In Pakistan, suffering from a mental health disorder is a source of shame. One that applies not only to the individual, but also to anyone associated with them. Pakistani society is bound together by the social pressure of “loug kya kahenge”. This coerces individuals to keep their issues to themselves instead of seeking the help they may need, as well as denying nationwide exposure on these issues.
Pakistan’s brand of stigma around mental health is a unique one. It is interesting to examine when looking at the facts. According to the World Health Organisation, 25 per cent of Pakistani’s suffer from mental health illnesses. Sixty per cent of Pakistani’s live in rural areas with little to no access to effective health and educational facilities. Add to this the statistic that certain mental health illnesses such as depression and anxiety affect women more than men. Couple the facts with Pakistan’s complex interplay of religion, culture, urban legends, illiteracy and patriarcy and you’re left with Pakistani society’s unique perception of mental health and a stigma that is intensified ten-fold.
In addition to the stigma lies the harmful stereotyping of individuals with mental health disorders. Trivialising individuals as ‘crazy’ or ‘dangerous’ is a convenient way to dismiss and exclude them from families, friends and social gatherings. Moreover, it is an easy justification for discrimination and prejudice. Those suffering from mental health disorders are assumed to have had a direct role to play in acquiring their illness and there is oftentimes no acknowledgment that these issues stem from complex and multiple contributing factors.
The issue with negative public perceptions of mental health is that the resulting effect may be the individual beginning to internalise negative associations with themselves and their condition. This ultimately results in feelings of hopelessness, low self-esteem and distress, worsening the problems they are already facing. Those battling with these illnesses are therefore encouraged to suffer in silence, hide their symptoms, isolate themselves and be reluctant to speak out or get help.
Another unfortunate side-effect of the negativity is an aversion to the fields of psychology and psychiatry. I remember opening up to my family members of the possibility of perusing psychology in my higher education. “If you’re not mad when you start, you will be by the time you’re done” was their reaction.
Many brilliant minds are encouraged to pursue other professions because they are more “well-regarded”. This is especially unfortunate in the context of the severe social stigma around mental health issues and therapy in Pakistan. In a country that is in dire need of better mental health professionals and facilities, it is imperative that we encourage our youth to look into the possibility of these fields as career options. Otherwise we risk aggravating an already prevalent issue.
The problem is that within our society, given the lack of education or awareness on mental health issues, these problems are barely understood let alone considered legitimate health problems. For those suffering with these issues, taking the first step and confiding in someone or opening up about these problems becomes incredibly difficult because this lack of understanding can lead to people using these issues against them.
The first step we can take to attempt to remove stigma is to work at an individual level. Only then can this catalyst social change. Let’s start here: it is untrue that people suffering from mental health issues do not recover. It is further untrue that their illness is a result of a personality or character flaw. Depression is not equivalent to over-sensitivity or “playing the victim” and the acts of self-harming are not an attention-seeking grab. It is also wrong to assume that mental health issues are the result of religious anecdotes and can be fixed with a simple visit to a faith-healer. Although research has proven that prayers and meditation can help depression and anxiety, this cannot be the begin all and end all. Most importantly, it is false to believe that those suffering from mental health issues are categorically unable to partake as effective members of society.
It is imperative to begin an open discourse about mental health: be it our own struggles or the struggles of someone around us. We should attempt to educate ourselves and others about the parallels between physical and mental health and be cautious of the type of language we use so as to not belittle the experiences of those with those conditions.
We cannot continue to dismiss mental health in this manner when it is affecting 25 per cent of our population. We cannot and should not continue to silence ourselves over the prevalence of mental health because society dictates that we should. We cannot continue to lose lives because our ignorance makes us unwilling to accept realities.