In a written reply to a series of questions posed by parliamentarians, the National Health Services minister informed the National Assembly on Wednesday that there were no federal government-run dedicated mental health hospitals or institutes in the country.

Between Pims, Polyclinic, Federal General Hospital and the National Institute of Rehabilitation, only Pims has a functional psychiatry department.

The number of mental health patients registered at Pims is staggering: about 39,000 in 2017.

This figure accounts only for those able to access such services at one facility in the federal capital.

So when the minister states that the prevalence of mental health disorders is considerably less than commonly estimated (ie one-third of the population), the question that naturally arises is: are we stumbling in the dark when it comes to an issue that WHO considers a public health priority for developing countries?

The answer, to a large extent, is yes.

It was only in 2001, through the Mental Health Ordinance, that the issue was reframed as a disease, a shift from the colonial-era praxis of treating it as a sign of criminal deviancy.

Since devolution, most of the provincial legislatures have passed the MHO.

Yet, in the past 17 years, such laws have remained virtually unimplemented.

Between the stigma of mental illness, the lack of quality mental health provisions, and the threat of cruel, unsafe ‘treatments’ that still persist, and that are exacerbated by a range of psychologically destabilising socioeconomic factors, Pakistan will continue to suffer from a high disease burden and its concomitant impact on the economy.

A course correction away from this bleak path will require informed decision-making — through research, yes, but also through increasing awareness and sensitisation among public health policymakers, guided by mental health advocates.

While specialist capacity building is needed, any mental health policy ought to prioritise and approach this issue holistically by focusing on entire populations, instead of the medical needs of a particular subset of individuals.

Such a policy must focus not only on providing quality mental healthcare at the tertiary level, but also building capacity at the primary and secondary levels — from prevention, to early detection and treatment, to rehabilitation.

Speaking to the Assembly, the NHS parliamentary secretary said that this government is in the process of developing such a policy.

The hope is that this matter is treated with the urgency and importance it deserves.

Published in Dawn, November 9th, 2018