Impact of Conventional Beliefs and Social Stigma on Attitude Towards Access to Mental Health Services in Pakistan

Shah, Inayat; Khalily, Muhammad Tahir; Ahmad, Ismail Sheikh; Hallahan, Brian

doi:10.1007/s10597-018-0310-4

Cited by 20 publications

(16 citation statements)

References 40 publications

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“…To the best of our knowledge this was the rst study to determine the factors associated with anxiety and depression among a representative and diverse group of frontline physicians from 65 cities of Pakistan. Yet, depression and anxiety may have been underreported here as mental illness is a social stigma in our part of the world not only among the general population but also among healthcare providers (20,21). Moreover, we only used one scale to report depression and anxiety as the survey was online and asking a too many questions from frontline doctors was not feasible.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Pandemic- Knowledge, Perception, Anxiety and Depression Among Frontline Doctors of Pakistan

Amin

Sharif

Saeed

et al. 2020

Preprint

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BackgroundCOVID-19 is a global pandemic and has become a major public health burden worldwide. With already fragile healthcare systems it can have long lasting effects in developing countries. Outbreaks especially a pandemic situation evokes fear related behaviors among healthcare professionals and there is always an increased risk of mental health disorders. Therefore, this study aims to determine knowledge and perception about this pandemic, prevalence and factors associated with depression/ anxiety among frontline physicians of Pakistan.MethodsData were collected through an online survey released in the last week of March-2020. 389 frontline physicians from all four provinces and 65 cities of Pakistan participated. Survey questionnaire consisted of 4 parts including informed consent section, demographic section, knowledge and perception about COVID-19 pandemic and assessment of depression through World Health Organization Self-reporting questionnaire (SRQ-20). A score of 8 or above on SRQ-20 was used as cut-off to label the participant as depressed. Data was analyzed using SPSS version22.ResultsA 43% prevalence of depression/anxiety among frontline physicians of Pakistan was reported. Almost all the doctors had moderate to high knowledge score. Majority of participants marked N-95 mask as essential while aerosol generating procedures, assessing patients with respiratory symptoms, in COVID patient care area, ER triage and direct care of COVID-19 patient. Only 12% of the doctors were fully satisfied with the provision of PPEs and almost 94% felt unprotected.In multivariable model, the odds of depression was high in physicians who were assessing more than five COVID suspects/patients per day (aOR=2.73, 95% CI: 1.65 – 4.52), who were working 20 hours/week or less (aOR=2.11, 1.27 – 3.49), had children among household members (aOR= 1.58, 95% CI: 1.00 – 2.50) and had moderate to low knowledge of the infection (aOR=2.69, 95% CI: 1.68 – 4.31).ConclusionDepression/anxiety among more than a third of frontline doctors of Pakistan warrants the need to address mental health of doctors caring for patients during this pandemic; control modifiable factors associated with it and explore the effectiveness of interventions to promote psychological well-being of physicians.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Pandemic- Knowledge, Perception, Anxiety and Depression Among Frontline Doctors of Pakistan

Amin

Sharif

Saeed

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…To the best of our knowledge this was the first study to determine the factors associated with anxiety and depression among a representative and diverse group of frontline physicians from 65 cities of Pakistan. Yet, depression and anxiety may have been underreported here as mental illness is a social stigma in our part of the world not only among the general population but also among healthcare providers [ 21 , 22 ]. Moreover, we only used one scale to report depression and anxiety as the survey was online and asking a too many questions from frontline doctors was not feasible.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 pandemic- knowledge, perception, anxiety and depression among frontline doctors of Pakistan

