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. 2014 Jun 25;9(6):e97939.
doi: 10.1371/journal.pone.0097939. eCollection 2014.

Offering mental health services in a conflict affected region of Pakistan: who comes, and why?

Safieh Shah  1 , Rafael Van den Bergh  2 , Benedicte Van Bellinghen  3 , Nathalie Severy  3 , Sana Sadiq  4 , Sher Ali Afridi  4 , Asma Akhtar  4 , Jacob Maïkére  3 , Catherine Van Overloop  3 , Saeed-ur-Rehman  5 , Tahir Bashir-ud-Din Khilji  5 , Saleem-ur-Rehman  5 , Johan van Griensven  6 , Serge Schneider  7 , Philippe Bosman  3 , Erwin Lloyd D Guillergan  1 , Francesca Dazzi  3 , Rony Zachariah  2
Affiliations

Offering mental health services in a conflict affected region of Pakistan: who comes, and why?

Safieh Shah et al. PLoS One. .

Erratum in

  • PLoS One. 2014;9(7):e103700

Abstract

Background: North West Pakistan is an area ravaged by conflict and population displacement for over three decades. Recently, drone attacks and military operations have aggravated underlying mental disorders, while access to care is limited. Among patients attending a mental health clinic integrated in district hospital conducted by psychologists; we describe service utilization, patient characteristics, presenting complaints, morbidity patterns, and follow-up details.

Methodology/principal findings: A retrospective study using routinely collected programme data was conducted from February to December 2012. A total of 1545 consultations were conducted for 928 patients (86% females). There were 71(8%) children and adolescents. An increase was observed from February to July, followed by a decline. 163 new patients (18%) were on psychotropic medication at presentation. The most common morbidity in females (36%) were symptoms of adjustment disorders and acute reactions. Depression and anxiety were common in both genders while post traumatic disorder was frequent in males (21%). Out of the 928 new patients, 639(69%) had a follow up visit planned with their psychologist, but only 220(34%) new patients returned for a follow up visit.

Conclusion: In a district hospital, mental health services managed by psychologists were well attended. There is a need to consider widening the current package of care to cater to the diversity of mental health disorders, gender difference, children and adolescents. Standardized diagnostic and monitoring tools would also need to be adapted accordingly and to assess patient progress. Innovative approaches to tackle the problem of the low return rate are needed.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Scale of Severity.
Separate pictorial scales, for both genders, used by the patient to score the magnitude of their mental health problem, assessed at their first mental health consultation, Timurgara district hospital, Pakistan (May - December 2012).
Figure 2
Figure 2. Trend in mental health consultations, Timurgara district hospital, Pakistan (February - December 2012).
Figure 3
Figure 3. Score of patients.
Patients (n = 671) whose Scale of Severity was assessed at their first mental health consultation, Timurgara district hospital, Pakistan (May - December 2012).
See this image and copyright information in PMC

References

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