Development of mental health services in Pakistan

Issue 1, July 2003 despite the obvious pressures, the integration of hospital and community work and of health and social services, and a significant per capita increase in public spending on health care, led during this period to worthwhile improvements in mental health services. These are things that may or may not have happened had peace prevailed. That services have improved and the population as a whole has coped remarkably well does not mean, of course, that those individuals who are seriously affected do not require appropriate help and treatment. Daly (1999) examined the treatment needs of the community generally as well as specific victim groups such as the security forces, children, the bereaved and prisoners. This raises a further but as yet still anecdotal observation. After the much publicised cease-fires there was a substantial, albeit ragged, reduction in terrorist activity; however, many health care professionals would corroborate the remark by Curran & Miller (2001) that with this reduction in violence there has been some increase in the presentation of victims of the Troubles. One implication may be that once the curiously ‘holding environment’ of the Troubles is lifted we may observe a negative as well as a positive ‘peace dividend’. Who knows if it may yet be too early to be fully clear about the impact of the past 30 years on the psychological welfare of the people of Northern Ireland? References