et al. 2020

View full text Add to dashboard Cite

Background COVID-19 is a global pandemic and has become a major public health burden worldwide. With already fragile healthcare systems it can have long lasting effects in developing countries. Outbreaks especially a pandemic situation evokes fear related behaviors among healthcare professionals and there is always an increased risk of mental health disorders. Therefore, this study aims to determine knowledge and perception about this pandemic, prevalence and factors associated with anxiety/depression among frontline physicians of Pakistan. Methods Data were collected through an online survey released in the last week of March-2020. 389 frontline physicians from all four provinces and 65 cities of Pakistan participated. Survey questionnaire consisted of 4 parts including informed consent section, demographic section, knowledge and perception about COVID-19 pandemic and assessment of depression through World Health Organization Self-reporting questionnaire (SRQ-20). A score of 8 or above on SRQ-20 was used as cut-off to label the participant as depressed. Data was analyzed using SPSS version22. Results A 43% prevalence of anxiety/depression among frontline physicians of Pakistan was reported. Almost all the doctors had moderate to high knowledge score. Majority of participants marked N-95 mask as “essential” during aerosol generating procedures, assessing patients with respiratory symptoms, in COVID patient-care area, ER triage and direct care of COVID-19 patient. Only 12% of the doctors were fully satisfied with the provision of PPEs and almost 94% felt unprotected. In multivariable model, assessing more than five COVID suspects/day (aOR = 2.73, 95% CI: 1.65–4.52), working 20 h/week or less (aOR = 2.11, 1.27–3.49), having children among household members (aOR = 1.58, 95% CI: 1.00–2.50) and moderate to low knowledge of the infection (aOR = 2.69, 95% CI: 1.68–4.31) were found to be independent predictors of anxiety/depression among physicians. Conclusion Anxiety/depression among more than a third of frontline doctors of Pakistan warrants the need to address mental health of doctors caring for patients during this pandemic; control modifiable factors associated with it and explore the effectiveness of interventions to promote psychological well-being of physicians.

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“…People frequently view psychiatric help as the last option. They prefer to consult religious healers ( Maulvi , Peer / Fakir ), naturopathy ( Tibb ), homeopathic doctors, faith healers ( Aamil Sanyasi ), or sometimes school teachers for guidance and solace (Mirza et al, 2009; Mirza, Mujtaba, Chaudhry, & Jenkins, 2006; Naeem, Ayub, Kingdon, & Gobbi, 2012; Shah et al, 2019; Usman et al, 2018; Zafar et al, 2008). On the contrary, some people also prefer consultation from general practitioners (Farooqi, 2006).…”

Section: Resultsmentioning

confidence: 99%

“…Mental health services are sought in a few cases, especially by residents of urban areas. This action is influenced by factors such as suggestions from others to engage in mental health services, the ineffectiveness of traditional healing treatments, the risky behaviors of individuals with psychiatric disorders/problems (threatening themselves, their caregivers or others), or a combination of these factors (James et al, 2002; Mirza et al, 2009; Naqvi, Hussain, Zaman, & Islam, 2009; Shah et al, 2019; Zafar et al, 2009). Pharmacotherapy was the most common psychiatric treatment, followed by psychotherapy and electroconvulsive therapy (Naeem et al, 2012; Zafar et al, 2009).…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of mental health literacy in Pakistan

Munawar

Khaiyom

Bokharey

et al. 2020

Asia-Pacific Psychiatry

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Individual mental health has become a primary global concern. In Pakistan, the prevalence of mental health issues is still unclear, as not many studies have assessed the level of mental health literacy (MHL) in the country. This systematic review aims to bridge this gap by encouraging the early detection of mental disorders, lessening stigma, and improving helpseeking behavior. Nine electronic databases were searched to identify empirical literature in this area. Only studies that evaluated MHL efficacy and those published in English were selected. Non-peer reviewed articles and gray literature were excluded. From 613 studies retrieved, 59 studies met the inclusion criteria and were reviewed. Forty-three of the included studies mentioned mental health outcome measures (of which only four mentioned reliability indices), 13 discussed stigma, 18 examined help-seeking approaches to mental illness treatments, and 47 discussed mental health knowledge. Additionally, the outcome of the MHL measures had considerable heterogeneity and limited validity. Meta-analysis was not conducted due to a lack of MHL operationalization. Besides, the measurement tools in the studies lacked consistency and standardization. This review compiled the available studies on MHL to assist researchers currently studying the various dimensions of MHL, as well as those designing new studies or investigating effective methods to increase MHL. This review highlights the need for well-designed controlled intervention studies. Further implications for researchers, practitioners, and policymakers are mentioned.

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Impact of Conventional Beliefs and Social Stigma on Attitude Towards Access to Mental Health Services in Pakistan

Cited by 20 publications

References 40 publications

COVID-19 Pandemic- Knowledge, Perception, Anxiety and Depression Among Frontline Doctors of Pakistan

COVID-19 Pandemic- Knowledge, Perception, Anxiety and Depression Among Frontline Doctors of Pakistan

COVID-19 pandemic- knowledge, perception, anxiety and depression among frontline doctors of Pakistan

A systematic review of mental health literacy in Pakistan

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