Have Terrorism, Floods, Poverty Left 1/3 of Pakistanis Mentally Ill?

This The News article about a mental health conference in Peshawar, northern Pakistan, alleges that 1 in 3 Pakistanis suffers from mental health problems as a result of the terrorist attacks of recent years and this past summer’s massive flooding. Bombing campaigns have struck areas such as Swat Valley in the north as well as major cities such as Rawalpindi, Lahore and Karachi, spreading a sense of dread and insecurity. The Great Deluge of 2010 affected 20 million Pakistanis and left 8 million of them in need of temporary housing.

The significance of the 33% figure is hard to judge without knowing more about the authors’ definitions. Persons with a mental illness sometime during the year in the US are estimated at between 15 and 20 percent of the population. This statistic concerns persons with a cluster of mental problems that interferes with their ordinary functioning. A much larger proportion have what US psychiatrists call ‘mental health problems’ (one study suggested that over 80 percent of people in Manhattan suffer from such maladies.) If the Peshawar mental health professionals are saying that a third of Pakistanis have a cluster of mental problems that prevent them from coping with life, then Pakistan’s rate would be twice that of the US (a much, much wealthier and more secure country). But it is more likely that the one-third proportion refers to mental health conditions rather than debilitating clusters.

Other authorities estimate the mentally ill at closer to 9 percent of the population.

An overview of the issue in Pakistan is here.

Given that a third of Pakistanis live on a dollar a day, that terrorist bombings have become widespread and all too frequent, and that drug addiction has spread as Afghanistan poppies and heroin have created a transit route through Pakistan, the 1/3 figure may be plausible regarding people with a mental condition.

Posted in Pakistan | 6 Responses | Print |

6 Responses

  1. While I am as far from a doctor as one could imagine, I think I can offer two diagnoses for our Pakistani allies: Drapetomia (the US-slave disorder causing a wish to run away) Dysaethesia Aethiopica (“rascality” of same) to name just two.

    What does our money buy there anyway?

  2. What would be the best way of measuring if 1/3 of the population is mentally ill? Perhaps a survey: “What is the President’s religion? Was he born in our country? Is he constitutionally barred from serving in his office? What are his goals for the nation? Is climate change real?”

    More seriously, I would not be surprised if between the nation’s poverty, overpopulation, and a huge environmental crisis a significant percentage of the population is showing signs of acute mental illness, although I would expect that things will normalize as the crisis passes. It’s not just that people adapt – I think people and societies recover from shared trauma much better than they do with individual trauma. People who suffer individual trauma seem more apt to focus on their own losses (Why me? What did I do to deserve this?) while society at large often attempts to insulate itself from the idea that “it could happen to me, as well” (He must have done something to deserve it). A shared trauma is much less likely to make somebody feel like their loss is worse than that of others, or that they’re somehow being punished. A massive shared trauma can also necessitate pulling together in ways that would not otherwise occur.

    To the extent that the broad provision of mental health services is to occur in a nation like Pakistan, it seems to me that it would have to be through a network of “lay counselors”, trained and to the extent possible supervised by mental health professionals, primarily operating through group sessions that are open to the public. Even then, resources would likely be stretched very thin.

  3. Let’s make it clear at the outset that I am not making light of the tragedy in Pakistan, but 1/3 of America’s electorate have succumbed to mental illness for the same reasons.

    We need a more solid “Sister Cities In Tragedy” program.

    • I appreciate and endorse your preface.

      It must be said that while the US does not do a skillful job of bridging the divide between Pakistan, Afghanistan and we might as well include Iran in this, the violence simply barricades future progress in the vast region mentioned.

      Recall that we had Iran offering help in this area as recently as nine years ago. Partnership could have born fruit if we could place more trust in potential allies in this most difficult of regions to navigate (i.e., forget domination.

  4. Let´s not forget that 100 years ago, children were declared mentally ill (and thus unfit to leave Ellis Island and immigrate to the US) when they associated the picture of a rabbit with “food” instead of “cute”.
    What is “mentally ill”? Sleep disturbance? Mood swings? Feelings of hopelessness? In the US, you might very well get a prescription for antidpressants for this these days. But who wouldn´t suffer from these symptoms with a permanently empty stomach, flea in the mattress and no idea where and how you will live a month from now? I´d say it´s rather a healthy reaction to feel depressed under these circumstances. It´s definitely a sign that you can still tell right from wrong even after having had to endure “wrong” for so long. And that, again, is the basis for national recovery once war and flood are over instead of falling into a state of agony like Haiti.

    Drug addiction on the oher hand is, under these circumstances, a very serious national mental health matter. I´m pretty sure that crises of the individuum constitute a dwindling pecentage of even those Pakistani mental health cases overall that do receive treatment. Most will be addicts, paranoid schizophrenics and manic depressives (like anywhere else on world independent of circumstance).
    So while it´s definitely important to feel with the Pakistani in their everyday worries, we better be careful to label something a mental illness before we´ve made clear what that is, for us.

  5. Prof Cole.

    I have been a regular reader of your blog for last 6 years. I have learnt tremendously from you. I am originally from Lahore, Pakistan. Grew up and lived there. I would like to add to it.

    Prof Cole, more than these tangible factors that have been referred to, other metaphysical factors are more more responsible, according to me. In Pakistan there is a culture of contempt for the commonality on the part of the authority. The state is in the state of dysfunction. No services are being delivered to the public that are necessary for a decent living. If your electric power is off, your telephone line is out of order, your sewage in the street is overflowing, or you require service of police because your vehicle has been stolen, you will need to visit the relevant government office. In each of these offices, wherever you go, you encounter arrogance and incompetency of the officials. Imagine you want to lodge a complaint to a Superintendent of Police (SP), because you have been a victim of high-handedness of some petty police office. In the first place it is so hard to see him in person. And if , somehow, you succeed in seeing him and he lets you in his office. You stand in his office, and he is sitting before you, arrogant, supercilious and disdainful. You are made to believe that there is no limit to your inferiority in front of him. You are treated disrespectfully and are given a short shrift. And afterwards there is no one to follow up on your application. This is a story of every office. It happens daily, in the life of every Pakistani. It breaks your self-respect and breaks your soul. It ages you and you cannot recover from it, if you have lived your 30 years in that country. Apart from pecuniary aspects, floods, or other mundane reasons, it is this destruction of your soul and ego that makes you mentally ill.

    This is what I have felt, and this is what I have experienced.

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