KARACHI: Growing economic crisis, including price hike and joblessness, is not only a matter of concern for whole society but is also behind rising mental health problems amongst the poor and low-income segments of society, said a noted psychiatrist here on Friday.
Dr Kishor Kumar Chimnani, consultant psychiatrist Kharadar General Hospital and AKH Garden Clinic said that it is an accepted fact that poverty increases the risk of mental illnesses, including schizophrenia, depression, anxiety and substance addiction.
He said that there was no exact data available about the number of patients suffering from mental issues; however, as per estimates in Pakistan, mental disorders account for more than 4% of the total disease burden, with the mental health burden higher among women. It is estimated that 24 million people in Pakistan are in need of psychiatric assistance. Sadly, our country lacks proper facilities to cater to the needs of these patients.
According to WHO data, Pakistan has only 0.19 psychiatrists per 100,000 inhabitants, one of the lowest numbers in WHO Eastern Mediterranean Region, and in the whole world. He said as per a study, in our country, depressive and anxiety disorders appear to be highest, followed by bipolar, schizophrenia, psychosomatic disorders, obsessive compulsive disorder and post-traumatic stress disorder.
Dr Kumar said poverty coupled with mental illness also manifests in suicides. He said we see this phenomenon in poverty-stricken area of Thar desert. He said it is believed that the suicide rate among men is two to three times higher than among women.
It is believed that mental illness will be among the leading causes of death by 2030. He said as per ADB data, in Pakistan, 21.9% of the population lives below the national poverty line in 2018. In Pakistan, the proportion of employed population below $1.90 purchasing power parity a day in 2021 is 3.7%.
However, the World Bank has estimated that poverty in Pakistan has increased from 4.4 per cent to 5.4 per cent in 2020, as over two million people have fallen below the poverty line. He said growing poverty has also diminished the chances of the low-income people to seek medical assistance, as medical care particularly the prices of medicine in Pakistan are very costly.
He said our government policymakers generally do not consider poverty as a catalyst for diseases, especially mental health issues. He said; however, the experts believe that understanding the links between poverty and mental health matters can help policymakers design more effective policies to both improve mental health and reduce poverty.
Depression and anxiety are the most common mental illnesses, afflicting nearly 3% to 4% of the world’s population at any given time and significantly contributing to the global burden of disability. While cost-effective mental health treatments are widely available, many governments invest far less in mental health care compared to physical health services – particularly in low- and middle-income countries.
Dr Chimnani said that the government should give universal social security cover to citizens. He said national health insurance services should be extended to all citizens. He said in every district level hospital there should be well equipped mental disease wards. He said in fact Pakistan needs a teaching hospital at every district to cater patients and also to produce trained medical practitioners.
He said once thought to be “diseases of affluence,” a growing number of studies leveraging natural and controlled economic experiments involving populations worldwide suggest that people who live below the poverty line are often substantially more likely to be affected by anxiety and depression.
Similarly, those afflicted with mental illnesses are much more likely to face greater economic challenges due to a related loss of employment and income, leading to poverty. Dr Kumar said in megacity Karachi the healthcare facilities in government sector are not sufficient to cater the mammoth population. He said not only new tertiary care hospitals should be opened but free-standing clinics should be opened in all suburban areas to lessen patient burden on downtown hospitals.
He said training facility for doctors seeking to make career in psychiatry should be increased. He said growing energy crisis, inflation and joblessness are not only economic issues but they have also serious healthcare consequences. He said a better and holistic economic policy coupled with adequate healthcare infrastructure and proper social security cover would surely help in improving the health of our citizens and lessen the growing number of patients in need of a serious mental health intervention and care.