Abstract

<h3></h3> Deeply entrenched socio-cultural norms dictate everyday life In Pakistan and it is vital that correct attitudes towards Child and Adolescent Mental Health (CAMH) are fostered. In a sub-specialist field where early diagnosis is imperative in securing the best possible outcome, its importance cannot be over-emphasised and is of public interest. Despite having potentially life-long consequences, there is inadequate awareness, scarce CAMH facilities and a significant dearth of research about CAMH in Pakistan. This study aims to explore the views of doctors and students towards Paediatric Psychiatry in Pakistan. Doctors were recruited by convenience sampling and a snowballing method was used to recruit participants. They were asked to complete an online survey and data was analysed both quantitatively and qualitatively. Approval was granted by the Research &amp; Development Department at South West London and St George’s Mental Health NHS Trust, UK. There were 80 participants; the vast majority 50(62.5%) were Paediatric doctors, 30(37.5%) were other specialists/student doctors. 85% of all participants felt that increasing the number of child psychiatry specialists would be beneficial and all participants felt that the main issues facing CAMH in Pakistan are related to parents, infrastructure and taboos/socio-cultural stigma. Of the 50 paediatric doctors, 30/50(60%) had &lt;10years experience in Paediatrics. Identifying and referring to mental health specialists was the most common role of paediatric doctors 32/50(64%) in CAMH cases whereas 15/50(30%) reported that they are involved in initiating psychotropic treatment. Paediatric doctors felt less competent in prescribing psychotropic medication in children than in counselling parents where they felt more competent: 46/50(92%) of paediatric doctors reported being ‘little/not at all’ competent in prescribing psychotropic medication to children whereas 47/50(94%) reported feeling ‘little/very’ competent in counselling parents about CAMH issues. Taboo and socio-cultural stigma form a large barrier in CAMH in Pakistan and a specific anti-stigma campaign is needed to lift the veil of socio-cultural taboos, broaden the nation’s vision and gain a clear perspective. The way forward requires multidisciplinary collaboration to educate, empower and engage all levels of society. Improving infrastructure, living environment and economic stability as well as promoting public and professional education is vital. Media campaigns involving celebrities/influential figures and leaders (political and religious) need to be disseminated to bring Paediatric Psychiatry into the limelight. Increased emphasis on identifying and managing CAMH disorders will help shift socio-cultural norms to remove the shackles of stigma and relieve the silenced agony.

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