Journal of Pakistan Psychiatric Society

SCHOOL-BASED MENTAL HEALTH: PARADIGM SHIFT IN ADDRESSING MENTAL HEALTH OF PAKISTANI YOUTH

2024-12-27T21:28:57+00:00

About 20-25% of the youth suffer from mental and substance use disorders. About 50% of these mental disorders have an onset before age 15, and 75% by 25 years contributing to about five trillion dollars of economic losses every year. Youth’s mental health is imperative in how they think, behave, and learn. School is a critical place in the lives of developing youth, presenting a unique place for prevention and early interventions. Developed countries, such as the United States of America (USA), Canada, the United Kingdom, and Australia, have established a framework that focuses on enhancing teachers' efficacy in recognizing warning signs for mental health problems. They also liaise with school counselors and mental health professionals to ensure that at-risk individuals get appropriate help for early prevention. Moreover, students are also taught about mental health problems to raise awareness and reduce the stigma associated with it. Pakistan is also making considerable progress to counter mental health in its youth. The School Mental Health Programmes for teachers and Theory of Change model are a few examples of initiatives taken by our government in collaboration with other stakeholders which have shown promise in addressing the mental health problems in children. Moving forward it is essential for the stakeholders, policymakers, and state institutions to collaboratively build a framework that serves the mental health needs of the Pakistani youth, keeping in perspective the cultural context and limited infrastructure.

FORENSIC MENTAL HEALTH – TIME TO IMPLEMENT SAFIA BANO

2024-12-27T21:10:50+00:00

Over 3 years have passed since the landmark Safia Bano Supreme Court judgement. This judgment laid the foundations for capacity building in the area of forensic mental health however there is more work needed to improve the basic understanding of forensic mental health in professionals who interact with the mentally offender on behalf of the courts. In 2023 the Noor Muqaddam case showed that lessons from Safia Bano seemed not to have been completely implemented. However, there has been some progress in this area and the need for legislative changes to add accountability in implementing the historical Safia Bano judgement.

TRENDS IN THE CLINICAL PRACTICE OF LIAISON PSYCHIATRY AT A TERTIARY CARE HOSPITAL IN LAHORE, PAKISTAN

2024-12-27T21:14:04+00:00

Objectives: To ascertain the trends in referrals made to the Department of Psychiatry from all other departments of Mayo Hospital, Lahore, Pakistan.
Study design: Descriptive cross-sectional research design.
Place and duration of study: Mayo hospital, Lahore, Pakistan. Six months (Dec,2023-June,2024)
Methodology: Convenience sampling was used to select participants, consisting of patients admitted to all wards at Mayo Hospital requiring Psychiatric consultation. Patients were enrolled using a pre-designed online form. Data included details of participants' age and gender, number and type of consultation, reason for hospital admission, reason for referral, active complaints, past psychiatric history, mental status examination, co-morbidities, risk of self-harm or harm to others and management plan. Informed verbal consent was obtained from each patient. Patients who refused to give informed consent were excluded. Data analysis was performed using SPSS 27.
Results: 220 patients received Liaison Psychiatric services, the most patients (36.4%) were admitted in General Medicine followed by (19.5%) in General Surgery. Majority (26.8%) were adolescents and 89.1% consulted a Psychiatric service for the first time. 53.2% women received liaison Psychiatric services. History of substance use was reported by 20%. The commonest reason for admission was multiple comorbidities (16.4%). Majority of the patients were referred to Psychiatric services with symptoms of depression (21.8%), self-injurious or suicidal behavior (14.5%), altered state of consciousness (14.1%), substance use disorders (14.1%), irritability or uncooperative behavior (11.8%), acutely disturbed behavior (10.9%).

Conclusion: Consultation model is being used by physicians however, there is a need to educate the clinical teams about Liaison Psychiatry model to help solve difficult liaison cases.

DEVELOPMENT OF FORMAN MORAL DEVELOPMENT SCALE FOR YOUNG ADULTS

2024-12-27T21:42:43+00:00

ABSTRACT

Objectives: To identify the moral components especially in Pakistani cultural context and to develop an indigenous scale of Moral Development for young adults

Place and Duration of Study: Lahore, Pakistan. 1 year.

Design and Method: The study was carried out into 2 phases; in the first phase, a pool of 40 items was generated while conducting two separate focus groups with clinical psychologists and young adults and , and semi-structured in-depth interviews with university professors. A 5-point Likert scale of 40 items was developed. 280 young adults, aged 18-25, (M=139(49.6%) F=141(50.4%) from two private and government university students were approached through non probability purposive sampling. In the second phase, the scale was administered on young adults, content and construct validity was established. Exploratory factor analysis was conducted using SPSS 25.

