Putting People at the Heart of Mental Health Investment in Pakistan
By Taha Sabri, Co-Founder of Taskeen and Speak Your Mind Campaigner
COVID-19 in Pakistan
I founded Taskeen (Urdu: “to comfort”) just under 5 years ago to raise awareness about mental health and try to address the root causes of mental illness in Pakistan. It’s a huge challenge and I am proud to say we have achieved a lot in this time. Initially the focus was campaigns to raise awareness. As we have grown, we now also engage in community outreach and advocating to the national government to increase funding for mental health.
In January this year, we were delighted to join 18 other countries to become part of the global Speak Your Mind campaign. At that point, and so soon into Taskeen’s journey, I didn’t think that we would be working to mitigate the mental health impact of a global pandemic.
But that is what we are now faced with. In Pakistan, some of the issues we face combatting the outbreak of COVID-19 are consistent with those faced by many countries, such as lack of access to sufficient PPE for healthcare workers, indecisive actions by the relevant stakeholders, lack of resources to respond to the pandemic and the economic implications of the lockdown.
As with other countries where there has been an outbreak, COVID-19 also has substantial mental health implications leading to:
1) An influx of unaffected worried people, at already burdened hospitals, for testing of corona virus.
2) Mental health problems in people because of:
a. Fear and anxiety of contracting the virus
b. Fear and anxiety of vulnerable loved ones contracting the virus
c. Financial problems due to layoffs loss of earnings of daily wage earners
d. A sense of confinement due to the sudden transition from an active working life to being quarantined at home.
3) Causing exacerbation of psychological problems in people with pre-existing conditions.
4) Causing stigma and discrimination against individuals/families/communities exposed to or thought to be the main vectors of the virus.
5) Causing people to reject social distancing because it conflicts with their socio-cultural beliefs.
We all have a part to play. So Taskeen has joined hands with other mental health organizations and has launched the “Pakistan COVID Mental Health Response”. This consists of a social and mass media awareness campaign, online mental health workshops (for healthcare providers and laypeople) and a mental health helpline to help people deal with the crisis. So far we have reached more than 10 million people through our activities but in a country with more than 210 million people it is still an uphill battle.
It’s #TimetoInvest in mental health
When we come through this crisis, our government will rightly focus on our preparedness for future pandemics. Our call to the leaders of Pakistan is to not forget about mental health. Not just the mental health impacts of pandemics (and the use of widespread isolation as means of defence) but also the ongoing mental health of everyone in Pakistan.
Pakistan is a country of 225 million people. It is estimated that 50 million people have a mental health condition. The government only spends 1% of its total budget on health out which only 1% is spent on mental health. Infrastructure for treatment of mental health is poor, the system is disorganised and there is a lack of mental healthcare professionals. There is little to no focus on mental health promotion and mental illness prevention. Suicide is still illegal and culturally embedded beliefs prevent many people seeking access to what support there is.
So even before the outbreak of a pandemic which has major impacts on mental health, there was a huge need for investment - not just in services but also in understanding, in an appropriate legislative framework and to ensure the right of all people to good mental health is upheld.
But how do we make this case?
Earlier this year, before the outbreak of COVID-19 prevented international travel, I joined with nearly 80 other mental health campaigners at the global Speak Your Mind planning meeting. It was incredibly inspiring to join like-minded people to develop and share our campaign plans. While each country has its own unique circumstances which will mean how money is allocated will be different, it was clear that the requirement for greater investment in mental health is common to us all.
At the meeting, Taskeen ran a friendly role-play competition challenging campaigners to meet with a minister to persuade them to invest more in mental health in Pakistan. It was popular and fun. But there was a serious point. Facts and figures don’t always win arguments. Of course they are needed and we should always ground our work in evidence; but it is people and stories that win arguments. When we make the case to governments to invest in mental health, we need to put the individual at the centre.
So, the ROI Report is an important and fantastic resource that will help our work in Pakistan. One that universally tells the human story, puts people at the heart of the argument and makes a strong wider societal case for investment in mental health.
Crucially, one we can adapt so it can also put to direct use in Pakistan. We can add our own national data, context and stories and use it for our upcoming advocacy efforts.
Taskeen has been part of Speak Your Mind for just 4 months. So much has happened in such a short space of time. Now, more than ever, our leaders need to invest in mental health. The global mental health community is speaking with one voice to put people at the heart of the argument and show that, when these investments are made, the returns are not just financial; they benefit the whole of society.