Psychiatry in Pakistan (1947–1994): the balance sheet

Abstract

At the time of independence (1947) Pakistan with a population of 40 million had three asylum-like hospitals with a total of less than 2000 beds. The hospitals were prison-like and they provided custody with little care. Patients were mostly brought in chains. Detention and reception orders were used for admission as provided in law and the law was and continues to be the Lunacy Act of 1912. The common man referred to them as pagal-khanas (mad houses) or jail hospitals. The doctors appointed were mostly general duty doctors with no training and often no interest in psychiatry and their average stay was two to three years. In place of nurses there was a cadre of attendant staff, most of them illiterate, untrained and acting more like police sepoy or jail warder than nurse.

Mental Health in South Asia: Ethics, Resources, Programs and Legislation

“…Pakistan with a population of over 160 million also struggles with the mental health programs due to a number of reasons (Shafique 1995;Gadit 2006a). Mental illnesses are stigmatized and widely perceived to have supernatural causes.…”

Psychiatry in Pakistan

“…The Government of Pakistan spends each year about 0.2% of its total income on health (Mackay, 1993) and the average number of people served by a primary care physician is 2,364. There are more than two hundred qualified psychiatrists with marked clusters in the urban zones (Shafique, 1995). background At the time of independence in 1947 Pakistan inherited a large mental hospital in Lahore, a smaller one in Hyderabad and a psychiatric wing within the premises of the Central Gaol in Peshawar.…”

Community psychiatry in developing countries – a misnomer?

“…In many countries a few mental health hospitals were built by the colonial powers, mainly in big cities, but the number of beds in these hospitals had no comparison with those in the developed nations. For example, Pakistan, with a population of over 40 million, had only three mental health hospitals in the early 1950s (Shafique, 1995). In developing countries almost all the care was provided by the family without any involvement of psychiatric services.…”