PAMH celebrates World Mental Health Day 2018

Experts discuss Child Abuse and
the preventive strategies

KARACHI: To celebrate the World Mental Health Day, the Pakistan Association for Mental Health organized a seminar, on 14th of October at Jinnah Medical and Dental College, highlighting the mental health issues of young people. The issue of child sexual abuse was also discussed with special reference to recent incidences of sexual assault and murder of young children.  Prof. Haroon Ahmed, President of Pakistan Association for Mental Health gave the opening remarks and Dr. Uzma Ambreen introduced the theme of this year.

Dr. Ayesha Sarwat spoke about the major psychiatric disorders seen in children and adolescents. She stated that suicide is the 3rd leading cause of death in this age group.  Prof. Raza ur Rehman emphasized the need for providing adequate psychosocial support in childhood, which can prevent many major psychological problems. He explained how the daily hassles of current life style are hindering the engagement of positive and healthy activities of young people and not letting them to achieve their full potential.

Prof. Iqbal Afridi, Dean of Jinnah Sindh Medical University discussed the detrimental effects of excessive use of gadgets and social media and its repercussions for health with special reference to effects on sleep and how this might interfere with overall performance in the growth of young minds. He suggested different ways and strategies to deal with this ongoing every day challenge.

Senator Dr. Karim Khawaja updated audience about the progress in implementation of the Sindh Mental Health Law, 2013. He reported that different groups of concerned professionals were being educated in Karachi and other cities of Sindh, for better understanding and implementation of this law. He also highlighted the role and responsibilities of Sindh Mental Health Authority and reported that a budget is already allocated by the government in this regard.

Ms. Nida Khan, Clinical Psychologist discussed concepts of complex trauma and developmental trauma in survivors of childhood emotional, physical and sexual abuse. Dr. Naim Siddiqi raised questions about response to sexual crimes by the media, government officials, law enforcement agencies and mental health professionals. He also emphasized the need for psychological evaluation on perpetrators of abuse which would provide guidance in developing preventive measures against abuse. He stressed that the issue of child abuse can only be managed by a coordinated and multipronged approach with a serious participation by all stake holders.

 This scientific session ended with a set of recommendations developed as an outcome of the discussion during the seminar which are as under:

  1. It was agreed that the issue of child abuse must be accepted as a widespread problem that needs to be tackled at various levels and through sustained effort. Any effective response in this matter has to be multipronged and must include interventions at various levels.
  2. Awareness  campaigns about child abuse should be run in the society  with particular attention  towards children of different ages, students and  teachers of different teaching institutions, parents, general practitioners, pediatricians, emergency department doctors, social workers, lawyers,  police, policy makers, media, religious and community leaders were stressed.
  3. This awareness campaign should be an ongoing activity that should go on the whole year.
  4. This campaign should include health education incorporating the reproductive health as a component to children. This education and information must be sensitive to our cultural, social and religious values and the information provided must be age appropriate.
  5. Process of complaint to police should be made accessible and police should be bound to take these complaints seriously without any consideration of media scrutiny. They also should be sensitive towards the issue of respect and confidentiality.
  6. Interviews with child victims must be conducted in a sensitive way and police should be provided specialized training in this aspect.
  7. The assessment of need of counseling and legal aid and protective services should be established from outset and this must be provided by state.
  8. Protocols for evidence gathering that include DNA testing must be followed and state should establish purportedly functional forensic laboratories in all provinces.
  9. The culture of victim blaming must be discouraged at all levels that include media and legal community.
  10. Media should be assisted to develop their own code of conduct for responsible and ethical reporting while commenting on these sensitive issues. A close liaison between the mental health professionals and media is therefore highly recommended.
  11. Serious efforts should be made to implement the existing laws for protection of children’s right while more effective and specific legislation around child abuse and protection of rights of minors should be legislated.
  12. Mechanism should also include discouragement of false accusations.
  13. Pakistan has a National Action Plan for Children.  This comprehensively covers the issue of child abuse and neglect of all types. This plan must be revisited and implemented.
  14. Promoting and protecting adolescent health will not only be beneficial to adolescents but will also be beneficial to economies of community. Therefore managing mental health conditions with right support and treatment is mandatory.
  15. Parents, teachers and young people should be educated about the early warning signs & symptoms of mental illness and its efficient and appropriate management.
  16. Parents and teachers should also be assisted to help children and adolescents for building life skills so that they can cope with everyday challenges of life in a constructive manner.
  17. Psychosocial support can also be provided in schools & community settings through training of mental health workers to enable them to detect and manage mental health disorders.
  18. Combination of therapies e.g. using different sensory modalities, music, mindfulness, mediation and trauma releasing exercises should also be explored for management of different stressors in appropriate settings and indications.

Collaboration and cooperation of public and private sector organization should be sought with an aim to develop skills in young people for building resilience to face the growing challenges of rapidly changing world.

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