By Zubeida Mustafa
1985 is the International Youth Year. At a time when world attention will be focussed on the youth — those in the age group 15 to 25 years — the state of the young men and women in Pakistan should arouse some interest, if not concern, in the public mind.
After all the young people are numerous enough to warrant some attention. They make up 17 per cent of the population. Moreover, they are more educated than others — the literacy rate in this group being 31 percent compared with 21 per cent for the nation (1972 census).
Then, being at an age when they are full of energy — both physical and mental — boundless enthusiasm, idealism and a sense of adventure they constitute a potent force in society.
On the threshold of responsibility in life, the youth have a profound bearing on the political, social, economic and moral evolution of a nation.
Where does the Pakistani youth stand? According to Dr. Haroon Ahmed. Associate Professor of Psychiatry at the Jinnah Postgraduate Medical Centre, Karachi. young men and women in Pakistan as a class suffer from alienation, insecurity and an identity crisis. These emotions manifest themselves in the false sense of confidence which most voung people display.
“This confidence certainly helps to sustain them but it does not really go deep and falls to pieces under the slightest stress.”
The major factor responsible for this underlying insecurity in the youth is the general environment in the country. Dr. Haroon emphasises that the classical theory that a child’s personality is irrevocably formed by the age of five no longer holds true. According to him the general environment (as against the immediate family environment) continues to shape the attitudes and personality development of boys and girls throughout adolescence and well into their teens.
Dr. Haroon attaches considerable importance to what he terms the “social environment” — the dominant perceptible atmosphere in society at a given time — which according to him profoundly affects the mental attitude of young people.
“A child is not born with a moral philosophy, he imbibes it from his environment by cognitive interaction.” In a study he conducted to investigate the influence of cultural milieu on the delusions of schizophrenic patients. Dr. Haroon found that people with magico-religious delusions belonged to families whose religiosity level was quite low and vice versa. In Pakistan, as in a number of other Third World countries, a major factor which has determined the national environment is the hold a small elite has exercised over power and the decision making process.
Comprising a small group of people who draw up policies which are designed to promote their own interest and are not relevant to the masses generally, this elite represses the need of the people. Lack of participation and involvement has created alienation in the youth.
To illustrate how the pattern of politics and the working of the controlling elite has created disorientation in the youth. Dr. Haroon cites the example of the Pavalian experiment:
“You ring the bell and give the dog food and condition the dog to that, so much so that when you ring the bell and don’t give it food, the dog still salivates. Then you change the tone of the bell, leaving the dog so confused that it becomes neurotic.”
This is precisely what the ruling elite has been doing to the people. Every government which comes into power seeks to legitimise itself by tearing to shreds its predecessor. The values accepted by the previous rulers are thrown overboard. What was good yesterday becomes illegal and immoral today. What was wrong yesterday becomes acceptable today.
With norms and values of society in a constant state of flux, it is not strange that people have no faith in the system enforced in any particular period, since they cannot be certain that tomorrow it will continue to hold good. This lack of continuity and the absence of stable norms and values have forced the youth to turn inwards.
The “self” has become the most important element in determining a young man’s attitude towards life. Since there are no permanent codes to guide him. the criterion on which he bases his judgment is: “What is good for me is right and I must get it”.
This disintegration of institutions, according to Dr. Haroon, is the most damaging thing that could have happened in Pakistan. It has led to dual standards in public life, failure to enforce rules uniformly and consistently and lack of recognition of personal achievement.
What effect has this produced on the youth?
Such an environment which has no permanent values does to the youth what a “broken home” does to a child who cannot know what the rules are. It engenders insecurity. It also kills the idealism in the youth making power and money the most important goals in life for them.
There are two other developments which have had a far-reaching effect on the personality development of the youth in Pakistan, says Dr. Haroon. One is the migration which has taken place on an unprecedented scale in this country. First, there was the large scale migration from the Muslim minority provinces of India to Pakistan at the time of Independence.
Next came the in-migration from one province to another, from one city to another, and from the rural areas to the urban centres. Now there is the phenomenon of young people leaving the country in search of greener pastures.
Since migration has not been accompanied by a process of assimilation which takes place when two cultures meet, conflict has resulted. For the large number of migrants who have been uprooted this has brought intense insecurity in the absence of a sense of belonging.
The youth have been the worst affected for many of them were born in the place where they now live and yet they do not belong to its culture, language and heritage, for no fault of theirs. This has given rise to an acute identity crisis in them.
The second factor Dr. Haroon identifies as a negative force in the personality development of the young is the practice of suppressing information. “This suppression of truth which denies a person the right to find out facts for himself is the biggest tragedy to have befallen our youth. It has killed their spirit of enquiry,” observes this psychiatrist from the JPMC.
In an environment in which the freedom to unearth the truth is suppressed and a person is handed down tailored information with no option but to accept it unquestioningly, it is inevitable that a young person loses his faculty of critical analysis. When he cannot express dissenting opinions, what incentive does he have to think independently?
