Why do we need to talk about Mental Health in Pakistan?

Suicide by an unemployed youth inside a shopping mall in Karachi, a family tried to drown itself in the sea due to financial troubles in Karachi, a female policewoman committed suicide due to domestic issues in Rahim Yar Khan, suicide by a man in Rawalpindi just after two days after his marriage, and suicide by a girl in Badin allegedly due to social media blackmailing shows that the vulnerability cuts through regardless of age group, social class and gender in Pakistan.

Reportedly, around 13,000 people committed suicide in Pakistan in the year 2021. This might be an underestimation. Suicide is considered a criminal act according to the Pakistan Penal Code, which means all suicides have to be reported to the police and medical centers. However, most families cover up suicide incidents by reporting those suicides as accidental deaths because of fear of harassment from the police or want to avoid the complicated legal procedures or to avoid being a pariah by the society due to the social stigma that is associated with suicide.

If divided into gender, the suicide rate of men is two to three times higher than those of women. It is believed that by 2030 mental illness would be the leading cause of death worldwide.

Mental disorders are significantly related to suicides. Most of them are related to psychiatric diseases like depression, substance abuse disorders, and trauma-related disorders. According to one estimate, almost 90% of suicides were related to mental illness.

Psychological disorders may show a wide range of symptoms as they come in many forms. Some of those include mood disorders such as depression, personality disorders such as antisocial disorder, psychotic disorders such as schizophrenia, sexual disorders such as sexual dysfunction, and eating disorders such as anorexia nervosa.

Poverty is often connected to suicide cases but it is not the only reason. An online survey in Pakistan shows that poverty and financial strain and mental illness as the primary reason for suicides followed by the experience of being abused or bullied or strained family relationships as another reason for suicides. Divorce was seen as a low-risk factor in suicides.

Some personal narratives showed that forced marriages, breakups in relationships, domestic abuse by parents to children, sexual abuse, psychological disorders, and poor academic records were the major causes of suicide in Pakistan.  Some widely accepted social norms, like a girl getting married early in her age when she is not mature enough to handle the married life properly, also society putting pressure on her to get pregnant and adjust to her in-laws no matter what the circumstance contributes significantly to female suicides in Pakistan.

Psychological problems in Pakistan are fairly common. According to one source, around 50 million people suffer from mental disorders. Several cases have been reported related to depression, substance abuse, schizophrenia, bipolar disorder, and post-traumatic stress order. 36% of Pakistanis suffer from anxiety and depression due to family relations not going well, the feeling of not fitting well, and the country’s unstable political and economic environment also takes its toll on the human mind.

Bipolar disorder causes extreme shifts in mood, energy, and activity levels. According to a study, it was found that 14% of young students have bipolar disorder. Post-traumatic stress disorder occurs when a person has suffered from a huge trauma in the past. Physical assault is the most common reason for PTSD.

While society accepts people going to hospitals for physical pain, they are more stigmatized when someone with a mental illness tries to seek professional help, they are often frowned upon by society. It is often associated with supernatural forces and witchcraft. Families often hide mental illnesses due to fear of being shunned by society.

The government through extensive PR campaigns should educate society that mental illness is just like any other illness if we want to have any chance of getting rid of this silent killer disease.