Mental health care in Pakistan boosted by the highest office
2019; Elsevier BV; Volume: 394; Issue: 10216 Linguagem: Inglês
10.1016/s0140-6736(19)32979-4
ISSN1474-547X
Autores Tópico(s)Mental Health Treatment and Access
ResumoPakistan's President Arif Alvi launched the President's Programme to Promote Mental Health of Pakistanis on Oct 10, 2019, World Mental Health Day. Mental health, a long-neglected global priority—stigmatised, under-resourced, and under-researched in most low-income and middle-income countries—is finally drawing attention. For Pakistan, which faces major health concerns, such as polio and dengue outbreaks, humanitarian disasters, and a struggling economy, this prioritisation of mental health by the government is a testament to how far the field has come in the past decade. Following the recommendations of the Lancet Commission on Global Mental Health,1Patel V Saxena S Lund C et al.The Lancet Commission on global mental health and sustainable development.Lancet. 2018; 392: 1553-1598Summary Full Text Full Text PDF PubMed Scopus (924) Google Scholar the programme in Pakistan emphasises the role of early-life interventions that promote mental health and prevent mental illness, and calls for a phased implementation of two evidence-based interventions. The first is the WHO Thinking Healthy Programme for mothers, a psychosocial intervention delivered by community health workers to high-risk mothers in low-resourced settings.2Rahman A Malik A Sikander S Roberts C Creed F Cognitive behaviour therapy-based intervention by community health-workers for mothers with depression and their infants in rural Pakistan: cluster-randomised controlled trial.Lancet. 2008; 372: 902-909Summary Full Text Full Text PDF PubMed Scopus (603) Google Scholar The second intervention is the WHO School Mental Health Programme adapted for Pakistan.3Imran N Rahman A Chaudhry N Asif A World Health Organization "School Mental Health Manual"-based training for school teachers in urban Lahore, Pakistan: study protocol for a randomized controlled trial.Trials. 2018; 19: 290Crossref PubMed Scopus (12) Google Scholar This programme includes training teachers in skills and strategies to promote mental health in their schools and the early recognition and management of mental health problems. These interventions, to be implemented in one district in the first year, are planned to be rolled out across all four provinces of Pakistan within 5 years. Another aspect of the president's plan is an emphasis on technology to improve access to mental health. Pakistani and UK researchers have collaborated on several initiatives, such as online training programmes, technology-assisted delivery tools, and self-help apps to circumvent the hurdle of having few available specialists.4Hamdani SU Minhas F Iqbal Z Rahman A Model for service delivery for developmental disorders in low-income countries.Pediatrics. 2015; 136: 1166-1172Crossref PubMed Scopus (28) Google Scholar, 5Rahman A Akhtar P Hamdani SU et al.Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomised controlled trial.Glob Ment Health. 2019; 6: e8Crossref Google Scholar More research is underway that will assist the delivery and scale-up of the programme in low-resource settings without huge costs. The president's programme is likely to provide important lessons to the global mental health field in the years to come. ZM is State Minister for Health and oversees the implementation of the Programme to Promote Mental Health of Pakistanis. AR is a scientific adviser to the Programme to Promote Mental Health of Pakistanis. The Lancet Commission on global mental health and sustainable developmentThe Sustainable Development Goals (SDGs) represent an exponential advance from the Millennium Development Goals, with a substantially broader agenda affecting all nations and requiring coordinated global actions. The specific references to mental health and substance use as targets within the health SDG reflect this transformative vision. In 2007, a series of papers in The Lancet synthesised decades of interdisciplinary research and practice in diverse contexts and called the global community to action to scale up services for people affected by mental disorders (including substance use disorders, self-harm, and dementia), in particular in low-income and middle-income countries in which the attainment of human rights to care and dignity were most seriously compromised. Full-Text PDF
Referência(s)