PAKISTANIS are rightly upset by US President Joe Biden’s categorization of their country as “one of the most dangerous nations in the world”. Perhaps our anger would have been less if he had mentioned today’s pressing challenges – climate change, food insecurity, domestic militancy – rather than the tired group of nuclear weapons in shaky hands. The fact is, Pakistan may be a dangerous nation – but not for the reasons Biden suggests. And unfortunately, we are probably more of a danger to ourselves than any outside party.
One of the reasons for this is the unprecedented and growing mental illness in the country. The mental health crisis has yet to be addressed and prioritized by our politicians, but it is likely to lead to widespread social and economic challenges. Left unchecked, Pakistan’s collective mental health will become increasingly dangerous.
In a recent column in these pages, Asma Humayun outlined the mental health challenge created by this year’s devastating floods. She cited WHO estimates that one in five people need mental health care in a humanitarian crisis and highlighted that 55 of the 80 districts most affected by the floods did not have a single psychiatrist. This is today’s crisis, but it may be worse in the future.
A recent study in the Journal of Child Psychology and Psychiatry found that the stress expectant mothers experience during a natural disaster significantly increases their child’s risks of anxiety, depression and other behavioral disorders, including attention deficit and disruptive behavior. The study – based on children who were in the womb during Hurricane Sandy in the US in 2012 – found that 53 percent of children exposed to the hurricane in the womb suffered from an anxiety disorder, compared to 22 percent who were not. are.
The mental health crisis has a material economic cost.
Given that approximately 650,000 pregnant women were affected by the floods, we can expect a significant increase in children’s mental health in the coming years. And this will have future consequences, as poor mental health in childhood and adolescence is known to increase the likelihood of poverty and other health consequences in adulthood.
For Pakistanis, the mental health challenges associated with the floods come on the heels of the pandemic, during which the global prevalence of anxiety and depression increased by 25 percent, according to the WHO.
And before that, Pakistanis endured more than a decade of conflict in the form of widespread militancy and terrorist attacks (this in addition to the routine and appalling levels of violence inherent in our fragmented cities, feudal systems, law enforcement and patriarchal structures). WHO estimates, published in a 2019 study in the Lancet, show that one in five people in a conflict-affected area suffers from some form of mental disorder, ranging from mild depression to anxiety or psychosis. In the late 2000s and early 2010s, there were many reports of increasing rates of PTSD in the civilian population. The resurgence of the Pakistani Taliban in the northwest will be deeply triggering for many.
The drivers of poor mental health among Pakistanis are increasing and intersecting, but support is not forthcoming. Pakistan has one psychiatrist for every 100,000 people, and 90 percent of people with mental disorders remain untreated, according to a 2020 report by Siham Sikander in the Lancet.
The cumulative national mental health crisis has serious social consequences. For many, especially men, mental illness manifests as substance abuse, antisocial or violent behavior and an inability to work. This means an increase in crime, domestic violence, addiction and other challenges – but on an unprecedented scale, possibly enough to destabilize families and communities.
There is also a material economic cost to the mental health crisis. Mental health and poverty exist in a vicious cycle: people with mental health problems struggle to find and keep work, and their family members become poorer as they are burdened with caring responsibilities. At the same time, poverty and widening income inequality fuel depression and other mental health challenges, which in turn lead to further poverty.
The World Bank has estimated that up to nine million Pakistanis have been pushed into poverty due to the loss of livelihoods, livestock, homes and crops in the floods; mental health implications can cause that number to spike.
So here’s what lies ahead: more despair, more conflict, more poverty, a socio-economic spiral and an endemic mental health crisis affecting young and old alike. As our government tries to create a future for our flood-stricken country, it must prioritize both mental health support and poverty reduction programs to ensure that Pakistan does not find itself in a truly dangerous position .
The author is a political and integrity risk analyst.
Posted in Dawn October 17, 2022