Dr. Haroon cites the example of the textbooks which present information quite differently from the impressions a youth might have imbibed from the environment. Initially a young man or woman goes through a crisis but ultimately finds a via media by learning to live with dual standards and hypocrisy. This is in effect a defence mechanism for self-protection devised by nature. At present, hypocrisy is the order of the day — a way of life.
What effect does a national crisis have on youth?
Dr. Haroon feels that any public event with far-reaching implications such as a war, elections, political agitation, etc. touches every individual emotionally. For a young person a crisis acts as an emotional catharisis and his energy finds a focus. But if this is not followed up by a long-time goal into the attainment of which the people’s roused emotions are channelled, they will find an outlet in violent bahaviour.
Dr. Haroon points out that during 1970 and 1971 when the country had its first general elections, the Bangladesh crisis and the war with India, the number of new patients seeking medical help at the JPMC psychiatric unit fell to an all time low, although the attendance of the registered patients increased considerably.
But in 1972 when the crisis was seemingly over, the number of new cases, especially of anxiety and schizophrenia, was almost doubled. This was what experts call the rebound phenomenon. The shock period was followed by one of intense insecurity.
How would he sum up the state of the youth in Pakistan?
Dr. Haroon feels that fear has contained the energy and frozen the emotions of the youth. That is why many of them appear to be in a state of collective immobility. But this is misleading. It could prove to be the proverbial lull before the storm.
What, however, merits serious attention is the high incidence of mental illness in the youth which is brought on by the environment. Although genes are an important causative factor, a healthy environment can neutralise genetic handicaps. Stresses and strains generated by the surroundings help trigger off mental illness. A person who cannot anticipate happenings and is in a state of uncertainty fails to adjust to new stresses.
Dr. Haroon points out that this is becoming very common in the young. In fact nearly 60 per cent of the cases of affective illnesses (such as anxiety, depression, and phobia), schizophrenia and drug addiction being reported to hospitals relate to young people in the 15 to 25 years age group.
Some of the statistics Dr. Haroon has collected from the JPMC pyschiatric unit are quite disquieting. Over 32 per cent of the cases of depression reported are young people between the ages of 15 and 25 (nearly two-thirds of these are women).
Corresponding figures for anxiety cases are 56 per cent youth (over two-thirds being young women) and for schizophrenia it is 41 per cent youth (nearly two-thirds being young men).
The large proportion of young women suffering from depression and anxiety points to their disadvantaged position in society and how that affects their mental health.
Worst is the incidence of drug addiction among young people. In 1983 of the total of 351 addicts who reported 189 (54 per cent) belonged to this age group when in 1982 only 49 out of 116 (42 per cent) were youth.
Suicide rates are also alarming. Previously nearly 52 per cent of those committing suicides were in the 20-30 age group. Now 64 per cent are under 20.
Although there has been marked increase in the number of cases of mental disorders being re ported to hospitals. Dr. Haroon observes that one cannot be certain how far this is to be attributed to greater incidence of various illnesses. Growing awareness in the people about the nature of mental illness has meant that some who suffered because of ignorance or visited “pirs” are now seeking medical assistance.
Among the various mental and psychosomatic ailments affecting the youth. Dr. Haroon takes special note of drug addiction. He feels that drug addiction is not a basic ailment but the symptom of other disorders such as anxiety, depression or even intense insecurity. That is why some drug or the other has always been in vogue. The pattern has, however, changed. From opium and charas, the addicts have moved on to heroin which is more damaging to the health. What is more alarming is that the average age of the addicts has come down from 30-35 to 20 years.
These trends indicate that the youth of today is more insecure and therefore more prone to mental illness. Dr. Haroon blames the environment for the problems of the youth — specially the lack of consistency and continuity in public life.
Moreover, we have provided no outlets for the energy and emotions of the youth, he adds. What does a young person of 18-25 years of age do after he returns from school/college? There are no playgrounds, clubs, cultural groups, tourist expeditions or other avenues of healthy activity available to him/her. The most practical approach is of course the preventive one. “But I can hardly venture to suggest that change the entire social, political and cultural environment of the country,” remarks Dr. Haroon. Involving the youth in constructive activities will certainly help.
For the treatment of the youth affected by mental illness, Dr Haroon suggests a radical but positively more down-to-earth approach (in fact this applies for the entire mental healthcare system in the country). Rather than follow the pattern set by the West, where more than half the hospital beds are occupied by the mentally ill and geriatric patients, we should provide out-door psychiatric counselling and treatment for those in need.
But it is more important that mental health should be taken care of outside the hospitals. Locally trained manpower, such as social workers, psychologists and health visitors, should be mobilised to attend to the mentally ill in the community. This would certainly cost less than a psychiatric hospital and in our conditions would be more effective and practical.
Source: Dawn, 9 Nov 1984