Results: Principal Component Analysis with Varimax rotation and Kaisar normalization, Kaisar-Meyer-Olkin (KMO) measure of Sample adequacy yielded a value of 0.753, indicating satisfactory sample adequacy, and Bartlett's test of Sphericity was significant (p < 0.001). The Scree plot suggested 4 factors; Moral disengagement, Moral maturity, parental/societal influence, social media/peer influence.

Conclusion: Present study contributed in the development of indigenous assessment tool for young adults of Pakistan. Presently no such tool was available to study moral development in young adults.

Key words: Morality, Moral Development, Parental influence, Moral Judgment, Moral maturity, Ethical Sensitivity, Moral disengagement.

URBAN-RURAL COMPARISONS OF ATTITUDE TOWARDS MENTAL ILLNESS AMONGST HEALTHCARE UNIVERSITY STUDENTS

2024-12-28T08:11:28+00:00

Abstract:

Objective: To examine and compare the differences in attitudes of healthcare university students towards mental illness from urban and rural backgrounds.

Design: Cross-sectional study

Place and duration of study: Study was conducted at Liaquat University of Medical & Health Sciences Jamshoro, Sindh from October to December 2023.

Methods: Sampling population were undergraduate students registered in different undergraduate healthcare programs (MBBS, BDS, DPT, Pharmacy, Nursing, Biomedical Engineering, BS MLT, BSRT, BS Forensic Chemistry/Biology and other allied departments), aged 18-27 years, of either gender, gave their consent of participation were included in the study. Data was collected with the help of online questionnaire. Mental Illness Clinician Attitude Scale (MICA-2 and 4) were employed to assess the healthcare student’s attitude towards mental illness.

Results: There was female preponderance and mean age of subjects was 21.38 years ± SD 1.689. Majority of students were from MBBS and studying in final year and belonged to rural areas. The Median MICA score was 52. There was significant difference between scores of rural and urban students and statistically significant difference was noted among students from different departments and academic years.

Conclusion: Overall attitude of healthcare university undergraduate students towards mental health illness is unsatisfactory. Whereas, the students from rural areas had poor attitude towards mental illness compared with those from the urban areas.

A 10-YEAR STUDY OF LENGTH OF STAY OF PSYCHIATRIC ADMISSIONS IN A TERTIARY CARE HOSPITAL IN RAWALPINDI

2024-12-27T21:20:36+00:00

Objective

To study the frequency of demographic variables along with the Length of Stay (LOS) in inpatient psychiatric facility related to category of psychiatric diagnosis.

Design

Retrospective chart review

Place and Duration of Study

The medical records of all admissions in Benazir Bhutto Hospital Rawalpindi spanning the period from January 2007 to December 2016 were reviewed.

Patients and Methods

Length of Stay (LOS) of patients admitted at the Institute of Psychiatry, Benazir Bhutto Hospital were noted. LOS greater than 10 days was considered as a cut-off point for lengthier stay.

Results

In this study involving 3,975 psychiatric inpatients, nearly 70% of the admissions were female, with depressive disorder being the most prevalent diagnosis. Over the decade, there was a notable reduction in the average length of hospital stay, decreasing from 13 to 9 days. A significant proportion (18.2%) of patients left against medical advice, with a higher percentage among females (19.3%) compared to males (15.5%). Patients were categorized into five age groups, and the highest admissions occurred among those aged 16 to 30 years (52.3%). The data also revealed fluctuations in the mean length of hospital stay over the years, ultimately averaging less than two weeks. Psychiatric diagnoses included a range of disorders, with depressive illness, schizophrenia, and bipolar affective disorder being the most common, while certain disorders like anorexia nervosa were less frequently encountered.

Conclusion

This study reveals that over the decade there is significant decrease in average hospital stays. This study underscores the need for further research to enhance psychiatric care in resource-limited regions.

