Psychiatry and psychology are two branches of medicine that are dedicated to the study, diagnosis, and treatment of mental health disorders. In Pakistan, mental health is an important issue that affects many individuals and families. The development of mental- health systems and services in Pakistan has been a slow and challenging process, but progress has been made in recent years. In this article, we will explore the current state of mental health in Pakistan, the challenges facing mental health services, and the development of mental health services in the country.
Psychiatry and Psychology in Pakistan
Psychiatry and clinical psychology are two disciplines that are closely related to mental health law and healthcare in Pakistan. Clinical psychologists and psychiatrists are the primary mental healthcare providers in the country. in Clinical psychology, psychologists focus on providing psychological therapies to patients with mental health disorders. Psychiatrists, on the other hand, are medical doctors who specialize in the diagnosis and treatment of mental health disorders. They are trained to prescribe medication and other treatments for mental health disorders.
What Are The Doctors Of Psychiatry & Psychology Called?
Psychiatrists are medical doctors that are specifically trained to prescribe medication to treat the patient’s symptoms. Psychologists however concentrate on treating the emotions, physical complaints, and mental suffering of their clients through psychotherapy and behavioral interventions.
Development of Mental Health Services in Pakistan
The national mental health program was first created during a multidisciplinary workshop in 1986 and incorporated into a national development plan for seven- nine years. On the basis of this, it is apparent that the program cannot achieve its intended goal without the use of purely skilled workers. Instead, the idea would be integrated into the Primary Healthcare service system. These are being undertaken across five districts of India with its four provinces including Azad Kashmir. In this regard, Pakistan is currently budgeting an additional Rs 22m.
The development of mental health services in Pakistan can be divided into four stages
First Stage (1947-1979)
During this period, mental health services were provided through mental hospitals and asylums. The focus was on the institutionalization of psychiatric patients rather than the treatment of their disorders. The Mental Health Act of 1947 was the first law to be passed in Pakistan that dealt with mental health.
Second Stage (1980-1999)
The second stage saw a shift in the national level of focus from institutional care to community-based care. Mental health services were provided through primary care clinics, outpatient clinics, and mental health units. The National Institute of Mental Health was established in 1986 to provide training and research in the field of mental health.
Third Stage (2000-2010)
The third stage was characterized by the development of mental health policies and the establishment of mental health facilities in remote areas of developing countries and developed countries. The Mental Health Ordinance of 2001 was a major step towards improving mental health care in Pakistan. The ordinance aimed to protect the rights of mental health patients and to provide them with access to treatment and care.
Fourth Stage (2011-Present)
The fourth stage is characterized by the integration of mental health services into the general health system. Mental health care is provided through primary care clinics, district hospitals, and tertiary care hospitals. The Mental Health Act of 2017 was passed to provide legal protection to mental health patients and to promote mental health literacy in the country.
Mental Health Literacy and Services in Pakistan
Mental health literacy is an important aspect of mental health, as it refers to the knowledge and understanding that individuals have about mental health disorders, their symptoms, causes, and available treatments. Unfortunately, mental health literacy in Pakistan is still low, which contributes to the stigma surrounding mental health problems and the reluctance of individuals to seek help.
Despite this, mental health services in Pakistan are available in both public and private sectors. Public sector facilities include mental hospitals and psychiatric units, while private sector facilities include clinics and hospitals with specialized mental health services. However, the quality of mental health services can vary widely, and there is a shortage of mental health professionals in the country.
Mental Health in Pakistan
Mental health disorders are prevalent in Pakistan and affect individuals of all ages, genders, and socioeconomic backgrounds. Common mental illnesses in Pakistan include anxiety disorders, depressive disorders, and obsessive-compulsive disorder. Severe mental illnesses, such as schizophrenia and bipolar disorder, are also prevalent in the country. Mental health issues in Pakistan are further complicated by the lack of mental health literacy among the general population, as well as the prevalence of traditional healing practices sought by Muslim psychiatric patients.
Mental Health Disorders in Pakistan
Mental health disorders are common in Pakistan, with an estimated 34% of the population experiencing some form of a mental illness or health issue. Despite this, mental health literacy in the country is low, and many people do not understand the symptoms and treatment options for mental illnesses. As a result, mental health problems are often left untreated, leading to significant negative impacts on individuals and society as a whole.
The Mental Health Act was introduced in Pakistan in 2001, but its implementation has been slow. There is a lack of mental health facilities in the country, and those that do exist are often overcrowded and under-resourced. Additionally, there is a shortage of psychiatrist or a psychologist, with only 400 psychiatrists and 500 clinical psychologists serving a population of over 220 million. The most common mental health disorders in Pakistan are:
Common Mental Illnesses in Pakistan
Mental health issues affect a significant proportion of the population in Pakistan, and the prevalence of these issues is increasing rapidly. According to a study published in the Journal of Pakistan Medical Association, approximately 34% of Pakistanis suffer from some form of mental health disorder. This means that over 65 million people in the country may require some form of mental health services.
