By Helen Stokes, Managing Director for Specialist Services at CareTech plc.
As part of the ongoing work and commitment from the CareTech Foundation, Dr Alice Parshall and I visited Pakistan to support and advise the British Asian Trust with their Mental Health and Wellbeing programme.
Coordinated by the British Asian Trust and with support of donors, the projects have opportunities to: draw a clearer picture of need; look at ways to scale up on the ground; drawing in wider community partners and partner organisations; and, produce a more consensual/aligned vision of what other interventions would be needed
Day 1 – Wednesday 4th December 2019
Well, we have our visas and we’re off! A flight from Heathrow to Dubai and now our destination is in sight. An onward journey from Dubai to Karachi in Pakistan, followed by a short car journey (which was an eye opener and helped with the tiredness!) and we arrived at our base for the next few days.
After a quick snooze, we met with colleagues from the British Asian Trust and headed to the British Deputy High Commissioner’s residence for an event to create a shared agenda for Mental Health. This event was attended by over 70 people from a wide range of third sector organisations, representatives from government, psychiatrists and education leads. I formed part of a panel, which included the Pakistan Women’s football captain, where we shared experiences both personally and professionally regarding the range of issues affecting the disparate services available to those with mental ill health within the country. The sheer commitment and determination to get mental health awareness raised in Pakistan, as well as providing services to those in need, was overwhelming! However, given the programme and strategic direction of government support or funding, the challenges were equally abundant.
The event itself raised the publicity of these issues and was a resounding success, although the work has only just begun.
Day 2 – Thursday 5th December 2019
Sanaa, the British Asian Trust’s Mental Health Manager in Pakistan, took us to one of their partner organisations Interactive Research & Development (IRD). After a short presentation of their work, we went into the local community to see first-hand the mental health awareness raising sessions that are being provided. This project has been named “Pursukoon Zindagi” which translated means “Peaceful Life”. Going into some of the poorest areas, it was heartening to see that after weeks (and in some cases months) of gaining the trust of these communities that sessions appeared to be having a significant impact. We also saw a further follow-up session and visited the local hospital where lay counsellors are operating with the support of IRD and the British Asian Trust.
In the afternoon, we met over 10 lay counsellors who are trained and supervised by a qualified psychologist. This discussion was really useful in helping us to understand the challenges they face in a country that doesn’t have any safeguarding processes in place, which continued to highlight the significant differences and lack of priority to such vulnerable people.
Day 3 – Friday 6th December 2019
The start of another day with a packed schedule.
Our first stop was to the offices for Sehat Kahani, which is another of the British Asian Trust’s partners. They operate tele-medicine within Pakistan and this allows low income families to gain access to healthcare professionals within local communities. We had the opportunity to attend one of these clinics where a local and well-respected nurse within the community operated the clinic with support from direct online consultations from a psychiatrist. We met several women who had been able to access this support all of whom described the positive impact this had upon their lives.
Another programme operated with the partners is to raise awareness on mental health within schools. Despite the overriding focus on the academic curriculum, of which there are no physical, health, social or emotional elements, we witnessed this session and the gravity this holds for a new generation in Pakistan. It was clear that this is an opportunity which should be scaled up; however, the challenges prevail as state schools as we know them have very little resource or structure.
At the end of the day, we were able to get together with a number of organisations to share our observations and experiences and identify ways we could support them from CareTech plc through the company’s in kind contribution to the programme to complement the CareTech Foundation’s financial support. What was clear was the overwhelming commitment to highlight awareness of mental health issues and provide support to the poorest communities in Pakistan.
Day 4 – Saturday 7th December 2019
Today we flew back to the UK.
A time for our own reflections: all the people we met – whether professionals, lay counsellors or those within the local communities – were hospitable…….oh, and they all wanted to feed us!
But the realities are stark. The lack of government priority and support is palpable. Some of the communities are incredibly poor and have no understanding or access to physical and mental health services. Given their living conditions, it is unsurprising the levels of distress and despair they encounter. Whilst organisations such as the British Asian Trust, which rely on charitable donations, are doing their best to raise awareness and provide support, it is very much just touching the tip of the iceberg. The opportunities are abundant. In the main, people in Pakistan want help and education, they want better and sustainable lives. Mental health should be a priority, but sadly it’s not. So, we continue. We continue to make a difference and reach as many people as we can.
I’ll leave you with this though:
Did you know suicide is illegal in this Islamic state? The suicide rate in Pakistan is high, although statistics are unreliable and under reported due the fear of prosecution and shame. This adds to the challenges of those opening up and acknowledging mental health difficulties, therefore unless this is decriminalised and younger generations start to understand, accept and seek help for mental health problems this is unlikely to make any substantial changes to the loss of lives.