Mental health services sought for militancy-hit people

PESHAWAR: Médecins Sans Frontières (MSF) has urged the authorities to provide services to people in conflict-hit areas of the country to protect them from mental and psychological ailments. “The people in insurgency-prone areas are willing to take advantage of mental health services as they recognise that continuous lawlessness have wreaked them,” according to a study, conducted between February and December 2012 at the district headquarters hospital in Timergara. Entitled ‘Offering mental health services in a conflict affected region of Pakistan: Who comes, and why?’ indicates that more innovative approaches are required to adapt mental health services to the prevalent needs in the area. Médecins Sans Frontières (Doctors Without Borders) has been providing mental health services to people in collaboration with provincial health department in Timergara. “The study highlights the pressing need to integrate mental health care as part of the minimum package of services at district hospital level in a conflict-affected region,” according to Dr Safieh Shah, the principal author of the study. “Contrary to the perception that these services would not be utilised due to stigmatisation of mental health disorders, we received almost 1,000 patients,” Dr Shah said. Under the programme, the MSF psychologists provided counselling and mental health care with support of doctors and psychiatrists. Counselling support to patients was essential along with psychiatric treatment. “The study shows that relying on psychologists as first line mental health care providers an approach referred to as ‘task-shifting’ that can significantly ease the burden on the small number of highly trained psychiatrists in Pakistan,” Dr Awais Yaqub, coordinator of MSF medical programmes in Pakistan, said. “This demonstrates that implementing mental health services in conflict-affected areas can be feasible even with limited medical resources,” he said. Eighty-six per cent of patients were female and eight per cent were children and adolescents. Depression and anxiety were common among both women and men, utilising the services. However, symptoms of adjustment disorders and acute reactions were more commonly experienced by female patients, while men suffered more frequently from post-traumatic disorder, Dr Yaqub said. The study shows that the great challenge to providing effective mental health care is the difficulty that the patients face in returning to hospital for follow up care. Sixty-nine per cent of all patients had a follow up visit planned with their psychologist, but only 34 per cent turned up. The medical charity provides services only to patients at the district hospital, because it can’t reach community due to security issues. This creates a significant barrier in terms of distance and transport costs for people living away from the district capital, particularly for women and the elderly. Despite challenges and difficulties, it was feasible to include mental health services in the healthcare system to benefit dwellers of the war-affected regions. Published in Dawn, July 2nd, 2014