Mental Health in Pakistan: Yesterday, Today and Tomorrow

Abstract

Muslim communities have a peculiar mental health scenario. The Muslim communities in the precolonial Indian subcontinent did have mental health conceptions, later termed Muslim psychology. The introduction of formal mental health institutions implanted the Western notions and practices of mental health in British India. The Partition did not disturb the largely autonomous evolution of the two traditions. Drawing its sustenance from the West, Western style psychiatry and psychotherapy became an integral part of Pakistan’s officially maintained public health system, whereas the alternative practices have continued in the informal sector and benefitted from the increase in Islamization initiatives. The disruptions in the traditional way of social life in Pakistan, produced by factors such as the growing (disorderly) urban development, poverty, unemployment, cultural conflict and snowballing mistrust in state institutions, have significantly increased the incidence of mental health problems in Pakistan. In the case of Pakistan, the narratives about the nature and quality of the social environment have become a site of contestation between modernists and traditionalists in Pakistan, where the former would like the traditional cultural environment to make place for a modern social environment, putting individual freedom above the family and community. As the modernists dominate the cultural discourse in Pakistan, particularly in modern, urban settings, in their zeal to create strong sentiments in people against the traditional culture, the ‘everything is wrong and rotten in Pakistani society’, aided by the media, is creating an acquired helplessness, aggravating the mental health picture in Pakistan. Such a situation is unique to Muslim societies and sets these societies apart from the other societies in engaging with mental health problems. At the same time, the modern, affluent, urban sections of society are experiencing newer kinds of globalized life style linked to soft social pathologies, which become a fertile medium for serious mental ailments of epidemic proportions. The polarization on the questions of aetiologies and remedies has created a stalemate, which is helping nobody. The vacuum thus created should better be filled by research than the quackery of healers of different hues and shapes. Different traditions of mental health conceptions and practices in Pakistan need to develop a policy and practice consensus, with retooled techniques by the mental health professionals, to start addressing the pain and misery of growing mental health problems in Pakistan.