The mhgap; will it bridge the mental health Treatment gap in Pakistan?

In Pakistan, the treatment gap for mental disorders is significantly high. Pakistan faces a unique problem of sustainable delivery. In 2009, WHO launched a mental health gap action program (mhGap) to provide evidence-based services at the primary and secondary level for the prevention and management of psychiatric and neurological disorders. This article highlights the discrepancies of the systems and issues related to mental health services provision in Pakistan. By discussing two initiatives of mhGap implementation for the Pakistani health system, authors have surveyed core areas where the sustainability of such a model can be compromised. The structural challenges marked by the stresses of an economy under pressure, poverty, health disparities, weak administration, allocation of resources and stigma attached to MNS exacerbated by both natural disasters and geopolitical crises make implementation an ongoing challenge. Despite these challenges, in recent years, Pakistan has taken positive strides to start the conversations at leadership and the professional landscape, a trend that is likely to continue. The various components of public and private healthcare systems have remained inadequate to reduce this treatment gap. To create and maintain the momentum, support in terms of capital resource, human resources, infrastructure, and need for advocacy at governmental and non-governmental levels is necessarily required

Dementia survey among Attendees of a Dementia Awareness Event in Karachi, Pakistan

There is little information available about peoples\u27knowledgeregarding symptoms of dementia, dementia diagnosis, and care arrangementsfor dementia patients in Pakistan. Aims: We aimed to find out if patients with dementia and their caregivers were aware of diagnosis, the most common and most distressing symptoms, and care arrangement for these patients

Catatonia in The General Hospital: A Case Series Wading Through Diagnostic & Management Challenges

ABSTRACT Catatonia is a cluster of affective, behavioral, and motor symptoms. Its causes are multifactorial ranging from severe and untreated psychiatric illnesses to neurological diseases and other general medical conditions. It is estimated that 20% of catatonia causes are due to medical conditions out of which two thirds are due to an underlying neurological condition which might include encephalitis, neural injury, developmental disorders, structural brain pathology, or seizures. Symptoms of catatonia can wax and wane, fluctuating between the retarded and the excited type within hours making it more difficult to identify and diagnose. If left untreated, catatonia can lead to multiple medical complications which can lead to significant long-term morbidity and mortality. The initial complications include dehydration, malnourishment, electrolyte imbalance, deep venous thrombosis, pulmonary embolism, pneumonia, urinary tract infection, and retention. In the long run, patients can have sepsis, rhabdomyolysis, DIC, decubitus ulcers, arrhythmia, renal failure, and liver dysfunction. This article will describe three patients (adolescent & adult) that presented to Aga Khan University Hospital (AKUH), Karachi with challenging presentations of catatonia. Their diagnostic and management difficulties will be discussed