In the 3rd part of this series, Dr. Syed Ali Wasif points out that mental health is not just a biochemical problem, due to the medical model of diagnosis and pharmacological means of treatment, it has social maladies and therefore, mental health is ignored and overlooked.

Mental health relates to the ability of an individual to withstand stress of everyday life. Stress stimulates individually to withstand stress of everyday life. Stress stimulates individual’s adaptive potentials they could be physical, biological of psychosocial. Some amount of stress is necessary for an individual to function normally, as stress causes emotional arousal which is needed for alertness. When stress is too intense or prolonged the individual can no longer control it, there is no social and emotional support, it can have destructive physiological and psychological effects and then it becomes the major cause of mental illness as well as psychosomatic illnesses like, hypertension, peptic ulcer, asthma, allergy, myocardial infarction, angina, uncontrolled diabetes, migraine, acne and many more.

According to WHO in most developing countries which includes Pakistan, the minimum number of people needing psychiatric attention is about 10-15% of the total population. If psychosomatic disorders and epilepsy are including this figure rises to over 35% and the facilities available are severely in adequate.

It appears that due to mounting stress an increasing awareness in rural and urban society, the need of psychiatric services will be considerably higher in future. Health needs more than the health services; primary healthcare is more than basic health unit (BHU) or a rural health center (RHC). Better health services need better communication systems, roads transport, telephone, electricity, portable water and housing, which are the basic human needs for the man of this new millennium. It means upliftment of a common man at economic, educational and aesthetic levels, and it calls for radical changes in the attitudes, outlook, beliefs and behavior.

It is estimated that emotional stress plays an important role in more than 50% of all medical problems, and it all depends on the behavioral and his reaction to stress, conflicts and frustrations.

It is therefore the behavior initiated, maintained or altered by the social environment, which is the determining factor. The micro and the macro environment are the reflection of socio-economic etho-economic and religio-political states of society.

Exploitation, subjugation, deprivation, neglect and social humiliation of man by man are a moral sin. Changing the lifestyle means changing the economic status of the society and removing injustice and achieving freedom to choose one’s own destiny. In other words, mental health of a community or a nation depends on its social organization, which determines the attitudes and the lifestyle. It is a collective responsibility of the whole society and requires participation of all concern people to bring a radical social change for a better tomorrow. Let’s hope for a change and a saner stigma free world for the generations yet to come!

Dr Syed Ali Wasif lives in Karachi and works with children and on child abuse in Pakistan. He can be contacted at wasif_ali@hotmail.com

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