Karachi, September 09, 2021 (PPI-OT):The Government of Sindh has taken concrete steps to address the issue of mental health morbidity and mortality. The Sindh Mental Health Authority, established through an assembly act, has undertaken various policy and service measures to address the challenges posed during current times of COVID-19. World Health Organization (WHO) has dedicated 10th September as the World Suicide Prevention Day.
Sindh Mental Health Authority (SMHA), working as a health regulatory body, has endeavoured since its inception in August 2017 to the advancement of mental health. The primary and one of the most important tasks accomplished by SMHA is the registration of all the Psychiatrists, Trainings, awareness Seminars, Researches and other relevant mental health care providers in the Province of Sindh.
Recently three surveys were conducted through SMHA in the province to gather scientific data related to suicide trends. In the first quarter of this year (2021), Sindh Mental Health Authority published a report: “A Study of Registered Cases of Suicide between 2016 – 2020 across the Province of Sindh” conducted in collaboration with the provincial Home and Health departments.
The findings of the study were informative in terms of unique socio- cultural, psychological and anthropological risk factors operating the community. This was a unique, one of its kind survey, carried out only in Sindh. No other province in the country has taken the initiative to address this human catastrophe.
The findings from initial survey, which included 767 cases from 2016-2020, showed that the District of Tharparker reported 79 suicidal deaths, highest in 2020, with 48 females and 31 males victims, followed by districts Badin, Dadu, Mirpurkhas, Sanghar, Umerkot, Tando Allahyar and Tando Muhammad Khan. Malir was ranked highest in Karachi division with 24 suicide cases during the said period, out of total 75 suicide deaths reported between 2016 and 2020 in Karachi. After the publication of report on suicide rates in last five years across the province, Sindh Mental Health Authority (SMHA) was asked to explore the root causes to establish facts on scientific basis.
Sindh Mental Health Authority, working with reputable institutions of Psychiatry, Psychology, Sociology, and corporate sector supporting health care sector, framed the issue for an in-depth inquiry. Sindh Mental Health Authority conducted ‘Psychological Autopsy’ of registered cases of suicide at District Tharparker in collaboration with Dow University of Health Sciences (DUHS), Liaquat University of Medical and Health Sciences (LUMHS), Jinnah Postgraduate Medical Centre Karachi (JPMC), Sir Cowasji Jahangir Institute of Psychiatry and Behavioural Sciences Hyderabad (Sir CJIP and BS), University of Sindh (UoS) and Sindh Engro Coal Mining Company (SECMC) Thar foundation (Tf).
The psychological autopsy reported some disturbing, but preventable trends through focused intervention in times to come. The results of psychological autopsy conducted in Thar were in line with International data; more females and younger age group individuals died by suicide. Study found 52 percent suicides were pre-planned and 48 percent suicides were sudden and impulsive act as described by the family members. It was noted that 15 percent of suicide victims had attempted suicide previously before completed suicide (female to male ratio, 4:1). Social difficulties, interpersonal conflicts and financial problems were reported to be major risk factors behind suicide.
Another survey “Psychosocial impact of Covid-19 a Cross Sectional Survey of Sindh, 2021” was conducted by interviewing 1494 individuals in six rural and six urban cites of Sindh to map out the impact of COVID-19 on mental health. Almost 62 percent reported major loss of income or earning due to pandemic which was more pronounced in rural (81%) then urban (43%) setting. When asked directly 24 percent individuals reported receiving funds through Government agency. The estimated prevalence of depression as assessed on self-reporting questionnaire (SRQ-21) was 42 percent. When inquired about the financial difficulties, 36 percent reported borrowing money, while 21 percent reported selling property, possessions or livestock.
This survey is one of its kind which was done in collaboration with HANDS, DUHS, LUMHS, CJIP, Shaheed Mohtarma Benazir Bhutto Law College, Malir and Edhi Foundation by Sindh Mental Health Authority. The findings of this survey are expected to help design strategies from relevant Government agencies, NGOs’, INGOs’ and other concerned stakeholders. Through Sindh Mental Health Commission various training initiatives have been conducted in the province to appraise the doctors in recognition and management of depression, which is the primary reason behind suicide. Awareness sessions have also been carried out for Government officials in the relevant sectors to facilitate the causes of mental health.
Federal Government should take an initiative to revisit Section 325 of PPC, the law that deals with suicide attempts. In Pakistan both suicide and attempt to suicide are criminal acts (section 325 of Pakistan Penal Code). Attempt to suicide is punishable with a jail term and heavy financial penalty. As a matter of fact, suicide is not a crime, but a mental morbidity. Therefore, a victim should be dealt as patient, not as a criminal. Various countries, including United Kingdom – the architect of the law – has repealed the section.
Underreporting of cases and reluctance of citizens to seek mental help is a direct result of this law. Government of Sindh, mental health professionals and civil society appeal and desire that the said law be repealed through legislation to enable citizens to seek and prioritise mental health and prevent suicide.
For more information, contact:
Press Secretary,
Chief Minister House, Sindh
Tel: +92-21-99202019 (Ext: 336)
Website: www.cmsindh.gov.pk