EXPERIENCES OF MOTHERS OF CHILDREN WITH INTELLECTUAL DISABILITIES IN SPECIAL SCHOOL SETTINGS IN KARACHI, PAKISTAN: AN EXPLORATORY QUALITATIVE STUDY

2024-12-27T21:04:01+00:00

OBJECTIVES
To explore the experiences of mothers of children with intellectual disabilities in special school settings, and to understand the beliefs, views, feelings, specific challenges and lived experiences of raising a child with Intellectual Disability (ID).
STUDY DESIGN
Exploratory qualitative study.
PLACE AND DURATION OF STUDY
Four schools for special need students in Karachi, Pakistan from July 2018 to February 2019 (6 months).
METHOD
Qualitative interviews were conducted with mothers with ages ranging from 18 to 55 years and with only one ID child. A total of 19 mothers agreed and took part in the study. Prior to the start of interviews, written informed consents were taken from all mothers for the interview session, that were conducted in the participants’ local language. The results gathered were analysed by using thematic framework analysis method comprising five steps.
RESULTS
Five major themes were identified that reflected the experiences of mothers of children with intellectual disabilities: (1) Diagnosis and Reaction to Diagnosis, (2) Maternal Concerns and Future Uncertainties, (3) Effects on Mothers and Coping Strategies, and (4) Perspectives on Support Systems and Recommendations for Improvement. Each theme provides insight into the unique challenges and resilience of mothers navigating their caregiving roles.
CONCLUSION
The themes identified conclude that mothers’ sufferings are caused by the societal attitude and the adequate provision of health, educational, monetary and moral help. This necessitates the establishment of appropriate and efficient measures, resources and assistance for mothers coping with this stigmatising situation.
KEYWORDS
intellectual disability, mothers, thematic framework analysis, effective interventions

MENTAL HEALTH COMMUNITY TO BRACE FOR A NEWER GAMING ADDICTION

2024-12-27T21:24:27+00:00

Video game addiction is defined as the steady and repetitive use of the Internet to play games frequently. IGD is now included in DSM-5 under conditions for furthur research.The proposed symptoms of internet gaming disorder include Preoccupation , Withdrawal symptoms , possible (sadness, anxiety, irritability),Tolerance, Inability to reduce playing, unsuccessful attempts to quit gaming , Giving up other activities ,Continuing to game despite problems, Deceiving family members or others about the amount of time spent on gaming. It is estimated that 4.7% of the population is affected by this disease on average, based on research conducted over the previous two decades. In a study done in Pakistan the alarming level of IGD was found in youth in Pakistan (58.9%).Most effective is CBT for Internet addiction (CBT-IA).

EXPLORING THE IMPACT OF CLIMATE CHANGE ON PAKISTANI WOMEN'S MENTAL HEALTH

2024-12-27T21:26:12+00:00

The urgency of climate change cannot be overstated. Its impact is felt by everyone worldwide, regardless of wealth, development status, or stability. Hence it is crucial to work together to reduce the effects of climate change and protect the most vulnerable populations. There is a strong and intricate connection between the health of women and climate change, which is further complicated by existing gender disparities

Research and evidence from various regions indicate that climate change and severe weather events have adverse effects on the health of women

FOUNTAIN HOUSE LAHORE: A PIONEERING FACILITY IN THE FIELD OF TREATMENT AND PSYCHOSOCIAL REHABILITATION IN PAKISTAN

2025-01-01T13:55:04+00:00

Psychiatric rehabilitation is still in its infancy in Pakistan, and over the last few decades is going through several developments in various areas related to psychosocial rehabilitation.⁴ The major milestone in this journey was the establishment of the Lahore Mental Health Association (LMHA) in 1962 to mobilise community resources for the uplift and promotion of psychosocial rehabilitation in the country. In 1963, the association started a project with the objective of rehabilitation and resettlement of chronically mentally ill patients discharged from Mental Hospital to the community. This day-night rehabilitation facility was started in 1971 and named Fountain House following its links with the Fountain House in New York. Fountain House moved to its present premises in 1976 and presently offers a wide range of community-based treatments for long-term mental health patients.⁵ Since its inception, it has continued to extend its services in the community & has successfully expanded its branches & now operates in three cities of Pakistan - Lahore, Sargodha, and Farooq Abad (Sheikhupura).

THE BEAUTY OF PURITY, TRANSFORMATION AND RENEWAL

2024-12-27T20:49:51+00:00

Traditionally, rare and striking creatures are revered as powerful emblems of transformation and personal growth. One such symbol is a bird that embodies purity, renewal, and spiritual awakening. With its extraordinary appearance, this bird represents not only beauty but also resilience—the ability to overcome challenges and emerge stronger. It serves as a reminder that healing and growth are possible despite adversity. This symbolism is most powerfully portrayed by the white peacock, whose rare and serene presence highlights the potential for profound transformation, inner peace, and the beauty found in renewal. As a metaphor of strength, this magnificent being encourages us to embrace our uniqueness, find beauty in our struggles, and pursue balance in our mental and emotional well-being. The white peacock’s rare presence provides us a compelling inspiration, that like this majestic bird, we too can rise above our challenges and emerge into a new chapter of growth and self-discovery.