THE psychiatric profession faces a fundamental question: are we treating people’s distress as a problem located inside their minds when much of what troubles them lies outside, in the conditions of their lives? The question has particular urgency in Pakistan, where a recent national survey of more than 17,000 individuals showed that one in three adults suffers from some sort of diagnosable mental disorder. What is leading to this mental health crisis in Pakistan?

The answer may lie in understanding people’s circumstances rather than assigning diagnoses. Unfortunately, we have become so preoccupied with diagnosing and treating individuals that we have lost sight of the social conditions that make them ill.

What does it mean to treat the anxiety of someone whose future is insecure or offer counselling to a man who cannot provide for his family? How far can psychological therapy help a woman who is in constant fear due to unabated domestic violence? Treatment may offer some relief, at least temporarily, but if the circumstances remain unchanged, we risk helping the person endure a problem that society continues to create — and ignore. This is the central limitation of an individualised approach to mental health: it turns a social problem into a personal responsibility.

Pakistan’s mental health discourse focuses on ‘raising awareness, reducing stigma, increasing access to psychological support, early identification, and referral to specialist services’. While these are important, they can become politically convenient substitutes for confronting the structural determinants of psychological distress.........

© Dawn