Sunday, April 18, 2010

Might be off topic but is a great example

I watched this Hindi movie back in 2007 called Taare Zameen Par.

Ishaan Awasthi is an eight-year-old whose world is filled with wonders that no one else seems to appreciate; colors, fish, dogs and kites are just not important in the world of adults, who are much more interested in things like homework and grades. And Ishaan just cannot seem to get anything right in class.

When he gets into far more trouble than his parents can handle, he is packed off to a boarding school to ‘be disciplined’. Things are no different at his new school, and Ishaan has to contend with the added trauma of separation from his family.

One day a new art teacher bursts onto the scene, Ram Shankar Nikumbh, who infects the students with joy and optimism. He breaks all the rules of ‘how things are done’ by asking them to think, dream and imagine, and all the children respond with enthusiasm, all except Ishaan. Nikumbh soon realizes that Ishaan is very unhappy, and he sets out to discover why. With time, patience and care, he ultimately discovers that Ishaan is dyslexic.

I highly recommend you all see this movie to understand the perspective on mental health in India and Pakistan.

Taare Zameen Par Movie Link

Monday, April 12, 2010

Important Study

A large study at Jinnah Post Graduate Medical Center, Karachi back in early 1990s (4) showed that twice as many women as men sought psychiatric care and that most of these women were between 20s and mid 40s.
Another 5-year survey (1992-1996) at the University Psychiatry Department in Karachi (Agha Khan University/Hospital) (5) showed that out of 212 patients receiving psychotherapy, 65% were women, 72% being married. The consultation stimuli were conflict with spouse and in-laws. Interestingly, 50% of these women had no psychiatric diagnosis and were labeled as 'distressed women'. 28% of women suffered from depression or anxiety, 5-7% had personality or adjustment disorders and 17% had other disorders.
The 'distressed women' were aged between 20 to 45. Most of them had a bachelor's degree and had arranged marriage relationships for 4-25 years with 2-3 kids, and the majority worked outside home (running small business, teaching or unpaid charitable community work or involved in voluntary work). Their symptoms were palpitations, headaches, choking feelings, sinking heart, hearing weakness and numb feet.
A study on stress and psychological disorders in Hindukush mountains of North West Frontier Province of Pakistan (6) showed a prevalence of depression and anxiety of 46% in women compared to 15% in men.
A study on suicidal patients (7) showed that the majority of the patients were married women. The major source of suffer was conflict with husband (80%) and conflict with in-laws (43%).
A study of parasuicide in Pakistan (8) shows that most of the subjects were young adults (mean age 27-29 years). The sample showed predominance of females (185) compared to males (129), and the proportion of married women (33%) was higher than males (18%). Housewives (55%) and students (32%) represented the two largest groups among females. Most female subjects (80%) admitted problems with spouse.
A four-year survey of psychiatric outpatients at a private clinic in Karachi (9) found that two thirds of the patients were females and 60% of these females had a mood disorder. 70% of them were victims of violence (domestic violence, assault, sexual harassment and rape) and 80% had marital or family conflicts.


Women's mental health in Pakistan

In this entry, I am going to be talking about cultural practices playing a vital role in women's mental health. The religious and ethnic conflicts, dehumanizing attitudes towards women, joint family system (involving in-laws) represent major issues in the daily lives of women. In Pakistan, such practices has has an adverse psychological impact. Violence against women has become one the acceptable means whereby men exercise their culturally constructed right to control women. Statistics show that Pakistan women are relatively better off than their counterparts.

It has only been in the past few years that honor-killings and rape has received attention in Pakistan. The women's movement in Pakistan in the last 50 years shed light on forced marriages, violence, and tribal laws/disinheritance. There are still a vast majority of women who are unaware of these debates in the rural and slum areas in Pakistan.

The mobility of women:
Restricted mobility affects their education and job opportunities. Societal issues such as sexual harassment and violence has reached its peak and lack of awareness or denial confine women to the sanctity of their homes. This type of restricted mobility further lowers women's empowerment in society.

Honoring boys more than girls:
Birth of a baby boy is rejoiced and celebrated, while a baby girl is mourned and is a source of guilt and despair. Boys are given priority by giving better food, education, and overall care. This is where we get into child brides, exchange marriages, and dowries or "bride price." Females are shunned when they divorce and marriages often lead to wife-battering, conflict with spouse, conflict with in-laws, homicide/suicide, and stove burns.

In Pakistan, there are cultural institutions, beliefs and practices that undermine women's autonomy. Marriage practices can disadvantage women. Dowry can often times escalate to harassment, physical violence and mental abuse. This makes the female confined to an abusive relationship because of the social and cultural pressures. Divorce or separation is not encouraged by parents for fear of being stigmatized.

A United Nations research study found that 50% of women in Pakistan are physically battered and 90% are mentally and verbally abused by their men. A study by Women's Division on "Battered Housewives in Pakistan" showed that 80% of households has domestic violent acts. Human Rights Commission reports that 400 cases of domestic violence occur each year and half of the victims die.

Reasons for women to stay in abusive relationships: fear of retribution, lack of other means of economic support, concern for children, emotional dependence, lack of family support, and hope of husband changing one day. (70% of abused women have never told anyone about the abuse).

Psychological consequences of abuse are more severe than physical: Erodes self-esteem, increases chance for disorders like depression, post-traumatic stress disorder, suicide, alcohol, and drug abuse.