World Mental Health Day meeting by PAMH

Speakers discuss promotion of Mental Health
and Prevention of mental disorders

KARACHI: Pakistan Association for Mental Health (PAMH) organized a meeting at Jinnah Medical & Dental College to celebrate World Mental Health Day on October 15-16th 2016. Dignity in Mental Health: Psychological and Mental Health First Aid for All was the theme for this year. On the First Day the proceedings were moderated by Ghazi Salahuddin. Prof. S. Haroon Ahmad spoke about the Hidden Stressors while Mr. Amar Jaleel talked about Today’s Stressors and Mental Health.

On the second day Dr.Rubeena Kidwai consultant psychologist made a presentation on Sindh Mental Health Act 2013, its historical background, current status and the way forward.  Sindh, she pointed out, was the only province which has so far come up with a Mental Health Act. Previously the people suffering from mental disorders were wrongly accused and imprisoned. The new Act states that all such people should be offered assessment of their mental health and if they suffer from such disorders, they should be provided treatment. Blasphemy accused should also be assessed for their mental health status. Now Mental Health Act has been made but we need Rules and Regulations for its implementation. She also discussed the functioning of Mental Health Authority, promotion of mental health and prevention of mental disorders. We must uphold human rights, civil rights. We have submitted the Rules and Regulations to the provincial government and she hoped that they will soon be notified. Psychiatric patients are victims of violence, she added.

Prof. Iqbal Afridi from JPMC who is also President-elect of Pakistan Psychiatric Society emphasized the importance of collaborative efforts by lawyers, physicians and psychiatrists. Previously after the FIR, mental health patients used to go either to Prison or to Police Station. Now we need to set up Child and Adolescent Psychiatry units, Psycho Geriatric Units. Atleast four weeks are needed for assessment of a patient and six months for treatment. There is also need to provide emergency care for twenty four hours, regulate admission and hospitalization of mental health patients. We will use the plateforms and good offices of CPSP and PPS to realize our goals besides teaching institutions and involving the media, he added.

Prof. Raza Ur Rehman from DUHS said that even today many patients are being administered ECT without their consent. Laws need to be made to protect patients with mental disorders. There are just about five hundred trained psychiatrists in Pakistan but the number of qualified Pakistani  Psychiatrists living in UK and USA was seven hundred and eight hundred respectively.  We have not a single forensic psychiatrist. Mental Health Authority and Board will conduct periodic inspection and we will also have Mental Health Tribunal Judges.

Dr. Saadia Qureshy talked about Psychological and Mental Health First Aid. She pointed out that majority of the mentally ill patients do not seek treatment and over 50% of these patients have their first episode at the age of eighteen years. There is lot of disability due to mental health disorders. AMAN Foundation has been affiliated with an NGO providing Mental Health First Aid in Australia which has its affiliates in twenty six counties. This was established by the Care Givers and has been doing a commendable job. Mental Health First Aid is given till the crises are over. Mental Health Patients should not be afraid to seek treatment. We need to appreciate, listen and give them support, encourage them to get proper help. We at AMAN also provide Tele Health Services. We train people from different profession who are not doctors or psychiatrists but they are encouraged to help these patients suffering from mental disorders. We are fortunate that in Pakistan Family and Social Network is still quite strong as compared to  developed countries which is of great help  First Aid in Mental Health also covers crisis situation. It has been found out that almost 79% of patients who attempt suicide suffer from depression and mental health disorders.  We also provide psychological First Aid, specific Focused First Aid, Care Givers, she stated, also needs to be protected from burn out and their needs also deserve to be looked into. Community healing, she opined, was the Way Forward.

Dr. Unaiza Niaz a well known psychiatrist who represented the World Federation of Mental Health in her presentation talked about Dignity in Mental Health. She commended the work being done by Prof.S. Haroon Ahmad and his colleagues in alleviating the sufferings of the patients suffering from mental disorders and getting the Mental Health Act passed without which practice of psychiatry is very difficult. At present, she said, the whole Muslim World and the Middle East in particular was faced with violence, wars. We have increasing cases of blasphemy. She was critical of processions and Rallies by political parties which she said create further stress and lead to violence. It ruins business activity, create traffic jams. We need to work parallel with Mental Health Act by providing Mental Health Services, expansion of health services, more funding. She was also very critical of the senior psychiatrists who she said, keeps their talented competent colleagues at a safe distance, are surrounded by mediocre, they have no regard for merit. Despite all the problems, all of us, she continued, must do whatever we can do.

Continuing Dr.Unaiza Niaz also talked about crisis in mental health, the revolution, Wars, Arab uprising, political disturbances in Palestine and Kashmir which all have further increased the intensity of mental health disorders. For research one needs team work and funding. Wars increase injuries and mental disorders.  On the positive side, we have made some progress, life expectancy in Pakistan has increased and people are capable to find their way to progress and happiness. Conflicts has disrupted and destroyed health infrastructure in many countries. Look at the situation in Palestine, Iraq in particular. Despite the fact that we have lot of positive things, we should be prepared to face the worst if God forbid, we are faced with any difficult situation. The whole Muslim World is burning and it will have long term impact on mental health. It will have impact on children. The seniors in the profession need to encourage juniors, talented individuals. Dignity in Mental Health is linked with social justice which is lacking in Pakistan. The day we start selecting talented people on Merit and encourage them, the situation will change for the better. She further opined that stigma has decreased but still it is seen more in educated people. Even healthcare professionals, our colleague’s attitude was not at all helpful and they need to be educated. They do not encourage patients with mental disorders to seek medical treatment from professional people. All institutions, organizations, she further opined should provide mental healthcare to their workers, employees and refer people with mental disorders to qualified psychiatrists. She quoted the President of World Federation for Mental Health who in his message has stated that it was not the symptoms but the attitude which was a greater barrier to the provision of mental health services. We need more child psychiatrists. There are problems with the psychiatrists as well in provision of mental health services, she concluded.

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