Level of mental health literacy in Pakistan - A study done in 2005

A survey was done in three cities of Punjab among a population sample of 1750 people from all different types of living conditions. Participants were requested to provide diagnosis, causes, prognosis, and possible treatments for their disorders. The majority of the population in Pakistan neither acknowledge nor accept mental health problems and a lot of the stigma is attached to being recognized as being mentally sick. When a mental health case does occur, individuals are most likely to consult in primary medical care and many of the staff are not trained to understand or deal with these problems. Faith healers and religious leaders are often the people who most mentally ill patients first approach (Mubbashar & Saeed, 2001). In a recent analysis of mental health profile in Pakistan, Karim, Saeed, Rana, Mubbashar and Jenkins (2004) point out that mental illness is stigmatized and widely perceived to have supernatural causes, and that the traditional healers along with psychiatric services are the main mental health service providers.An analysis of mental healthcare system in Pakistan reveals that things improved after the implementation of a new mental health law, which replaced the lunacy act of 1912 on 20 February 2001, and which embodies the modern concept of mental illnesses, treatment, rehabilitation, and civil and human rights. However, mental health services including policies, programmes and resources are still not in proportion to the total burden of illness in Pakistan.

Sample
The sample for this survey was obtained from three main cities of the province Punjab, i.e.,Lahore (the provincial capital),Multan and Faisalabad. To give some representation to rural populations, three villages near to these cities were also included. All three cities contain a rich mix of people ranging from very poor to very affluent as well as illiterate to highly educated. In villages, with a few exceptions, the people are usually poor and less educated or illiterate. In cities an attempt was made to give a suitable representation to different areas ranging from those with better socio-economic status (e.g., Defense, Gulberg in Lahore) to
inner city congested ones (e.g., Bhatti, Rang Mehal in Lahore). A special effort was made to obtain a good mix of sub-groups pertaining to gender, social class, education and age. A total of 1750 made the sample for this study.

The findings showed that depression was four times more likely to be diagnosed than psychosis (18.75% vs. 4.94%). A logistic regression analysis with forward selection for the predictors showed that the type of disorder, education status and area of residence contributed significantly to one’s ability to diagnose. More people believed that GPs (23.76%), psychologists (23.92%) and psychiatrists(20.73%) were the right people to consult for these problems. There were also some who considered hakims and homeopaths (4.22%), magical (13.11%) and religious healers (13.54%) as the appropriate people to contact. Those recognizing mental disorders were more likely to identify the underlying causes, prognosis and appropriate treatment of the problems.

Journal of Mental Health; Apr2005, Vol. 14 Issue 2, p167-181, 15p