Mental Healthcare in Pakistan

10.4103/TPSY.TPSY_8_20

Afzal Javed；Muhammad Nasar Sayeed Khan；Amina Nasar；Alina Rasheed

mental health system ； psychiatrist's education ； psychiatry ； stigma

台灣精神醫學

34卷1期（2020 / 03 / 01）

6 - 14

英文

Background: According to the latest report, over 15 million people in Pakistan are suffering from some form of mental illness. But for a population of 220 million, only 400 trained psychiatrists exist with few state-run psychiatric hospitals and a small number of psychiatric units in teaching and general hospitals. In a traditionalist society, there is frequently a social disgrace together with discussing dysfunctional or abnormal behaviors as mental health problems and is generally described as a ＂shortcoming of character.＂ Methods: We carried out comprehensive literature review to collect data on the current mental health picture in Pakistan, and we also compared and formulated the recommendations from the literature of the related countries in the region and developed countries whenever possible. Results: Mental healthcare is still not a priority in the health system in Pakistan. A dire need still exists for a recognition from both public and private sectors for improving mental health planning and services in the country. Government must actualize social strategies that should be simple, equitable, and practical, as well as being able to address the issues of the regular needs. Asset allotment for emotional wellness is horrifyingly low and wasted away by defilement and fumble. A requirement exists for expanded spending on mental healthcare and psychological and emotional well-being just as appropriate usage of accessible assets. Conclusion: In this review, we suggest that a progressive change is required in the current state of psychiatry in Pakistan and that a need exists for a continuing review about existing strategies with a focus on setting sustainable priorities in the field of mental health, especially in policymaking, capacity building, awareness among public, and the use of media to minimize stigma.

