Mental Illness in Pakistan: A Subject of Stigma, Ridicule, and Cultural Insensitivity
A commonly heard statement, “Iss par toh Jinn ka saaya ha [He/She is possessed by the devil]” is always being used in Pakistani society for victims of mental disorders. Unfortunately in Pakistan, overall prevalence of depressive disorder and anxiety is 34%. The province-wide prevalence is: Sindh 16%, Punjab 8%, Balochistan 40% and Khyber-Pakhtunkhwa 5%. These alarming statistics make immediate actions imperative to prevent further increase in mental illnesses.
Inaccessibility to mental healthcare facilities is due to stigmatization of patients as “crazy”, stereotyping mental illnesses and negative association of mentally ill people with ‘Pir Babas’ and ‘hakims’. One deeply rooted barrier to mental health is the cultural belief system in our country, due to which mental illness is often associated with supernatural forces, and thus tagging them as witchcraft, possession, and black magic. In Pakistan, about 53% patients attributed their disease to control by evil spirits. In addition to this, families often hide the mental illness to prevent the sufferer from being an object of discussion in the society.
Last year I encountered a patient who had attempted suicide because she was suffering from major depressive disorder. After her diagnosis, she had been locked in her room and was under strict orders to not to be a part of any social gathering because her family didn’t want to hear any shaming words due to her illness. It’s clearly time to ask ourselves, is having a mental illness a crime? And if not, then why we are treating it this way?
A major reason for this attitude in our society is lack of awareness regarding the importance of mental health, just because we give more importance to physical health over mental and sexual health. For example, we seek healthcare professionals for diabetes and hypertension – then why not for mental problems too? Almost 34% of Pakistani population suffers from some form of mental disorder and depression is implicated in more than 90% of suicide cases. Thus, ignorance often results in self-destruction and negative coping mechanisms of psychotic persons.
Cultural factors always hinder the progression of mental health in Pakistan. Firstly, in our society, there are many myths regarding mentally ill patients. There is discrimination of psychosis in our society by tagging these individuals as fearful and violent. Secondly, we feel that through interacting with them, their evil spirit or possessions can harm us too. Thirdly, many people feel that the right place for them is in shrines, where they are physically harmed to get rid of these possessions. All these misconceptions increase the taboo around mental illness thus we need to understand that mentally ill people are challenged doubly, on one hand they suffer from the symptoms of illness and on other hand the society increases their sufferings.
Another important factor is the contribution of mass media to stigmatization of mental illness. Through television, radio, and other social medias, mentally ill people are cruelly portrayed as a laughing stock. Moreover, they are stereotyped as different and subject of ridicule. Furthermore, the community is highly influenced by the way media portrays mentally ill people as being involved in criminal activities. Thus, the above-mentioned factors are potential reasons and explanations that elaborate the stigma on mental illness.
This requires a rigorous effort to get rid of these taboos and start dealing with mental health in a positive manner. It requires collaborative efforts by individuals, the community and stakeholders to address this issue in a prompt manner and to eradicate the consequences of mental illness. We must respect mentally ill patients as we respect others in our society as this will result in reduced discrimination and stereotyping. Moreover, our healthcare professionals must be trained in a culturally sensitive manner in order to avoid disgrace and acknowledge these issues in depth.
On a community level, there must be a strong collaboration between healthcare providers and faith healers as it’s our responsibility to value and respect a patient’s personal belief. In addition to it, awareness campaigns must be raised in order to enlighten issues like mental illness and mental health promotion through this way we can produce a mental health literate society and can acquire benefits such as greater gain in prevention and due recognition of symptoms.
Moreover, our government must intervene to produce fruitful outcomes and must implement Mental Health Ordinance for Pakistan, 2001. According to this law, all rights of a mentally disabled person must be protected and they should be guarded with safety and security. Furthermore, there is an emergent need to raise the allocated budget for health sector in Pakistan in order to work more effectively. Last but not least, we all need to change our current perception about mental illness and we all must accept and deal with these issues with a boarder aspect so in return we can up root this issue from our society.
“Mental illness is nothing to be ashamed of, but stigma and bias shame us all” –Bill Clinton
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