KARACHI: According to recent WHO statistics, half of all mental illness begins by the age of 14, but most cases go undetected and untreated. In terms of the burden of the disease among adolescents, depression is the third leading cause. Suicide is the second leading cause of death in people aged from 15 to 29 years old. Which is why this year on World Mental Health Day 2018, the theme was announced to be ‘Young people and mental health in a changing world’.

At a seminar on Sunday, organised by the Pakistan Association for Mental Health, these disturbing trends were discussed by experts and recommendations put forth.

Prof Haroon Ahmed, president of the Pakistan Association for Mental Health, spoke about the children of Pakistan and how they were constantly faced with situations that cause irreparable damage to their healthy mental framework.

‘Less than six hours of sleep per night may lead to greater than 30pc risk of dying’

Talking about the effects of rape, he highlighted various incidents where young children had been sexually abused systematically over years and were let down by all stakeholders, in particular by the police, who colluded with the criminals. “In the event of rape, there can be immediate and remote effects. Clinically they be broadly categorised as post-traumatic stress disorder (immediate) and borderline personality disorder (remote).”

Mental health professionals have a greater responsibility, especially in the absence of laws and with the state not making this a priority. “Sex education should be made part of health education in school to spread awareness among children on how to protect themselves from any sort of unwanted contact. We should formulate a comprehensive programme to educate mothers and also pressurise the government to introduce sex education in schools.”

Dr Uzma Ambareen, VP, spoke about the need to recognise the importance of building mental resilience by promoting and protecting the mental health of adolescents. “This can not only benefit these individuals and their families, but also economies and societies. Prevention begins with being aware of the early signs and symptoms of mental illness where parents and teachers can help. Also, psychosocial help should be made easily accessible in educational institutions and in the community.”

Chairman psychiatry at Dow University of Health Sciences Prof Raza ur Rahman showed the audience horrifying videos of young children in schools and madressahs being tormented by their teachers. He explained that such incidents could scar a child for life and cause mental health problems. “Even though NA 2013 bill and HC order 2018 prohibit corporal punishment of children in institutions, it is still practised. There is little awareness of the costs of abrasive methods of disciplining that are still commonly employed.”

He also stressed the need to make the socio-cultural context our starting point and seek to understand our children’s lives, their preferences and their experiences. “There is usually a reason why children and young people behave as they do, and openness to understanding their worlds bring opportunities for genuine connection and conversation.”

Senator Karim Khawaja was also present and spoke about the progress in the Sindh Mental Health Authority and explained that neither funds nor an office had been provided to the mental health authority by the provincial government despite the Sindh High Court’s directives. Yet there are plans in place for the establishment of an office in the city so it can start functioning next month.

Dean of the Jinnah Postgraduate Medical Centre Prof M. Iqbal Afridi highlighted the role sleep plays in modern life. “Sleep is not only important in the prevention of illnesses but essential for good performance in the academic and occupation domains. Despite it being an essential component for performance and well-being, people consider it a passive phenomenon and neglect its importance.”

Even statistics show that sleep patterns have changed over the years and more and more individuals are sleeping less than six hours per night. “Less than six hours of sleep per night may lead up to greater than 30 per cent risk of dying regardless of the cause. And sleep disturbances have been associated with non-organic and organic psychiatric disorders, including anxiety and mood disorder, substance use and psychotic disorder.”

Published in Dawn, October 15th, 2018