RESEARCH PROPOSAL

CAN THE MISCONCEPTION OF MENTAL ILLNESS AND THE STIGMAN THAT

FOLLOWS BE REDUCED IN PAKISTAN?

ALEEZA KHAN

THE LYCEUM

SOCIOLOGY

RESEARCH SKILLS

9TH NOVEMBER 2017

Research Question

How is mental illness viewed in our society and why is it considered as a taboo topic?

Why are there misconceptions about the people suffering from mental disorders?

Mental illness is a field which affects approximately 16 percent of Pakistan’s population, (Arif

Mahmood, 2014) However, it’s also the most neglected health field. Is the government taking

necessary steps in providing proper medical, educational and other important facilities for people

who suffer from mental illness?

Rationale

Pakistan is deprived of the appropriate resources imperative people struggling with

mental illness. The members of society heavily discriminate towards such people and mental

disorders such as Depression, Schizophrenia and Post Traumatic Stress Disorder are brushed off

as an ordinary disease or ignored. According to the WHO, only 400 psychiatrists and 5

psychiatric hospitals exist within the entire country for a population exceeding 180 million. This

roughly translates to an alarming psychiatrist-to-person ratio of 1 to half a million people (Arif

Mahmood, 2004). This results in patients who have gathered the courage and the support of their

family to look for medical help but later get to know there isn’t much help to offer them. Society

becomes ignorant and does not take the steps according to this matter making an individual’s

condition worsen. Mental health patients are stigmatized as social outcasts and their treatment is

kept protected by their family as a disgraceful secret (Khawaja, 2013).

Also certain eating disorders which do not pose a threat to social norms are often dismissed as an

actual issue. People along with the media and the fashion industry indirectly promote anorexia

nervosa by outlining certain weight criteria to be acceptable in society. (Khawaja, 2013)

Literature Review

The literature review will briefly set the context for the issue of the stigma surrounding

mental illness in Pakistan. Kishore, Gupta, Jiloha & Bantman (2011) explain that mental and

behavioral disorders are present worldwide in any year in about 10% of the adult population.

The burden of mental disorders is maximal in young adults which are considered as the most

productive section of the population. Neuropsychiatry conditions together account for 10.96% of

the global burden of disease as measured by disability-adjusted life years. In most countries,

families are forced to bear a significant proportion of these economic costs because of the

absence of public funded comprehensive mental health service networks which the government

fails to provide by not paying importance to such necessary facilities. Families also incur social

costs, such as the emotional burden of looking after disabled family members, diminished quality

of life for careers, social exclusion, stigmatization, and loss of future opportunities for self-

improvement. This burden emphasizes the need of scientific studies in various aspects of mental

disorders. Kishore et al (2011) provide insight on the common misconceptions and attitudes

embedded in them. Access to adequate mental health care always falls short of both implicit and

explicit needs. This can be explained in part by the fact that mental illness is still not well

understood and considered a taboo. The mentally ill, their families and relatives, as well as

professionals providing specialized care, are still the object of marked stigmatization as these

attitudes are deeply rooted in society and cannot be changed or altered easily.

Amy Morin (2015) talks about the misconceptions society has about mental illness. Considering

mental illness as a sign of weakness is one of them. Individuals who associate people with

depression, anxiety or any other mental disorders to be mentally weak are those who also claim

that somehow mental strength stigmatizes mental illness. Mental health and mental strength are
not the same. Morin (2015) gives the example of a person with diabetes being physically strong

and a person with depression being mentally strong; your mental health issue does not define or

affect your mental strength. Another stereotype created by the media is violence being linked to

mental illness. Whenever mental illness is mentioned by the media its often in regard to a mass

shooting or any other violent act. “The American Psychological Association reports that only

7.5% of crimes are directly related to symptoms of mental illness.”

Many mental health problems are not curable but they still can be treated to an extent where it

becomes easier for the individual to experience relief in their life. “The National Alliance on

Mental Illness reports that between 70 and 90% of individuals experience symptom relief with a

combination of therapy and medication.”

According to Rayan & Fawaz (2017) Mental illnesses are widespread in Lebanon, with

prevalence comparable to that in Western Europe the war-associated trauma, internal

conflictions, and political insecurity in the Middle East Region have augmented the emergence

of some mental health problems. With respect to research conducted by the American University

of Beirut, rates of posttraumatic stress disorder (PTSD) and depression have reached 30% in

some areas of southern Lebanon. Prevalence rates of PTSD ranged from 8.5 to 14.7% for the

civil war, 21.6% for the Grapes of Wrath War, and 15.4 to 35.0% for the 2006 July War.13

Furthermore, it is estimated that 152 people in Lebanon die annually due to suicide.