Anxiety Disorders
Anxiety disorders are among the most common mental health disorders in Pakistan. This group of disorders includes generalized anxiety disorder, panic disorder, and phobias. These disorders are characterized by excessive worry, fear, and avoidance behavior. According to a study published in the Journal of Pakistan Medical Association, the prevalence of anxiety disorders in Pakistan is around 7%.
Depressive Disorders
Depressive disorders are another common mental health issue in Pakistan. These disorders are characterized by persistent feelings of sadness, hopelessness, and loss of interest in daily activities. Major depressive disorder and dysthymia are the two most common depressive disorders. According to a study published in the Journal of Ayub Medical College Abbottabad, the prevalence of depressive disorders in Pakistan is around 16%.
Obsessive-Compulsive Disorder
Obsessive-compulsive disorder (OCD) is a type of anxiety disorder that is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). OCD can have a significant impact on a person’s life, making it difficult to perform daily tasks. According to a study published in the Journal of Pakistan Medical Association, the prevalence of OCD in Pakistan is around 2%.
Substance Abuse Disorders
Substance abuse disorders are also prevalent in Pakistan. These disorders are characterized by the excessive use of drugs or alcohol, which can lead to a range of physical and mental health issues. According to a study published in the Journal of Pakistan Medical Association, the prevalence of substance abuse disorders in Pakistan is around 5%.
Severe Mental Illnesses
Severe mental illnesses refer to a group of disorders or psychiatric illnesses that have a significant impact on a person’s life. These disorders are usually chronic and can require long-term treatment. The most common severe mental and psychiatric illnesses here in Pakistan are schizophrenia, bipolar disorder, and personality disorders.
Schizophrenia
Schizophrenia is a severe mental illness that affects approximately 1% of the population worldwide. The disorder is characterized by a range of symptoms, including delusions, hallucinations, disordered thinking, and behavior. According to a study published in the Journal of Pakistan Medical Association, the prevalence of schizophrenia in Pakistan is around 0.5%.
Bipolar Disorder
Bipolar disorder, also known as manic-depressive illness, is a severe mental illness that is characterized by extreme mood swings. People with bipolar disorder experience episodes of mania (elevated mood) and depression. According to a study published in the Journal of Ayub Medical College Abbottabad, the prevalence of bipolar disorder in Pakistan is around 1%.
Personality Disorders
Personality disorders are a group of mental health disorders that are characterized by long-standing patterns of behavior that deviate from social norms. These patterns of behavior can lead to significant distress or impairment in daily functioning. According to a study published in the Journal of Pakistan Medical Association, the prevalence of personality disorders in Pakistan is around 1%.
Mental Health Care in Pakistan
Mental health is an integral part of overall health and well-being, yet it is often neglected in Pakistan. According to the World Health Organization, one in four people will experience a mental health issue at some point in their lives. Despite this, there are significant gaps in mental health services in Pakistan, particularly in rural areas.
Mental Health Professionals
There is a shortage of psychologists in Pakistan, which is a major challenge in providing adequate mental health care. According to a report by the Pakistan Psychiatric Society, there are only around 400 registered psychiatrists in the country. This means that there is only one psychiatrist for every 300,000 people.
Clinical psychologists are another essential part of the mental health workforce. There are around 400 registered clinical psychologists in Pakistan, which is far too few to meet the needs of the population. The shortage of psychologists means that many people with mental health issues do not receive appropriate care.
Mental Health Literacy
Mental health literacy or mental healthcare, is the knowledge and beliefs about mental health disorders that help people recognize, manage, and prevent these disorders. Low mental health literacy can lead to delayed or inadequate care, which can worsen mental health outcomes.
There is a significant lack of mental health literacy in Pakistan. Many people do not understand mental health disorders or believe in traditional healing practices instead of seeking professional care. The stigma surrounding mental health issues also contributes to low mental health literacy.
Mental Health Education
Education is essential for improving mental health literacy and promoting better mental health outcomes. However, mental health education is not a priority in Pakistan. Mental health is not taught as a separate subject in most medical colleges, and there is limited training in mental health care for primary care physicians.
There is a need for more comprehensive mental health education in Pakistan. Medical colleges should include mental health as a separate subject in undergraduate training, and all health professionals should receive training in mental health care.
Mental Health Law
The Mental Health Act of 2001 is the primary law that governs mental health care in Pakistan. However, the implementation of this law is inadequate, and there are significant gaps in mental health legislation.
The Mental Health Act does not provide for the protection of the rights of people with mental health issues or ensure access to care. There is a need for comprehensive mental health legislation that addresses the rights of people with mental health issues and promotes access to care.
