Ira Naim, Pakistani, is a clinical psychologist who specializes in Eye Movement Reprocessing (EMDR) and Cognitive Behavioral Therapy (CBT). Naeem has ten years of experience in the mental health sector. She has practiced her profession in different countries including UAE, USA and Pakistan.
She also has extensive experience conducting psychological assessments (diagnostic and educational) for children and providing treatment strategies for schools and families to implement as part of Individualized Educational Plans (IEP).
Naeem is currently based in Nepal and is motivated to promote the integration of mental health into primary health. Recently, Onlinekhabar spoke with Naeem about various aspects of mental health ranging from her experience to the state of awareness of mental health in the current world and the challenges in the sector.
Mental health is a stigma in many parts of the world. How do you think an individual can work to normalize the concept?
I think it’s a very stigmatized concept. You know no one wants to accept it. And even if we are to accept that we are going through some challenges, the kind of social support and perception from people is not easy. But, if you want to make a difference in society, you can Start with yourself, as within you. So if you as an individual, you start to express your needs, express your true feelings, start validating your emotions and actually start talking about just that how I feel instead of suppressing your emotions. I think from there, change will come. For example, if someone sees you, let’s say your friend, as someone who is very good at expressing their needs, they will come to you and express their feelings. They don’t really suppress their emotions. Doing so will motivate them to express their feelings. So the moment we start validating our feelings and expressing ourselves, it will be easy for us to talk about difficulties as well.
Why did you choose the mental health sector as your profession despite its severe stigmatization in many countries, including your own?
When I was growing up, around my surroundings, I saw many people including children with a physical or mental disability. So in our culture, I’m sure in Nepal as well, if a kid has some physical or mental challenge, he’ll be like, “Oh, he’s upset about something evil.” But I’m starting to notice, like, “What’s going on? What’s the difference in their upbringing? And why am I different and why is it different?”
Our relatives, street people and neighbors struggle with each other. They express their anger, they are just angry. So from day one, I started noticing why we get angry and why we face challenges in a relationship.
I belong to Pakistan, and Pakistan is a very religious country. So in Pakistan, when someone is going through mental health challenges, they would prefer to go to a spiritual healer. From there, by looking at the advertisements and trying to understand them, I developed an interest in mental health, and in university, I knew this was the path I wanted to take.
In all these years, what kind of changes have you noticed in this sector?
So as I mentioned earlier, it’s been 10 years since I’ve been in the industry. At that time, when I was studying, I called my father and told him that I was going to study psychology. He was very supportive. And the next day, he called me and asked, “So are you going to be a doctor?” I answered yes, and he said again, “But you will not give the injection.” I replied “No”. And he asked me, “So, what are you going to do?”
It was difficult for him to understand what his daughter would do and how she would deal with patients. But, since then, in a single decade, a lot has changed. Even in Pakistan, people are starting to open up, and the number of psychiatrists and psychologists has increased exponentially. The situation is similar in many other countries as well, specifically in the United Arab Emirates.
As Dubai is a multinational hub, it houses almost all nationalities from all over the world. So, by having so many nationalities in one place, it kind of encourages, let’s say, others to also talk about mental health. And now, with social media engagement on the rise, I think we all have a responsibility to really spread awareness.
Therefore, we do not have to run large campaigns or projects. Even if I just started talking about mental health, maybe my brothers would start doing it too. After that, my siblings and friends will start talking about it as well. This is how we can make a difference in society.
But, yes, the mental health sector has definitely improved a lot. But compared to the West or the United States, we still have a long way to go.
In your opinion, what can Nepalese people in general do to improve their mental health status?
I think additional efforts should be made to increase the literacy rate. If we can really focus on sending our kids to colleges and universities, that would be the first step. The second step is more about parenting. If we can spread Awareness of parenting principles According to the psychological and emotional well-being, a significant change can be observed. Our parents and teachers can play an important role in improving this sector.
In addition, the government should also work hard because when I looked at the data in Nepal, I found that there are only 146 psychiatrists and 104 psychiatrists. Compared to the population, these numbers of doctors are not enough. So if the Nepalese government pays more attention or allocates more budget to spreading awareness, promoting psychiatry or psychology education, it is clear that it can bring about positive change.
Recently, cases of mental health problems are increasing, right? Is this due to increased awareness and people’s ability to be aware of these issues?
Yes, we can say that. Awareness of mental health has increased and will continue to grow. Because we have more awareness, this does not mean that at that time we did not have challenges or mental illnesses. We had it but no one knew about it. And we didn’t have enough data.
But at the same time, our lifestyles, family systems, and schedules have definitely added more to that. At that time, we had a joint family system. So if you are going through something, you will have enough social support. But, right now, we tend to be in a more core family system. So we have less social support, and we don’t have enough time to actually focus on ourselves.
In the past, people were not as busy. They’re used to work, but they’re used to managing their time to have fun, and to have a good self-care routine. But it has now changed.
In general, I would say with the growing awareness of mental health and everyone talking about it, we tend to compare a lot. So when we compare a lot, we expect a lot from us. So when we have unrealistic expectations about ourselves, this tends to frustrate us. So our expectations, our personal traits, our self-care routine, and the way we live our lives have certainly led to an increase in the number of cases of mental illness.
Currently, you are advocating the integration of mental health into primary health. Can you tell us why it is important to integrate this particular topic into primary care?
Imagine you have an upset stomach, your heart rate is really upside down, and you have a very persistent headache. Then you tell your parents about it. How do they react to it? They simply take you to the doctor. It is easier for you to go to the doctor and have your parents accompany you to the appointment. But if you go to your parents and tell them that you’re panicking or that you’re having panic attacks, will they ask you to go to a psychiatrist? number.
Very few cases… out of 100, maybe 1 person does. This is why it is a huge responsibility for primary care physicians to identify mental health problems. If they know the person is going through a state of anxiety, they can first read for themselves because they know the medication or what kind of suggestions they can give you.
And secondly, if this treatment does not work, the patient will talk to the doctor again and again. In such a case, the primary care physician can tell us which psychiatrist is available in the hospital. This is why mental health integration is so important to primary care.
Finally, is there anything you would like to add?
Well, if you really want to do something for society, first of all, start with yourself. Be more open to being healthy, and being healthy just means feeling good. And just make sure of what makes you feel good. Maybe you like to run, take a long walk, or maybe sit down and have a coffee with your friend. So do the things that nourish you and make you happy. Likewise, if someone comes up to you and starts to open up like “that’s how I feel,” don’t focus on giving good advice, just focus on listening.
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