Why you cannot afford mental health care in Pakistan

Ten percent of the Pakistani population suffer from mild mental health disorders, including depression, anxiety, and post-traumatic stress, to name a few. While 1% of the population has been diagnosed with serious mental health disorders, according to the World Health Organization.

With the stigmas and taboos associated with mental illness in the country, coupled with a shortage of qualified professionals, mental health disorders often go untreated, neglected and overlooked.

At a seminar last year, practitioners noted that the ratio of physicians to patients in the field of mental health is a staggering 1:100,000 patients. In addition, they questioned the government’s inaction and lethargy when designing public health policies.

In recent years, private doctors have increased their therapy and consultation fees, making these services even more inaccessible. This has even forced some patients to opt-out of mental health programs, as insurance companies do not cover mental health.

And these patients are also unable to turn to the public sector for help, as doctors say the country’s major government hospitals only provide psychiatric help to severely mentally ill patients, with no room for counselling and psychological therapy.

The cost of mental health

In the private sector, psychologists charge a high fee per session, due to a lack of government regulation, patients complain.

“I started going to therapy in 2019 when the fees for each session were 1,500 rupees,” says *Mahnoor, a 25-year-old NGO worker in Karachi, “but then the fees kept rising until they reached 7,000 rupees per session. session. . With a monthly salary of Rs 45,000, continuing mental health care became impossible.”

Dr Shoaib Ahmad, head of the psychiatry department at Dow University of Health Sciences in Karachi, agrees with Mahnoor.

He recalls that in recent years, he has seen patients forced to pay Rs 200,000 to Rs 300,000 in advance to a well-known therapist to book an appointment, but even after attending several sessions, they did not notice any improvement. In their lives.

But Dr Rafia Rafiq, director of the Institute of Applied Psychology, differs from Dr Ahmad’s statement. She explains that there is a difference between a psychologist and a psychiatrist, which is why the charges per session vary.

An average fee for therapy is 3,000 rupees, but it can also be as low as 1,000 rupees or as high as 7,000 rupees, the doctor said.

“Psychiatrists prescribe medication, while psychologists provide an hour-long therapy session,” he said. geo.tv, “The latter involves evaluation and report writing, which is why such sessions are often expensive and require multiple tests.”

What does the law say?

Last month, a bill to regulate the profession, titled the Pakistan Psychological Council Bill, was unanimously struck down by the Senate’s standing committee on National Health Services, with the objection that the areas mentioned in the bill were already covered in the Allied Health Professional Council Bill. It happened in February.

The Allied Health Professional Council Act 2022 is now law and is aimed at a basic and higher qualification standard in various Allied Health hospitals and to regulate the registration and licensing of professionals in the field.

The law defines “professionals” as those who provide diagnostic, therapeutic, preventive, curative or rehabilitative services in the field of health.

However, patients are demanding that the law also provide the option of affordable mental health services and address skyrocketing drug prices.

“A few months ago, the pills I took for my depression cost less than 400 rupees,” said Dr Moiz Merub Awan, a doctor in Karachi. geo.tv“Now I pay more than 3,000 rupees for the same pills.”

Dr Merub, who is an expert on global politics, said that the coronavirus pandemic took a toll on his mental health. “I pay 10,000 rupees every month just for four therapy sessions, then there is the cost of my medicines. And no insurance company will cover this cost,” he said.

the black market

Sometimes psychiatric drugs suddenly disappear from the market and are then sold on the black market for 10 times the original price.

Wasif, a 24-year-old student, said that when he can’t find the medicine he needs, shopkeepers at the pharmacy advise him to buy it from an unregistered seller.

“An antidepressant that normally costs 200 rupees at a local pharmacy costs 1,200 rupees if bought in black,” he said. Geo.tv.

Rising costs of psychiatric medications may cause patients to stop prescribed treatment, which can be detrimental to their long-term health, said Dr Imtiaz Dogar, president of the Pakistan Psychiatric Society.

Some patients, such as those with bipolar disorder, urgently need medication, he added.

“If these patients go untreated for a long period, the chance of their condition worsening and increasing by many folds can also lead to a person injuring themselves,” said Dr Dogar. geo.tv” Long-term treatment is necessary to save lives.”