The Role of Mental Health Professionals
The shortage of mental health professionals in Pakistan is a significant barrier to the development of mental health services in the country. While there are some undergraduate medical education programs that offer courses in psychiatry and psychology, there is a lack of postgraduate training programs for mental health professionals. As a result, many medical students and physicians are not adequately trained to diagnose and treat mental illnesses.
The Pakistan Psychiatric Society and the World Psychiatric Association are working to address these issues by developing countries promoting mental health education and training programs in the country. However, there are still significant challenges to be addressed, particularly in rural areas where access to mental health care is limited.
Mental Health Professionals in Pakistan
The mental health workforce in Pakistan is still quite small, with only around 350 psychiatrists and 500 clinical psychologists serving a population of more than 200 million. There is a significant shortage of psychiatrists or a psychologist in the country, particularly in rural areas.
Clinical Psychologists
Clinical psychologists are mental health professionals who specialize in the diagnosis and treatment of mental health disorders. They use psychological therapies to help people with mental health disorders improve their mental health and well-being.
Undergraduate Medical Education
Undergraduate diploma courses for medical education in Pakistan now includes mental health education, which is a positive step toward addressing the shortage of psychiatrist or a psychologist in the country. Medical students learn about common mental illnesses and how to diagnose and treat them.
Medical Students
Medical students in Pakistan can specialize in Psychiatry and Psychology, which provides them with the knowledge and communication skills needed to diagnose and treat mental health disorders.
Activities with non-governmental organisations
Non-governmental organizations (NGOs) play a vital role in the development of mental health services in Pakistan and developing world. These organizations often work in collaboration with the government and other stakeholders to promote mental health awareness, improve mental health literacy, and community based services, and provide mental health services to the community.
NGOs in Pakistan focus on different areas of mental health, such as advocacy, prevention, treatment, and rehabilitation. They conduct various activities to promote mental health, such as workshops, seminars, and awareness campaigns. They also provide counseling services and referrals to a psychiatrist or a psychologist for people in need of psychological medicine.
Patient’s expectations from mental health system
Patients with mental health disorders have certain expectations from the mental health system in Pakistan. These expectations include
Accessibility – Patients expect that mental health services should be easily accessible and available to everyone regardless of their location, income, or social status. They also expect that mental health facilities should be located in convenient and easily accessible locations.
Affordability – Patients expect that mental health services should be affordable and not cost-prohibitive. They also expect that the government should provide subsidies or financial assistance to make mental well-being services more affordable for low-income families.
Quality of care – Patients expect that psychiatrist or a psychologist should provide high-quality care that is evidence-based and tailored to their individual needs. They also expect that a psychiatrist or a psychologist should be well-trained, experienced, and have the necessary qualifications to provide effective treatment.
Privacy and confidentiality – Patients expect that their privacy and confidentiality should be respected and protected by psychiatrist or a psychologist. They also expect that their personal information should not be shared with anyone without their consent.
Respect and empathy – Patients expect that family physicians and mental well-beingprofessionals should treat them with respect, empathy, and compassion. They also expect that mental well-beingprofessionals should listen to them attentively and take their concerns seriously.
Availability of support – Patients expect that mental health facilities should provide support and resources for both patients presenting their families and caregivers. They also expect that psychologist should be available for follow-up appointments and consultations.
Overall, patients expect that mental health services should be patient-centered and focused on their needs and preferences. The mental health system in Pakistan needs to address these expectations to provide effective and accessible mental health care to those in need.
Areas of interest
Psychologists in Pakistan are interested in various areas related to mental health, including psychiatric epidemiology, psychological therapies, and complementary and alternative medicine (CAM).
Psychiatric epidemiology is concerned with the study of the distribution and determinants of mental disorders in populations. It aims to identify risk factors, protective factors, and the prevalence of mental disorders.
Psychological therapies refer to the different approaches used by mental health professionals to treat mental illness. These include cognitive-behavioral therapy, psychoanalytic therapy, and group therapy.
CAM refers to treatments that are not part of conventional medicine, such as herbal medicine, acupuncture, and yoga. Mental health professionals in Pakistan are interested in CAM as it is often used by patients, and they need to be aware of its potential benefits and risks.
Techniques which patients find helpful
Patients with mental health disorders in Pakistan often seek complementary and alternative medicine (CAM) and traditional healing practices. Some of the techniques that patients find helpful include
Spiritual and religious practices – Many patients find solace in religious and spiritual practices, such as meditation, prayer, and attending religious gatherings. These practices help them cope with stress, anxiety, and other mental health issues.
Traditional healing practices – Patients in Pakistan often seek help from native faith healers who use traditional healing practices, such as herbal remedies, massages, and cupping therapy. These traditional healing practices sought and the faith healers are deeply ingrained in the cultural beliefs of many people in Pakistan.
