While the world is left in shock at the barbaric, brutal murder of Noor Mukkadam, there are increasing concerns and debates over the lack of regulations targeting mental health practices and therapy-based treatments in Pakistan. Questions have been raised and fingers have been pointed. There have been waves of ambitious solutions and ideas that have surfaced on social media since the gut-wrenching events of 21 st July 2021.
The traditional society within Pakistan places mental health under taboo. As a result, we are still lagging in terms of implementing and orchestrating a regulatory review of mental health-based practices within Pakistan. However, the lack of regulatory frameworks for holistic therapies is not a situation that is specific to Pakistan but one which is equally overlooked across the globe. Therapies under the umbrella of Complementary Alternative Medicine (CAM) or Holistic Health are becoming increasingly popular within our communities and with that the need to have a regulated system in place which defines the criteria which need to be met before an individual is given free rein to advertise themselves as a therapist.
No doubt, most if not all holistic health practitioners are guided by their own traumas and difficult journeys which are perceived to give them greater insight into the feelings and sufferings their client may be experiencing. Mental health practitioners being a human can also be negatively impacted by adversities and that is why a huge emphasis is placed on working under expert professional supervision. It is, however, also, a fact that holistic health practitioners are not regulated under the jurisdiction of the medical or psychological bodies but recognized academic institutions such as IPHM, ACCPH, BATHH etc. do provide regulatory guidelines for licensed practitioners. Having said that, memberships are still primarily at the discretion of the individual or the teaching organisation. The terms “counsellor” and “therapist” are not protected and anyone can call themselves as such should they wish. This does leave a question mark on the criteria that should be considered in granting licenses to practice.
Due to the unprecedented events brought forth by COVID-19, the World Health Organisation (WHO) highlighted the risk of a secondary mental health pandemic as a consequence of COVID-19. This is one of the reasons due to which we saw a significant rise in the number of therapists, counsellors and ‘coaches’ which then had a ripple effect and many were seen to resort to online certification on holistic health-based therapies that bypass the stringent and formal academic system. There has been limited or no focus on seeking professional supervision or making efforts to seek accredited memberships with professional institutions to be regulated. To demonstrate how easy it is to become a therapist, in a debate held at the UK Parliament on 2nd March 2020 on Mental Health: Unregulated Treatment Volume 802, reference was made to a BBC journalist, who recently obtained a counsellor qualification certificate online for the price of £12.99; equivalent to the cost of a
session in a 24-hour gym or a wind-proof umbrella. Other measures to regulate the right to practice are also lacking. In some instances, holistic health practitioners are not even covered by professional liability insurance which leaves both the practitioner and the client more vulnerable and susceptible to risks than many.
As a nation, we are also blindsided by seeing a foreign stamp on the courses that are being run by institutions that make no efforts to carry out any kinds of checks of the person they are accrediting or placing on a ‘licenced practitioners’ list. On most occasions, a well-presented certificate, a shiny plaque, a rustic setting or luscious green gardens of luxurious premises offer reassurance to an anxious and vulnerable member of the public who cannot disclose their situation to anyone without fear of judgement. We are all victims of relying heavily on the advice of our friends and family rather than trusting our own intuition and judgement. When we are at some of the most distressing times in our lives and need assistance, the last thing on our mind would be to doubt or question the credibility of someone extending their help. Therefore, in interacting with mental health practitioners, we rarely do background research or homework and as result fall prey to the potential risk of falling prey to incompetent practitioners.
Unregulated institutions are prime examples of places where predators – like Zahir Jaffer – find ways to pretend to be someone they are not. There is no way to pre-empt what filth lies beneath the polished demeanour portrayed by such an evil mind. Even though Pakistan is not the only place where regulatory frameworks around mental
health are lacking, the irony is that the legal and regulatory infrastructure in Pakistan is already weak and the systems are crippled. It, therefore, becomes somewhat of a predicament to even know where to start from because it is not only the systems that guide the practices, it is the people who make it work.
Therefore, the million-dollar question remains! Who can I trust with my mental and emotional health? While we continue to push for regulation to be defined, the only advice is to take control of your well-being and do your research before disclosing your vulnerabilities to anyone regardless of how well-spoken or how well-connected or how polished someone may look. Do the due diligence, ask the right questions and verify the information provided. Your health and well-being are far too precious to be compromised in any way.