Women suffer more from depression, anxiety, take most decisions related to health in family-Unaiza Niaz

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  Psychosocial & Psychiatric Rehabilitation Conference

Women suffer more from depression, anxiety,
take most decisions related to health
in family - Unaiza Niaz

HCPs must be honest to their profession and
uphold professional ethics - Shaukat Jawaid

Doctors urged to use media effectively to highlight success
stories which will depict positive image of the medical
profession and healthcare facilities

KARACHI: Karwan-e-Hayat, Institute for Mental Health Care organized a two day conference on June 29-30th 2018 which attracted quite a few eminent psychiatrists besides a large number of psychologists and others interested in rehabilitation of patients suffering from mental disorders. Cultural Perspectives & Innovation in Psychiatric Rehabilitation was the theme of the conference.


Dr. Unaiza Niaz

Dr. Unaiza Niaz an eminent psychiatrist who has done a commendable work in the field of Women Mental Health was invited to be the chief guest at the inaugural session. Speaking on Women Mental Health in Pakistan, Dr. Unaiza Niaz highlighted the role played by women in development of mental health. She also referred to the advances in understanding of mental health, enormous cost of treating mental health disorders and its cost to the society. Women, she said, also take care of those who suffer from mental health disorders and they also suffer from mental illnesses. Not only is that it the women who make most of the health related decisions in their families. Anxiety is particularly three times high in women due to smoking, unsafe sex and abuse, she remarked.

Continuing Dr. Unaiza Niaz said that healthcare cost is much more if women suffer from diabetes, hypertension alongwith depression. Menstruation, pregnancy, post-partum and peri menopause add to their sufferings. There is a gender bias in the society and cultural disparity place women at greater mental health risk. History of violence, trauma, torture, abuse are associated with depression. Numerous neurological studies have shown that girl child who are abused in childhood suffer from many diseases later in life. They have low self-esteem, school failure. She then talked about the resilience and protective factors. There is a variety of efficacy of mental health treatments, she added.

Mr. Shaukat Ali Jawaid Chief Editor of Pakistan Journal of Medical Sciences and Secretary Eastern Mediterranean Association of Medial Editors (EMAME) was the next speaker who laid emphasis on the healthcare professionals to be honest to their profession and uphold professional ethics. With the advances in medical technology, unfortunately we are seeing the gradual demise of clinical medicine in Pakistan. Most of the healthcare professionals particularly the fresh medical graduates and juniors have become slaves of modern gadgetry and give least importance of clinical skills which are also not taught in most of our medical schools properly. It is a well-known fact that good history and physical examination is the key to reaching to the correct diagnosis. The doctors must listen to the patients patiently and it will help them in finding correct diagnosis However, unfortunately, most often the doctors do not listen to the patients and within few minutes before the patient has talked about his illness, they start writing the prescription. Apart from learning communication skills, they also need to learn listening skills. He then narrated a few instances to highlight the importance of clinical skills. When the physicians do not adhere to that, they often have to face an embarrassing situation, he added. In the late 60s and early 70s, consultants and medical teachers used to take night rounds but now even during the day, there are instances where some seniors and professors seldom take ward round which is extremely important in the training of the juniors and postgraduates. He also pointed out that public healthcare facilities despite lot of deficiencies and short comings still remain the last ray of hope for millions of patients who get benefit and get better but this is seldom highlighted by the media which enjoys criticizing the healthcare professionals and healthcare facilities which does not serve any good purpose and eventually it is the poor patients who suffer the most. The healthcare professionals also need to engage the media and use it effectively to highlight the success stories which will help project the positive image of the medical profession, he remarked.

Speaking about the discipline of psychiatry, Mr. Shaukat Ali Jawaid said that it has suffered the most at the hands of psychiatrists themselves. They need to do a lot more to overcome stigma attached to this discipline within the medical profession as well as the society at large. He then referred to the “One Man Departments” in most of the disciplines of medicine, psychiatry being no exception, the reluctance on the part of seniors to have more posts for juniors, discouraging the juniors rather than encouraging them, rampant intellectual corruption within the profession and the medical institutions. He recalled that it was a well-known secret that postgraduates in psychiatry were asked to appear from a particular center if they wish to pass with the result that many of the young psychiatrists some of whom had done DPM went to UK and over 75% of them later did MRC Psych and were now serving as consultants in the National Health Service. This was a great loss for Pakistan which has very few psychiatrists keeping in view the disease burden. We have not done much to start training people in Child Psychiatry where again it was the seniors who are at fault as they wish to monopolize everything and were least interested to promote the discipline of Child Psychiatry. We have a large child population suffering from mental disorders, ADHD, learning disabilities which continue to suffer in silence due to lack of proper care. Rehabilitation services for patients suffering from mental disorders are a few, i.e. Fountain House in Lahore and Karwan-e-Hayat in Karachi were doing a commendable job but these were not enough. Management of Karwan-e-Hayat, he said, needs to be commended and we all must help and support them in this noble cause.

Prof. Iqbal Afridi from JPMC talked about innovations in Psychiatry. WHO, he said, has defined health which includes emotional, physical, intellectual, occupational, social and spiritual health. He laid emphasis on predicting diseases and preventing diseases. In the days to come, we will have highly personalized diagnosis and treatment and personalized drug therapy. The patient, he opined, should have a participatory role in their treatment. They must be told to have a balance in life with healthy behaviour. He advocated holistic approach, promoting community psychiatry, using Tele Psychiatry, self-conversion, ensuring good sleep, consider work as worship and work is therapy. He also referred to the terminology Look, Listen and Link to promote mental health and highlighted the importance of careful selection of anti-depressants. He also referred to regenerative medicine, genetics and Nano-technology. In the past, Prof. Iqbal Afridi said we used to have over 80% of papers in psychiatric conference by psychiatrists but now psychologists are coming forward and playing an important role in mental healthcare as well as academics and research, he added.

Dr. Zafar from Karwan-e-Hayat speaking on the occasion pointed out that they have a hundred bed indoor facility, of the 70% admissions, most of them are poor. The institute has started a training programme and soon it will be recognized by PM&DC as well as CPSP for training of the postgraduates.

Earlier Ms. Talat Tayyabji and Dr. Ajmal Kazmi chairman of the organizing committee also briefly addressed the participants and thanked the keynote speakers, presenters in other scientific sessions. Later the key note speakers were presented mementoes on behalf of the organizers.

Scientific programme of the conference consisted of a few workshops, special invited talks. Some of the topics discussed during the conference included School Mental Health Programme by Prof. Fareed Minhas, Evidence Based Concept of QALB by Prof. Raza ur Rehman and Zafar Haider, Functional Impairment and, from Mood to Function evolving goals in depression treatment by Unaiza Niaz, Research on Asian Psychotropic Prescription Pattern by Prof. Mazhar Malik, Media and Mental Health by Prof. Sohail Ahmed, Self-harm and suicide prevention by Prof. Imran Chaudhry, Forensic Psychiatry, Autism by Ayesha Sarwat, Treatment challenges in Psychiatric Rehabilitation by Dr. Farrukh Z. Ahmed, Treatment resistance by Dr. Bilal Ahmad, Occupational therapy, Evidence based practice: Illness Management and Recovery by Dr. Ajmal Kazmi besides a number of presentations in Free paper Sessions. Dr. Nazish Imran from KEMU Lahore also conducted a workshop on Autism Spectrum Disorders.

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