Mental Health in South Asia: Ethics, Resources, Programs and Legislation by Jitendra Kumar Trivedi & Adarsh Tripathi

Author:Jitendra Kumar Trivedi & Adarsh Tripathi
Language: eng
Format: epub
Publisher: Springer Netherlands, Dordrecht

10.4.9 Pakistan (WHO 2009; Mubbashar 2001, 2011)

Pakistan has been a pioneer in developing community mental health programs since 1986. The chief approaches used are (i) integration of mental health with general health services; (ii) school mental health program; (iii) public mental health education and (iv) collaboration with traditional healers. Pakistan’s mental health policy was last revised in 2003. The mental health plan was also last revised in 2003. The disaster/emergency preparedness plan for mental health was last revised in 2006. The revised mental health legislation was enacted in 2001 and it focused on the access to mental health care including access to the least restrictive care; rights of mental health service consumers; family members, and other care givers; competency, capacity, and guardianship issues for people with mental illness; voluntary and involuntary treatment; accreditation of professionals and facilities; law enforcement and other judicial system issues for people with mental illness; mechanisms to oversee involuntary admission and treatment practices; and mechanisms to implement the provisions of mental health legislation. A national mental health ­authority exists which provides advice to the government on mental health policies and legislation. The mental health authority also is involved in-service planning, service management and co-ordination and in monitoring and quality assessment of mental health services. Mental health services are not organized in terms of catchment/service areas. Five mental hospitals are available in the country; these are organizationally integrated with mental health outpatient facilities.

The government provides economic support for both consumer and family associations. Family associations have been involved in the formulation or implementation of mental health policies, plans, or legislation in the past two years. Government agencies (e.g., Ministry of Health or Department of mental health services); NGOs; professional associations, private trusts; and foundations, International agencies have promoted public education and awareness campaigns in the last five years. 1 % of all admissions to community-based inpatient psychiatric units and 30 % of all admissions to mental hospitals are involuntary. Over 20 % of patients were restrained or secluded at least once within the last year in community-based psychiatric inpatient units, in comparison to 6–10 % of patients in mental hospitals. The density of psychiatric beds in or around the largest city is 2.15 times greater than the density of beds in the entire country. Such a distribution of beds facilitates access for rural users.

There is a coordinating body to oversee public education and awareness campaigns on mental health and mental disorders. Government agencies (e.g., Ministry of Health or Department of mental health services); NGOs; professional associations, private trusts; and foundations, International agencies have promoted public education and awareness campaigns in the last five years. These campaigns have targeted the following groups: The general population; children; adolescents, women, trauma survivors; ethnic groups; and other vulnerable or minority groups. In addition, there have been public education and awareness campaigns targeting professional groups including health care providers (conventional; modern; allopathic); complimentary/ alternative/ traditional sector; teachers; social services staff; and other professional groups linked to the health sector. The following legislative and financial provisions exist

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