Organised by the Pakistan Association of Mental Health (PAMH) at the Jinnah Medical and Dental College on Sunday to observe the mental health day, the meeting brought together some of the top psychiatrists, a police officer and a journalist. Although attendance was low, the small audience participated animatedly in the discussion, confirming that there was great public interest in this issue.
The growing incidence of suicide globally as well as in Pakistan prompted the World federation of Mental Health to choose suicide as its theme this year.
Prof Haroon Ahmad, president of the PAMH, told the seminar that one million suicides were reported every year worldwide. In Pakistan, 5,800 people took their own life in 2003 according to the LHRLA. But all cases were not reported, he said.
Prof Haroon warned people not to look for simplistic explanations for a person’s act of suicide, such as loss of job, failure in love or an argument with parents. There are more complex factors at work, especially the make-up of his bio-medical system, that are responsible. An overwhelming majority of those commit suicide are depressed. Stress may have acted as a trigger factor, he added.
Dr Murad Moosa, the head of the department of psychiatry, AKUH, who has done research on suicide, gave extensive statistics to prove that suicide has emerged as a major mental health problem in Pakistan.
He said that officially no data was collected on people committing suicide hence “we have no information on the rate of suicides, but trends are quite disturbing. For instance more younger people – generally men below 30 years – are taking their own lives which means more productive years are being lost.”
He also confirmed that at least 80 per cent of those who died had been diagnosed of clinical depression and 10 per cent had other psychiatric illness. What was a cause of concern was that 97 per cent of these cases had been receiving no psychiatric assistance.
Dr Murad Moosa made some specific proposals to address this problem:
• Adopt a multisectoral approach
• Restrict access to means of suicide (weapons, drugs, etc)
• Treat persons suffering from depression
• Train GPs and primary health care workers to recognize suicidal tendencies in people
• Provide professional support to survivors of suicide attempts
• Adopt school-based intervention strategy
• Open crisis centres and helplines
He called on the government to increase the health budget, work for social equity, decriminalise suicide so that it is no longer treated as a crime, and raise public awareness of the issue.
In an informative speech, Javaid Akbar Riaz, the TPO of SITE , shed light on this problem from the police’s perspective.
He agreed with Dr Murad Moosa that suicide should be decriminalised. Under the law the punishment for attempted suicide is a jail sentence and fine. But expressing his personal opinion, he said that the victim should not be taken to jail but to a psychiatrist. He confirmed that the police collected no data on suicide since it was hardly ever reported as such.
Mr Riaz explained that when a suicide was reported the police were obliged to interview the family to collect information for the legal process. He felt that if the police had the services of a mental health professional available, he could do it better. He suggested the creation of a forum of mental health professionals to receive information on suicide from the police.
Dr Tariq Sohail, chairman of SM Sohail Trust, and journalist Nusrat Nasrullah brought up the issue of suicide bombing. This was also the subject of discussion when the audience was invited to express its opinion.
Dr Sohail said that suicide bombers were not suffering from mental illness but were highly motivated and had a heightened sense of honour.
Speaking from his experience one of the participants said it was claimed that it takes only six weeks to convert a normal and mentally healthy person into a suicide bomber.
Another opinion was that a suicide bomber’s act was simply his protest against a system he resented. Since all avenues of communication had been closed to him he became desperate and felt had to act.
On Sunday morning, the friends of PAMH held a walk in Depot Lines before the clinic of the Institute of Behaviourial Sciences. The banners that the walkers carried proclaimed, “Mental illness is a part of our society, it should not be ignored” and “No health without mental health”.