first place. What is needed more than anything is a system to ensure that those who are in a vulnerable state of mind get the help they need, without any stigma attached to it.