Mental health problems in Pakistani society as a consequence of violence and trauma: a case for better integration of care

Abstract

Objectives: This paper discusses the increasing incidence of mental health problems in Pakistan, and specifically in the Swat Valley, in relation to the growing insurgency and current violence in Pakistani society. The paper argues that the health care system's response in Pakistan is not adequate to meet the current challenges and that changes in policy are needed to build mental health care services as an important component of the basic health package at primary care level in the public sector.

Method: This paper reviews the existing mental health situation in Pakistan with reference to the findings of a case study in the Swat Valley in Khyber Pukhtoonkhwa Pakistan. The figures presented in the case study are used to support the need for an integrated national mental health policy.

Conclusion: Mental health care needs to be incorporated as a core service in primary care and supported by specialist services. There is a strong need to provide adequate training for general practitioners and postgraduate training for mental health professionals to meet the current demands. A collaborative network between stakeholders in the public and private sector, as well as non-governmental organisations are required that promotes mental health care and advocates for changes in mental health policy.

Keywords: Pakistan; conflict; health policy; mental health; post-traumatic stress disorder; primary care.

Figure 1

Presence of PTSD symptoms in a population of (n=600), of age range 11–22 years in the Swat Valley.

Figure 2

PTSD symptoms in clusters in a population of (n=600) age range 11–22 years in the Swat Valley.