Psychological therapies – Psychological therapies, such as cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic therapy, are becoming more widely available in Pakistan. These therapies help patients identify and change negative thought patterns and behaviors that contribute to their mental health and psychological problems.
Exercise – Regular physical exercise, such as walking, running, and yoga, can have a positive impact on mental health. Exercise has been shown to reduce symptoms of anxiety and depression and improve overall mood.
Medication – In some cases, patients may benefit from medication to manage symptoms of mental health disorders. Medications, such as antidepressants and antipsychotics, are often prescribed by mental health professionals in Pakistan.
It’s important to note that patients may find different therapeutic techniques more helpful depending on their individual circumstances and cultural backgrounds. Mental health professionals in Pakistan should be aware of and sensitive to these differences when working with patients.
Mental Health Policies and Legislation in Pakistan
The Mental Health Act of 2001 is the primary legislation governing mental health in Pakistan. It outlines the rights of individuals with mental health disorders, including the right to access mental health services and the right to be treated with dignity and respect.
However, implementation of the Mental Health Act has been slow, and there is a need for greater investment in mental health services and facilities. The Mental Health Atlas of Pakistan, published by the World Health Organization in 2017, highlights the need for better integration of mental health services into existing health systems and the need for increased funding for mental health.
Conclusion
In conclusion, mental health is a crucial aspect of overall health and well-being. Unfortunately, in Pakistan, mental health disorders and issues are still highly stigmatized and under-addressed. The country faces significant challenges in providing adequate mental health care services, including limited resources, inadequate mental health literacy, and reliance on traditional healing practices.
Mental health professionals, such as clinical psychologists, play a critical role in addressing these challenges. Undergraduate medical education programs in Pakistan should prioritize mental health education to improve mental health literacy among medical students.
To improve mental health care services in Pakistan, there needs to be a coordinated effort to strengthen the mental health system, including the establishment of mental health facilities, the implementation of mental health laws, and the integration of mental health care into primary care settings. Patient’s expectations of mental health care services should also be considered, with a focus on providing patient-centered care and addressing the unique cultural and religious factors that impact mental health.
The use of complementary and alternative medicine and traditional healing practices in forensic psychiatry should also be acknowledged and explored further to identify effective therapeutic techniques that patients find helpful. Furthermore, research should continue to be conducted to inform the development of evidence-based psychological therapies for common mental illnesses, such as anxiety and depressive disorders, in Pakistan the developed world and developing countries.
In summary, the development of mental health services in Pakistan is a complex issue that requires a multifaceted approach, including increased mental health literacy, the expansion of mental health care services, and the incorporation of patient-centered care. By prioritizing mental health, Pakistan can improve the overall well-being and quality of life of its citizens.
FAQs
What is the difference between psychologist and psychiatrist in Pakistan?
In Pakistan, a psychologist is a mental health professional who has a degree in psychology and is trained to provide therapy and counseling to individuals, groups, and families. Psychologists use various techniques to diagnose and treat mental health issues and help their clients improve their well-being. On the other hand, a psychiatrist is a medical doctor who specializes in the diagnosis, treatment, and prevention of mental health disorders. They can prescribe medication to their patients, as well as provide therapy and counseling.
What is the meaning of psychology and psychiatry?
Psychology is the scientific study of the human mind and behavior. It encompasses a broad range of topics, including perception, cognition, emotion, motivation, personality, social interaction, and mental health. Psychologists use various research methods to understand and explain human behavior, as well as to develop and test interventions to improve mental health.
Psychiatry is a branch of medicine that focuses on social psychiatry and the diagnosis, treatment, and prevention of mental health disorders. Psychiatrists are medical doctors who have specialized training in mental health and psychological medicine and can prescribe medication to their patients. They use various techniques, such as psychotherapy, to help their patients manage and overcome mental health issues.
What is the 2 difference between psychology and psychiatry?
One key difference between psychology and psychiatry is the educational and professional background of practitioners. Psychologists typically have a degree in psychology and may hold a Ph.D. or a Psy.D., while psychiatrists are medical doctors who have completed medical school and specialized training in psychiatry.
Another difference between psychology and psychiatry is the focus on treatment. Psychologists typically provide talk therapy, using various techniques such as cognitive-behavioral therapy, while psychiatrists can prescribe medication and may also provide talk therapy.
How many years does it take to become a psychiatrist in Pakistan?
In Pakistan, becoming a psychiatrist requires several years of education and training. After completing a Bachelor of Medicine and Bachelor of Surgery (MBBS) degree, which takes five years, one must complete a one-year internship and then apply for a postgraduate training program in psychiatry. The postgraduate training program in psychiatry takes four years to complete, leading to a degree of FCPS (Fellow of the College of Physicians and Surgeons). So, in total, it takes at least 10 years of education and training to become a psychiatrist in Pakistan.