LAHORE: A panel of psychiatrists expressed their concern, at a press conference at the Lahore Press Club on Monday, about the transfer of the Punjab Institute of Mental Health (PIMH) to the Services Institute of Medical Sciences (SIMS).

Prof Dr Saad Bashir Malik said that it was a deeply disturbing issue because of several reasons.

In October 2018, the health secretary, on the orders of the Supreme Court, constituted a supervisory committee of mental health experts to look into the day-to-day affairs of the hospital.

Dr Malik, convener of the supervisory committee, said measures were already being taken to make changes but all of a sudden, the health department attached the PIMH with the SIMS. He added that the supervisory committee was not consulted on the decision. According to the World Health Organisation, more than 300 million people suffer from depression. Of 10 major causes of disabilities, five are related to mental health and depression is the second leading cause of disability.

Dr Mujtaba, associate professor of psychiatry at the Gulab Devi Hospital, said in fact the hospital should have been turned into a proper teaching hospital where doctors could receive training and study cases of mentally ill patients.

Dr Malik says corrupt people have been in charge of the place, however, we are now bringing about change from top to bottom. Psychiatry is an independent discipline and if there is a separate cardiac hospital and separate children’s hospital, why is the mental hospital being stripped of its independence?”

The PIMH is the only hospital in Punjab that treats mentally ill patients, said doctors.

It was launched in 1900. Its land was also used for the Services Hospital and some of it was converted into a residential area. Today it has 54 acres with 1,500 beds. The status of the hospital, however, needs dedicated attention, say the doctors, as 400 patients, of the 1,000 patients, are relatively stable, but have been clumped together with violent patients.

“Mental health in Pakistan is occasionally treated through physical violence,” said Dr Malik. “Instead of focusing on changing this through a better institution, the government is merging it with a hospital with only 35 beds and a principal who has a background in surgery.”

“It is because of these circumstances that we suspect that the PIMH land is being taken over,” said Dr Nabeel Ebad from the Shaikh Zayed Hospital. “The SIMS only has two supervisors who cannot be expected to handle so many patients – 1,000 inhouse, and 700 visiting patients every day.”

Dr Saad said that half of the posts in the PIMH are vacant, with only four psychiatrists from 22 working there. “We try and advertise but not one applies because the atmosphere is not encouraging.”

The doctors said it was questionable whether SIMS even had sorted out any SoPs to handle this institution.

“Most patients living there have been abandoned by their families, and need special attention,” said Dr Saad.

In Pakistan every fourth family has a member with a psychiatric illness, he said, adding they have 300 psychiatrists to a population of 200 million. In Punjab, there are 180 psychiatrists to a population of 110 million.

On the basis of this only, said Dr Saad, there is a dire need for a separate institution dedicated solely to mental health.

Published in Dawn, January 29th, 2019

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