When the term psychiatry pops into mind, it makes one think of the exaggerated narratives we see on our screens in films and dramas. However, it remains one of the most important aspects of our society to date. Psychiatry refers to the branch of medicine concerned with the study, diagnosis, and treatment of mental illnesses. As there are physical ailments of the human body treated by doctors in their respective fields and departments, similarly, the illness of the mind and struggles with mental health are also given due diligence in medicine through psychiatry, for a holistic approach.
Medicine aims to treat a person entirely, mind, body, and soul, and thus we have a branch that deals entirely with the wellness of the mind within psychiatry. It is a branch of medicine I really want to pursue further, for I have personally seen the many unfounded myths associated with this neglected domain, and the sparse representation of females from KP and beyond. The inadequate awareness level on the subject is causing harm to us as a community. Sadly, the whole country has a horrible image and understanding of the subject.
Having worked in various areas from tertiary government hospitals, in far-flung medical encampments for the underprivileged sectors of KP, and now my engagement with the patient care system in the United Kingdom, I have had significant experiences that have opened my eyes. Deplorably, our understanding of psychiatry is a poor one.
Working in psychiatry in Pakistan, especially KP, is fraught with too many dangers. On one hand, one is judged for being a female who has the gall to chart into the territory of traditional pirs and other established religious Babas (as they are known in their communities), and on the other hand, a female who has to navigate the entrenched patriarchal bounds. This subject offered to me many uncharted opportunities. One of them is to seek and understand the mental disorders that are prevalent within my community.
Psychiatry has long been shrouded in mystery, whispered about in hushed tones within families and communities, perpetuating myths and superstitions. It has often been treated as a taboo subject, with specialists being misconstrued as "crazy people doctors" or even heretics ('kaafir').
It has often been viewed as a place for "crazy people," a bedlam that inspires fear and stigmatisation. This fear has led many in desperate need of mental health care to shun treatment. In some cases, families have used severe diagnoses as an excuse to abandon struggling members, and misinterpreted illnesses have even been cited as grounds for divorce.
This lack of education into fundamental mental health illnesses often stems from tales whispered around homes which often get mixed in with religious sentiments, misinterpreted by community scholars and other traditional elders. When such elements come into play, it can be difficult to destigmatise and assure people that we are speaking of genuine disorders in a medical context rather than purely religious affairs or divine punishments.
Moreover, we have seen many patients come to us after having seen faith healers, who often fail in their endeavours to heal the patient and leave them worsening in their ailments. For example, the practices of burning the insides of the nose and trying to cast the evil out, which leaves the person more traumatised than before. This traditional approach is still preferred in most parts of KP.
That is not to say there exist no right moments for faith healers to step in. But often, it simply isn’t the case that they can help. More often than not, simple, researched, and defined disorders are mistreated, and even trying to educate people on the medical understanding regarding the mind proves difficult.
Professional mental healthcare is more widely accepted in Western civilisation, as I noticed while working in a hospital in the UK. Usually, a mental health professional is a permanent member of every medical team and is thoroughly empowered to analyse the patient entirely. He/she is an important part of the team, to provide physical and mental support. This is one of the main differences between us and them: that mental health is widely celebrated and is honed carefully in Western society, and is often given grace and due value at every level.
The journey into psychiatry in Pakistan is fraught with peril, especially for women who must challenge both religious Babas and a patriarchal system
The people are more receptive and lean heavily onto the mental wellness system when they require it. This recourse is not stigmatised; rather, it is championed as self-care. Education and awareness into disorders and mental health is integrated into every level from nursery to senior care, homes as well as within every segment of work and life.
There are stark differences in both worlds of mental health in regards to awareness, education, assistance, and rehabilitation, to name a few. Where there is a willingness to learn and adapt to the troves of knowledge around mental health and its various branches in the West—promoted by media, teaching facilities at schools and community centres, wellness centres, and mandatory awareness days in the UK—it remains a struggle to bring it up to the same level in Pakistan.
It is mainly the job of the governing bodies to allocate funds and speed up the spread of knowledge and awareness through media, as well as remove any misinterpretation of disorders and falsify myths in the region at the same time. Moreover, a wave of education needs to start at the foundation of our system, from the children right up to the top, with a supportive system in place to help those in need.
Although Pakistan, especially KP, has a long way to go in regards to this change in attitude towards mental health, it certainly did not spring up overnight in Western civilisation.
So, given the slow wave of awareness rising in the youth and with some effort and diligent work put in by the governing bodies of Pakistan, we can be hopeful that in time mental health will be taken at least as seriously as physical health.