Frozen. Stalled. Broken down. Hazed. Fogged. Jammed. We are neither talking about the car engine nor the weather; we are talking about the body engine and weather inside the mind. While corona vaccines have reduced the danger to lives, where is the vaccine for the larger pandemic that is more dangerous than Covid-19, i.e., mental health. If the human mind has been in the grip of fear, uncertainty, pain, agony, stress, grief, loss, anxiety, negativity for one and half years non-stop, imagine its injured, wounded, infected, affected, hemorrhaging state. But why are we not addressing it with the same emergency and urgency like Corona? Because unlike Corona you do not hear the horrible cough, you do not experience the weird absence of smell and taste, you do not struggle to catch the next breath, you cannot read the Fahrenheit rising. The lack of visible medical symptoms has let the silent invisible predator of mental depression attack the mind and kill the very life in humans -where you may be alive but not living, you may be living but dead.
Pre-pandemic almost a billion people were suffering from mental health issues. According to world data 2018, anxiety affects 284 million people in the world. Depression affects 264 million people.
Alcohol use disorder affects 107 million people. Drug use disorder affects 71 million people. Bipolar disorder affects 46 million people. Schizophrenia affects 20 million people. Eating disorders affect 16 million people. In Pakistan, according to a highly underreported data, 50 million suffer from mental health issues, mainly anxiety and depression. The metal health emergency is an urgency like none else:
Super spreader shocker- Coronavirus has made mental health virus a super spreader. A global research firm, IPSOS, recently carried out a study in affiliation with the Pakistan Mental Health Coalition. The study revealed that about 60% of Pakistanis experienced moderate to high levels of mental health issues, while 8 in 10 individuals showed some symptoms of mental illness during the coronavirus pandemic. Just compare the statistics of coronavirus and mental health virus. This virus has so far affected nearly 1.2 million out of 220 million people in Pakistan. This is barely 5% of the population but mental health issues have affected 60% of the people.
Mental health aggravates other diseases- It is always mind over body. The word "Will Power" is the best medicine for health. "Will" comes from a strong and healthy mind. Depression and mental issues weaken the mind and its power. With a weak "Will" medical treatment efficacy reduces, illnesses become exacerbated and life becomes hell leading to suicides, etc. Heart attacks, diabetes and even cancer treatments become futile if the recipient's mind has no will to fight off them.
Mental health devastates productivity- A disengaged person is almost a vegetable. We have seen in workplaces many people come to work but are absent. Their bodies are there but their minds are elsewhere. A disturbed mind lacks focus, comprehension, clarity and execution. These factors lead to below par performance. Such people fail to do the simplest of tasks. They do not register instructions of their bosses and colleagues. They miss deadlines. They make regular mistakes and default on their deliverables. A study shows that just a mentally disengaged employee has 37% higher absenteeism, 18% lower productivity and 15% lower profitability. Imagine if this disengagement turns to anxiety and depression these percentages would jump over 50%.
Mental health affects the family and relationships- Perhaps the biggest impact mental health issues makes is on interpersonal relationships. Marriages are the first victim. If one spouse is suffering from depression or any other illness, he or she rarely reveals it and admits it. This leads to conflicts and many times domestic violence. This in turn disturbs the whole family unit especially children. Children may either show poor academic performance or low self-esteem affecting their talent and future. The temptation to then turn to drugs at young age is many times irresistible. Violence, abuse, divorces, suicides are a consequence of unattended stress, anxiety and depression.
Mental health imbalances societal balance- A society that deals with mental issue as a stigma is bound to ignore, hide, trivialize this issue. In Pakistan for the rich it is a big avoidance issue and for the poor it is the ghosts casting spells on humans. Imagine, if out of 220 million people 120 million people are suffering mental health issues what impact it is going to have on our society. The latest Noor Muqaddam case is an example of the rich hiding this issue leading to horrendous crime and death. In the lower classes the rise of the sex crimes as typified with the Minar-e-Pakistan incident is something that shows the devastating impact this unaddressed issue is having on all segments of our society.
While the world has recognised it as an important issue Pakistan needs to recognise it as a health emergency issue. Pakistan cannot achieve its development goals if 120 million of 220 million people are unable to contribute to their potential. A three-dimensional approach is required to treat his pandemic in a holistic manner:
1 Lead from the top- This emergency needs a lead straight from the top. No government had even talked about this creeping crisis in seven decades. The health ministry had not even put it in its tier of priorities. Fortunately, the present government has given it due importance. Right from the President, Prime Minister and health minister all are urging action on it. Mental health has been officially included in the Health definition of the ministry of health. The government has formed a National Task Force on Mental Health to develop cross-cutting policies, action plans and initiatives to deal with this pandemic on a priority basis. Much more needs to be done on awareness, legislation, school programs and social awareness, etc., to really give it a coronavirus-like emergency treatment.
2 De-stigmatize it- It is a taboo subject. Having depression is considered a shameful thing. It is an abnormality. Parents feel guilty about not being good parents. Children think they may be considered mad. Society thinks it's not safe to have "lunatics" around. The result is avoidance and aversion all around. The victim feels castigated. The family feels anxious and ashamed. The society feels averse. The solution is frank discourse, open, logical and powerful at all levels. Schools need to be trained in these skills. Parents need to be briefed on it and society needs to become engaging and embracing. This requires all medical doctors to be talking to patients about mental health too regardless of their specialty. Since any disease is linked to mental health every clinic dealing with any disease should have material on it. This material should be handed over by the assistant instructing the patients to read and follow it. Counselling services in schools have been introduced in Islamabad and Punjab but more debates and discussions should be part of daily classroom activities.
3 Awareness and prevention- What we need is a paradigm shift in treating mental health issues. We need to teach people on mental well-being as a way of life. That includes a "Do it Yourself" approach of physical exercises, mental stimulation, having a purpose in life types of steps that are doable for all. Social media and help lines are excellent mass awareness. Engaging celebrities to talk and make it viral are great for older population. Cartoon animations are excellent for children awareness.
The green ribbon on 10th of October symbolizes the mental health day worldwide. It is time for more action on every forum on each of the remaining 364 days. It is time to introduce mental health activism. It is time for activists to treat this pandemic as an emergency bigger than any pandemic. It is time for people to realize that while Corona has a vaccine this pandemic has no vaccines. There are no brain transplants, mental surgeries, mindbotoxes that can change the thought process of an estranged mind. What is needed is an all-out, unashamed, unhesitant, unrestricted, untainted, unstigmatized approach. Let us break the mental shackles to discuss, debate, prioritize and activate initiatives that enhance peace of mind mandatory to unleash the true potential of human beings.
(The writer can be reached at [email protected])
Copyright Business Recorder, 2021
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