Depressed, anxious, delusional out-of-sorts, feeling high, zoned-out, being manic, on drugs, committed to a rehab, diagnosed bipolar, suffering from schizophrenia, having learning and attention deficit disorder and the list goes on and on when we talk about state of mental health in our beloved land.
Civilization has taken its toll on our minds. Many among us captives of human zoo find it hard to cope with raw, brutal reality in all its grandeur. Dashed hopes, anxiety-inducing interactions, broken hearts, fragile minds, shattered expectations along with endless struggle to find a constant place in an ever-changing world turns some of us into full-blown loonies while others hold on to sanity as hard as they could and for as long as possible.
And once the crazies cross the red line. They are thrown in the looney bin (read Rehabilitation Centre).
From Manto’s Tooba Tak Singh to One flew over the Cuckoo’s Nest, psychiatric wards and Lunatic asylums have been part of our collective cultural psyche. These rehabilitation centers offer treatment for drug abuse, psychiatric disorders, alcohol addiction, stress management, and other mental ailments. Here in our land of the Pure, interestingly, the number of psychiatric patients in these rehabs is far less than drug addicts. The number of heroin and charas addicts outnumber alcoholics and psychiatric patients in almost every single rehabilitation centre.
Psychiatric patients are involuntarily interred by either their parents, friends, children or spouses. Patients suffering from Depression, Schizophrenia, Bipolar Disorder, Suicidal Ideation and a history of self harm, on recommendation of a psychiatrist are admitted to these rehab centres as most government and private hospitals lack psychiatric wards. Strangely, the lunatic asylum called Society has a very special madhouses to inter it’s more insane ones.
Many of these rehabilitation centres take benefit of poor governmental regulations, lack of checks and balances by concerned governmental bodies, lack of rehabilitation facilities at government hospitals. The privatisation hasn’t even spared madness and its remedies.
Opened in small, rented houses in suburban areas, these rehabilitation centres provide services to both psychiatric patients and drug addicts at exorbitant prices. The staff hired at these rehabilitation centres are under-qualified and poorly paid. The most worrying aspect of all is that aforementioned rehabilitation centres who offer in-patient facilities are neither registered with the social welfare agency or health directorates in their respective provinces.
Up till 2001, the Lunacy Act of 1912 regulated both the medical treatment meted out to psychiatric patients in Pakistan and the rehabilitation centres—both in private and public sector—came under its purview. It took almost a decade to replace the outdated, colonial-era legislation with Mental Health Ordinance 2001 that aimed to bring about the necessary changes that took place in the mental health practice over a century.
I opted psychology during my bachelors and like many the chapters covering psychopathology caught my interest. From mild phobias to debilitating schizophrenia, the other side of sanity seems like a fantasyland without escape. However, when I visited a couple of rehabilitation centres located in and around Islamabad I was surprised to find out that majority of the patients brought there didn’t suffer from psychiatric ailments. Most of the patients were heroin and charas addicts who were committed to these rehabilitation centres against their will.
And as Nietzsche said about rarity of insanity in individuals and it being the norm in societies and epochs, our mad men await redemption from the darkness that surrounds them.