WE have all heard of the casting couch and the trials and tribulations attached to it. Who would have thought that the other couch, as well-known if not more, that of the psychologist, may be as fraught with risk as the former?
It is an uphill task to convince anyone in Pakistan to seek psychological help because of myriad reasons — stigma attached to mental health issues, illiteracy, poverty, access etc. The fact that there is no licensing or regulatory authority to authenticate professional qualification, quality of service and code of conduct, makes the task even more difficult.
It is unfortunate that bills passed by the National Assembly in 2013 and 2018 for the establishment of a regulatory body similar to the Pakistan Medical Commission, its maladies and controversies notwithstanding, to provide institutional oversight to practitioners of mental health could not be approved by the Senate. In May, the Pakistan Psychological Council (PPC) bill again sailed through the Assembly and is submitted to the Senate.
It is interesting to note that the bill, in its objectives and reasons, also mentions “sustainable development of the country on Islamic ideology”. It is hence not surprising that the only predecessor of sorts to the proposed PPC, the Pakistan Psychological Association, had this to say in the preamble to its constitution “whereas, the need of the hour is that psychologists play a more positive role in strengthening the ideological frontiers of Pakistan, both in thought and actions”. The association, according to its constitution available on its website, was created in 1968 and had its first session in “Dacca”.
The number of people in need of mental health support has multiplied.
According to media reports, a survey conducted recently on the impact of the Covid pandemic found that more than 40 per cent of Sindh’s population showed signs of depression. Add years of anxiety related to the wave of terror resulting in the loss of more than 70,000 lives across the country, bombing of a large number of girls’ schools by the TTP, ghastly attacks like the one on by Malala and her classmates and the soul-incinerating one on the Army Public School in Peshawar, and the number of people in need of mental health support could only have multiplied.
Pakistan, unfortunately, has also witnessed more than its fair share of calamities. Take for instance, the 1970 Bhola cyclone killing more than half a million Pakistanis, the 2005 earthquake killing close to 90,000 people in AJK and KP, the floods of 2010 submerging more than a quarter of the land area of the country for months, and the forced displacement of thousands of families in the aftermath of such disasters and the unlivable conditions created by terrorism. The need for psychological counselling to mitigate the trauma caused by such events swells manifold.
Contrast this with the total absence of regulation of the field of applied psychology in Pakistan and the extent of possible malpractices or less than optimal outcome of counselling interventions could be anybody’s guess. Just google psychology courses online and the number of programmes ranging from a few weeks to a few months will astound you.
We are quite a fatalistic lot when it comes to our health and usually go by word of mouth or degrees mentioned on the consultants’ office doors in terms of due diligence before putting our lives into a general practitioner’s or even a specialist’s hands. Even fewer background checks are undertaken or are possible in the absence of a licensing and registration authority in the case of psychologists.
This piece is in no way aimed at belittling the profession or questioning the importance of mental health practitioners. To the contrary, it is an attempt to underline the urgent need for well-regulated mental health services that a traumatised society like ours needs.
Remember, we are yet to fully address the trauma caused by the violence at the time of partition. Why do you think Saghar Siddiqui died on the street? Why could Nasir Kazmi not stop walking on the streets of Lahore while others suffered nightmares or lay awake in their beds replaying the horrors of partition in their minds? Why could Intizar Hussain not stop talking about Dibai, his hometown in Bulandshahr? Why did Munir Niazi say “jis shehr mein bhi rehna; uktai huey rehna” — to be fed up with whichever city one lived in?
A dear friend born in what was then Pakistan could only recently bring himself to talk about that fateful day some 50 years ago when his father, a gentle soul, was picked up from outside their house, never to be seen or heard of again. Today, the Baloch march from one end of the country to another, pleading, beseeching for the return of their loved ones, even if it is just the mortal remains of those who have illegally disappeared. We are an extremely traumatised people in need of a well-regulated mental health sector.
The writer is a poet and analyst.
Published in Dawn, July 28th, 2021