Rüsch, Angermeyer & Corrigan (2005) divide the struggles of a person dealing with mental

illness into two. The first struggle being to cope with the symptoms of the mental disorder make

it difficult for a person to work or live independently. The second struggle was defined as “the

misunderstandings of society about the various mental disorders result in stigma.”

In Germany, America and many other countries, consumer groups have actively targeted stigma

in an attempt to improve the lives of people suffering from mental illness. As a particularly

successful example in the US, the National Alliance of the Mentally Ill, a group of family

members and persons with mental illness, has been educating the public in order to diminish

stigmatizing conditions; e.g. by pressing for better legal protection for people with mental illness

in the areas of housing and work. Germany has also set up various anti-stigma campaigns such as

BASTA (Bavarian Anti-Stigma Action) and the Irrsinnig Menschlich (Madly Human). So

according to this review stigma’s main components consist of stereotypes, prejudice and

discrimination and its consequences consist of fear being produced which acts as a barrier to use

health services.

For a population of 180 million, there are only five psychiatric hospitals in the country.

However, several big private hospitals, including Aga Khan University Hospital (AKUH), have a

psychiatric ward for mental health patients. The hospital also has a short-term adult psychiatric

unit which includes 18 beds. Researchers say that the quicker a person seeks help the more

chances of recovery they have (Anwar, 2017).

WHO (world health organization) AIMS report on Mental Health In Pakistan states that a

“national human rights review body exists which has the authority to oversee regular inspections

in mental health facilities, review involuntary admission and discharge procedures; review

complaints investigation processes; and the review body has the authority to impose sanctions.”

Out of the 3729 outpatient mental health facilities available in Pakistan, 1 percent is only for

children and adolescents. These facilities treat 343.34 users per 100,000 general populations out

of which 69% are female and 46% are children or adolescents. However there are 624 inpatient

psychiatric units available which contain 1926 beds per 100,000 populations. 75% of the patients
are female and 18% are child or adolescents. By 2009 there were 5 mental health hospitals with

the ratio or 1.9 beds to 100,000 populations and the number of beds has increased 4% in the 5

years following this research.

Research Methods and Ethics

This section will state the procedure that will be used to conduct research on Mental

Illness, how society’s approach to it affects the people who suffer from such conditions and how

this stigma be reduced in Pakistan. My research would mostly consist of primary data since I

believe I would gain more information specific to my topic through this method. The data

collected in this research would mostly consist of qualitative data which would be accumulated

by conducting interviews, focus groups and other methods.

For quantitative data I will use age, gender and other factors to distinguish the information

gained form the focus groups. I will conduct these focus groups in the Lyceum campus and the

community in which I reside in. The general characteristics of the focus group are people's

involvement, a series of meetings, the homogeneity of participants with respect to research

interests, the generation of qualitative data, and discussion focused on a topic, which is

determined by the purpose of the research (Freitas, Oliveria, Jenkins, Popjoy 1998). In the focus

group my aim would be to interact openly with the people and give them a verbal description of

what the purpose this focus group is. The groups would either be held separately for men and

women or combined with a maximum of 10-12 people attending each session, since a larger

number would be more difficult to handle. The reason for segregating some sessions of the focus
group is so that both genders could openly answer and express their opinions on the questions

asked.

I also plan on visiting the small amount of schools which cater to the needs of children with

mental illness such as the Pakistan Navy Special Children School in Karsaz. The purpose of my

visits would be to get a little more insight on how these children receive their education and what

is the current condition of these schools. My plan is to gather more knowledge of the way mental

illness is viewed and treated in our country and to discover methods which would help reduce the

stigma that follows it.

References

Kishore, Gupta, Jiloha and Bantman (2011) Myths, beliefs and perceptions about mental

disorders and health-seeking behavior in Delhi, India.

WHO-AIMS REPORT ON MENTAL HEALTH SYSTEM IN PAKISTAN (2009).

Rayan PhD1, Fawaz PhD2 (2017) Cultural misconceptions and public stigma against mental

illness among Lebanese university students.

Rüsch, Angermeyer, Corrigan (2005) Mental illness stigma: Concepts, consequences, and

initiatives to reduce stigma.

The stigmatization of mental illnesses (2013). Retrieved from

https://www.pakistantoday.com.pk/2013/03/15/the-stigmatisation-of-mental-illnesses/

Mental illness in Pakistan: The toll of neglect (2014). Retrieved from

https://www.dawn.com/news/1133196

The 5 Most Common Misconceptions About Mental Illness (2015). Retrieved from

https://www.psychologytoday.com/blog/what-mentally-strong-people-dont-do/201511/the-5-

most-common-misconceptions-about-mental