KARACHI: Rise in suicide cases witnessed: Symposium on mental health
KARACHI, Sept 23: An abnormal increase in suicide related cases has been witnessed in the country over the last few years, as poverty, poor housing, low education, rising social problems, lack of employment opportunities coupled with steep rise in depression and psychiatric issues have added to the magnitude of the problem.
This was stated by eminent psychiatrists on the second day of national symposium on “Mental Health: Understanding the Challenges”, which was organized by the Aga Khan University (AKU) here on Tuesday.
The speakers deliberated in detail over the issue and presented critical analysis of rationale, which was primarily responsible for aggravating the problem.
In his presentation on ethics in psychiatry, R.S. Murthy, who had come from Banglore, said that mental health care in developing countries had become a public health issue during the last two and half decades. In this scenario, he added, a major push was provided by the World Health Organization (WHO) on mental health services in developing countries.
Mr Murthy said, “In the recent times, the WHO has focussed attention on mental health by choosing the theme of mental health for the world health day on April 7, 2001.” Moreover, the world mental health report 2001 (New Understanding: New Hope) was another effort of the WHO in this respect, he added.
He pointed out there had been an upsurge of interest as well as wide variety of innovations to address mental health problems in developing countries, which included sharing the responsibility with a wide variety of specialists, integrating mental health with primary health care, empowering families to become active partners in mental health care, public education on mental health and active role for voluntary organizations to support mental health initiatives.
He said that a number of countries had taken up legislative and policy changes to support community based mental health programme. In this connection, he cited the instance of enacting a new Mental Health Act in 2001 replacing the Lunacy Act of 1912.
According to him, the ethical issues of psychiatry in developing countries arise from need to de-professionalize mental health care. He said that the religious and other beliefs and practices often remain in conflict with modern knowledge, which was serving the cause of humanity.
“The developing countries have the advantage to start planning their mental health programmes on an open canvas to accrue benefit of advances in the mental health care and build structure and mechanisms on the foundations of strong communities, the family system, tolerance and spiritually,” he added.
In his presentation on effects of armed conflict on child mental health, Eli Berger, who had come from South Carolina, said that in view of the armed conflicts with indiscriminate and callous attacks against families, there had been a marked increase in number of refugee children. At least five million children were outside their country while 12 million were homeless in their own country, he added.
He claimed that the nature of war had been dramatically changed after the end of second world war in the sense that civilian population was being targeted deliberately, which had direct bearing on children directly in response to the traumatic events and indirectly in response to loss of parents, displacements of camps discontinuity of education’ lack of adequate medical care and for many the need to assimilate into a new culture and nation or to orphanage life.
Mr Berger said, “Unique features of today’s children of war includes kidnapping and conscription of youth into renegade military factions, training them in the ways to combat often under the influence of drugs.”
Discussing the suicide prevention aspect, Prof Murad Moosa Khan of AKU’s psychiatry department said that suicide was a complex issue for which no single cause or rationale could be cited.
He said that it may be attributed owing to complex interaction of biological, genetic, psychological, social, cultural and environmental factors.
Dr Murad said, “Based on estimates by WHO, approximately one million people across the globe commit suicide annually of which 10 per cent suicides takes place in Indian sub-continent, including India, Sri Lanka, and Pakistan.”
He claimed that suicide was a major public health issue in all countries, but its prevention and control was not an easy objective, as research had clearly indicated that prevention of suicides involved a whole series of activities. He said that these activities ranged from provision of best possible conditions for children and youth to the environmental control of risk factors.
He suggested appropriate dissemination of information and awareness to raise essential elements in reducing suicide ratio.
Dr Murad pointed out that suicide prevention efforts would be less effective if they were not set within frame work of large scale plans developed by multi-disciplinary teams, comprising government officials, health care planners and workers, besides researchers and practitioners from a variety of disciplines and sectors.
Among others, Badar S. Ali, Shifa Naeem and Waris Kidwai from AKU; Verda Dar from Fatima Jinnah University, Rawalpindi; Ali Akbar Mansoor from the University of Punjab; and Ambreen Ahmad from South Carolina, also spoke on the occasion.—PPI
