ISLAMABAD: Despite working in stressful and high-pressure environments, officials in the Islamabad police do not have access to counselling and mental health services to protect them provided to security forces the world over.

Police officials face odd duty hours, high pressure environments, financial issues, high expectations from superior officers and many other issues that can lead to depression and other mental health issues, and even suicide.

“Symptoms or tendency towards suicide starts in officials almost a year before reaching the point of no return. Though proper counselling should be provided to security officials, we are living in a country with a population of 200 million and around 1,000 psychiatrists,” Health Services Academy (HSA) Vice Chancellor Dr Asad Hafeez told Dawn.

Earlier this week, the inspector general of police Punjab announced that 30 psychologists would be hired to deal with issues of work-related stress affecting police across the province. The move came after the principal of the Police Training School in Rawat, Superintendent of Police Abrar Hussain Nekokara, killed himself in his office on Jan 13.

Nekokara’s suicide triggered debate online and in the mainstream media about mental health issues within the police force.

Head of the National Task Force on Mental Health Dr Rizwan Taj said that officials in security organisations such as the army and the police work under immense pressure.

He said personnel in such organisations feel a sense of responsibility, along with greater pressure. They can be called into duty at any time, which disturbs family life. Officials try to be more vigilant and there lifestyle is affected as a result, he added.

Dr Taj, who also heads the Pakistan Institute of Medical Sciences Department of Psychiatry, said that these officials do not have any outlets because their social lives, work and family lives are closely connected.

“Most of them have friends in the same profession, and they go out together so they do not get different avenues to release pressure or depression. The demands and needs of their families also increase with time and add to the pressure,” he said.

Dr Taj said stress management courses should be held for officials.

“Moreover, suicide is not a phenomenon that arrives all of a sudden. In fact, changes start months before the extreme step. The behaviour of the person starts changing but most people around them cannot understand that the person needs their help. I suggest that security departments take care of their staff and in case of any doubts, officials should be sent for treatment,” he said.

National Health Services (NHS) Secretary Dr Allah Bakhsh Malik said that the national task force has been tasked with making a policy regarding this issue.

“We have been considering launching the policy next month. The policy has four points: 100pc mental health coverage would be free, free counselling would be provided, once a person is enrolled he or she would be monitored throughout their life and called to attend counselling sessions,” he said.

Dr Hafeez from the HSAsaid suicide is preventable and a last resort that comes after many warning signs.

“In developed countries, warning signs are picked up and general practitioners and psychiatrists begin monitoring patients. Patients are not discharged from the hospital until doctors declare them to be safe,” he said.

He added: “In forces, the stress level increases because officials remain in stressful environments continuously and once they crack they find no option but to commit suicide. Officials should be monitored and picked for treatment. In developed countries, helplines are established for those who think about committing suicide but we do not have a helpline at the national level. Some organisations have tried it at the private level but they are not very familiar to the public.”

To a question, Dr Hafeez said the army has a psychological counselling system but the police lacks one.

“We have decided to work on mental health issues at the HSA and cooperation will also be sought from NGOs,” he said.

Psychiatrist Dr Bashir Hussain Shah told Dawn that police officials may be more vulnerable than the armed forces.

“The army has a mechanism [under which] officials are sent to peaceful areas after serving in hard areas.

“However, police officials remain under stress all the time. Moreover, rankers remain under more stress as they come from humble backgrounds and work hard to prove they deserve promotions or main positions. I have learned that SP Nekokara was under stress,” he said.

Dr Shah also recalled the case of a National Accountability Bureau (NAB) official Kamran Faisal, who killed himself in his room at a government hostel in Islamabad in 2013, three days after the Supreme Court ordered the prime minister’s arrest in the Rental Power Projects case. Faisal had been a part of the team investigating the case.

“The police call [psychiatrists] for sessions with cadets at the Police Training College Sihala. They should focus on counselling for on-the-job officials,” he said.

Deputy Inspector General of Police (Operations) Waqaruddin Syed said that in developed countries, police officials are not allowed in the field after a certain period of time because of the belief that depression becomes acute after eight to 10 years.

“We have introduced a mechanism for psychiatric tests at the time of recruitment of cadets. We give them picture stories to analyse the state of their mind just like it is done at the Inter Services Selection Board (ISSB). Psychological tests are also held at the level of assistant superintendent of police (ASP), as they are interviewed by three psychiatrists,” he said.

“However it is a fact that officials face depression after 10 or 20 years and we do not have a proper mechanism to deal with them. There are two psychiatrists deputed at women police stations in G-7 and they are requested to deal with such issues,” he said.

Mr Syed added that a meeting was held on this matter some days ago, and it was decided that a mechanism would be devised to check on all officials on an annual basis to avoid such incidents in the future.

Published in Dawn, January 23rd, 2020