1. Ali, TM,Gul, S(2018).Mental health services in Pakistan.Psychol Commu Health,7,57-71.
   連結：
2. Afridi, MI(2008).Mental health: priorities in Pakistan.J Pak Med Assoc,58,225-226.
3. Ali, N,McLachlan, N,Kanwar, S(2017).Pakistani young people’s views on barriers to accessing mental health services.Int J Cult Ment Health,10,33-43.
4. Bashir, A(2018).The state of mental health care in Pakistan.Lancet Psychiatry,5,471.
5. Bhurga, D(ed.),Tse, S(ed.),Ng, R(ed.)(2016).Routledge Handbook of Psychiatry in Asia.London, United Kingdom:Routledge.
6. Burns, A(ed.),Robert, PP(ed.)(2019).Dementia Care: International Perspectives.London, UK:Oxford University Press.
7. Christodoulou, GN(ed.),Mezzich, JE(ed.),Christodoulou, NG(ed.)(2016).Disasters: Mental Health Context and Responses.In London, UK:Cambridge Scholars Publishing.
8. Farooqi, YN(2006).Traditional healing practices sought by Muslim psychiatric patients in Lahore, Pakistan.Int J Disability Devel Edu,53,401-415.
9. Gadit, AA(2007).Psychiatry in Pakistan: 1947-2006: a new balance sheet.J Med Biol Sci,1,1-20.
10. Gadit, AM(2006).Mental health research in Pakistan and the developing world (an editorial).J Coll Physicians Surg Pak,16,169-170.
11. Gilani, AI,Gilani, UI,Kasi, PM(2005).Psychiatric health laws in Pakistan: from lunacy to mental health.PLoS Med,2,e317.
12. Gilbert, MJ(2017).South Asia in World History.New York:Oxford University Press.
13. Government of Pakistan: Ministry of Finance Economic Survey of Pakistan 2016-17. Islamabad: Government of Pakistan, 2016.
14. Government of Pakistan: Economic Indicators 2019 Islamabad: Pakistan Finance Division. Islamabad: Government of Pakistan, 2019.
15. Hassan, T,Nizami, AT,Hirji, S(2015).Forensic psychiatry in Pakistan.Int J Law Psychiatry,41,95-104.
16. Husain, N,Chaudhry, IB,Afridi, MA(2007).Life stress and depression in a tribal area of Pakistan.Br J Psychiatry,190,36-41.
17. Imran, N(2017).Innovative ways to promote children’s mental health: developing accessible and sustainable school mental health services in Pakistan 2017.Ann King Edward Med Univ,24,565-567.
18. Imran, N,Azee, MW,Javed, A(2018).Child and adolescent psychiatry in Pakistan: current scenario and future direction.World Child Adolesc Psychiatry,15,16-18.
19. Irfan, M(2013).Integration of mental health in primary care in Pakistan.J Postgrad Med Inst,27,349-351.
20. Isaac, M,Ahmed, HU,Chaturvedi, SK(2018).Postgraduate training in psychiatry in Asia.Curr Opin Psychiatry,31,396-402.
21. Javed, MA,Chaudhry, MR(2000).Rehabilitation psychiatry-description of a pioneering facility in Pakistan.Int J Rehabil Res,23,331-332.
22. Javed, MA,Chaudhry, UR,Sulanan, T(1993).Agrotherapy: new concepts of rehabilitation for chronic schizophrenics in Pakistan.J Pak Med Assoc,43,251-253.
23. Karim, MS,Mahmood, MA(1999).Health Systems in Pakistan: A Descriptive Analysis.Karachi:Department of Community Health Sciences, Aga Khan University.
24. Keely TS: One hundred years of lunacy administration. Camb Law J 1943; 8: 195-200.
25. Ministry of Planning, Development and Reform(2014).Pakistan 2025: One Nation, One Vision.Islamabad:Planning Commission, Government of Pakistan.
26. Mirza, I,Jenkins, R(2004).Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: a systematic review.Br Med J,328,794.
27. Mirza, I,Mujtaba, M,Chaudhry, H(2006).Primary mental health care in rural Punjab, Pakistan: providers, and user perspectives of the effectiveness of treatments.Soc Sci Med,63,593-597.
28. Mohiuddin, YN(2006).Pakistan: A Global Studies Handbook.Santa Barbara, California, USA:ABC-CLIO Publishers.
29. Mubbashar, MH(2003).Development of mental health services in Pakistan.Int Psychiatry,7,392-396.
30. Mukhia, H(2004).The Mughals of India.New Delhi:Wiley-Blackwell.
31. Naeem, F,Ayub, M(2014).Psychiatric training in Pakistan.Med Educ Online,9,19.
32. Naqvi, HA(2005).Mental health care and mental health legislation in Pakistan: no mercy for losers.PLoS Med,2,e397.
33. National Institute of Population Studies: Pakistan Demographic and Health Survey 2017-18. Islamabad, Pakistan, and Rockville, Maryland, USA: National Institute of Population Studies, 2018.
34. Niaz, U(2004).Women’s mental health in Pakistan.World Psychiatry,3,60-62.
35. Nizamie, SH,Goyal, N(2010).History of psychiatry in India.Indian J Psychiatry,52(Suppl 1),S7-S12.
36. Rana, MH,Farooq, S,Ali, S(2008).An outline of structured training programme (STP) for FCPS in psychiatry (intermediate module).J Pak Psychiatr Soc,5,58-64.
37. Saeed, K,Gater, R,Hussain, A(2000).The prevalence, classification and treatment of mental disorders among attenders of native faith healers in rural Pakistan.Soc Psychiatry Psychiatr Epidemiol,35,480-485.
38. Sathyanarayana Rao, TS(ed.)(2012).Psychiatry in India: Training and Training Centres.Misuru, India:Indian Journal of Psychiatry.
39. Shafique, M(1995).Psychiatry in Pakistan (1947-1994): the balance sheet.Psychiatr Bull,9,567-570.
40. Shaikh, BT,Hatcher, J(2005).Complementary and alternative medicine in Pakistan: prospects and limitations.Evid Based Complement Alternat Med,2,139-142.
41. Sharma, S,Varma, LP(1984).History of mental hospitals in Indian sub-continent.Indian J Psychiatry,26,295-300.
42. Syed, EU,Hussein, SA,Haidry, SE(2009).Prevalence of emotional and behavioural problems among primary school children in Karachi, Pakistan-multi informant survey.Indian J Pediatr,76,623-627.
43. Talbot, I,Singh, G(2009).Partition of India: the human dimension.Cult Soc Hist,6,403-410.
44. Tareen, A,Tareen, KI(2016).Mental health law in Pakistan.BJ Psych Int,13,67-69.
45. Tareen, IA(ed),Chaudhry, MS(ed),Javed, MA(ed)(1994).Current State of Psychiatry in Pakista.Lahore, Pakistan:Pakistan Psychiatric Society.
46. United Nations Development Programme=UNDP(2019).Human Development Report.New York:United Nations.
47. Varma, VK(ed.),Kulhara, P(ed.),Marselman, CM(ed.)(1998).Social Psychiatry: A Global Perspective.Delhi:Macmillan India.
48. World Health Organization(2009).,WHO Office Islamabad: WHO and Ministry of Pakistan.
49. World Health Organization(2017).Mental Health Atlas.Geneva:World Health Organization.