My sister’s forced marriage at the age of 13 fueled my resolve to challenge societal norms- Asma Toorkham

Q: You have been very active in the area of mental health and gender issue, what informed your decision to be involved in this?
A: I was born into traditional middle class family of south Punjab, especially Rahim Yar khan, a venerable district, infrastructure wise is a poor area. Where education facilities are limited, deep-rooted gender biases. Growing up in a patriarchal society, where being a girl was undervalued.
The family I was raised in, upheld strict traditions, barring women from pursuing education, that limited women’s decision making in their day to day tasks, burdened them with societal expectations. So, The joint family structure imposed numerous societal pressures on women. Witnessing my elder sister’s forced marriage at thirteen years of her age to a man much older to her fueled my determination to challenge these norms.
Throughout my school and college years, I stood up against sexual harassment targeted at girls. During Pakistan’s catastrophic flood in 2010, I committed myself to aiding vulnerable women, marking a significant turning point in my personal and professional growth.
My mission is to reshape the attitudes of men and boys, particularly targeting the youth, as influencing young minds is most effective. ensuring they recognize and denounce gender based sexual violence, harassment, child abuse, environmental crises and related issues .
That’s why I prioritize spending most of my volunteer time with future leaders. Because “I believe that “True change occurs when individuals are open to it, and I aim to cultivate that mindset, knowing that eventually the change will naturally follow”.

Q: You are the co-founder of SEVC. What does the organization mean and what do you do?

A:“Society for the Empowerment of Voice and Choice” is a non-governmental organization founded by our friends, operates solely through personal contributions without any national or international funding. Since its inception, all initiatives have been self-funded or supported through individual donations. Since 2018, our efforts have centered around four Sustainable Development Goals:SDG 3 mental health and wellness, SDG-5 gender equality, SDG 13 climate action.

Q: As a researcher, what are your observations about mental health around the world?

A: Mental health is crucial for individual well-being and societal harmony, impacting various facets of life, including work performance and social relationships.Globally, an estimated 970 million individuals grapple with mental disorders, predominantly anxiety and depression, contributing significantly to disability, accounting for approximately one-sixth of years lived with disability worldwide.
Moreover, individuals with severe mental health conditions face a reduced life expectancy of 10 to 20 years compared to the general population and are at a heightened risk of suicide and human rights abuses.
In recent decades, the world has faced numerous crises, ranging from natural disasters like earthquakes and floods to epidemics such as typhoons and the COVID-19 pandemic, as well as man-made disasters and conflicts. These adversities have adversely affected mental health globally. Engaging in open dialogue about mental health is imperative to address these challenges, yet amid crises, many opportunities to tackle mental health concerns may be overlooked.
My research underscores that mental health is a multifaceted issue influenced by socioeconomic status, cultural norms, access to healthcare, and stigma. While some countries have made strides in mental health services and awareness, others grapple with funding, infrastructure, and cultural barriers. The widespread prevalence of mental illness underscores the urgent need for increased research, advocacy, and legislation to tackle this pressing global public health issue.

Q:   Bringing it up to immigrants, do they suffer from mental health challenges?
A: Absolutely. Leaving one’s home due to natural disasters, wars, or economic hardships is an incredibly challenging experience. It’s emotionally wrenching to depart from the place where you were born and raised. This upheaval constitutes a significant psychological crisis. Moreover, being confined to tents or restricted areas, essentially living under a form of controlled existence, can be mentally exhausting and distressing. It’s akin to spending a night homeless under the open sky, knowing that movement requires permission. This reality takes a severe toll on mental health.

Q: Please share your experience engaging with immigrants with mental health challenges?
A:I dedicated time to Afghan refugees a few years ago, and it was truly emotionally challenging. Witnessing such profound suffering is incredibly challenging. Pakistan, already struggling as a developing nation, bears the burden of hosting Afghan refugees who have sought sanctuary here for decades due to the ongoing US- Afghan war. (which thankfully ended in August 2021).
I went with SEVC friends in a personal capacity to spend time with the refugees as a psychologist. I spent most of my time conducting sessions on mental health and emotional well-being, sexual and Reproductive and health & hygiene with the girls. I provided counselling to the young girls, boys and women.
It was emotionally hard for me to see innocent people enduring crimes they hadn’t committed. I struggled to sleep for more than a month afterward.

Q: Which case or cases touched your heart the most and how did you handle it?
A: Residing in a tent village where hunger prevails and access to sexual health facilities is absent was deeply distressing. Listening to girls recount their struggles accessing proper hygiene products during menstruation due to economic disparities, coupled with the absence of separate washroom facilities, left them feeling depressed. Witnessing the aimlessness and despair among residents sharing the same tent was equally painful for me.
While I am bound by ethical concerns to disclose specific cases, I can recount my sessions I conducted with young girls and boys. I provided them with techniques to cope with daily stress, including deep breathing exercises and the “5, 4, 3, 2, 1” method. Many refugees reached out afterward, expressing how these simple exercises had become invaluable to them, alleviating feelings of suffocation.
Some of the children I informed about educational scholarships have since pursued education and secured decent employment. These positive outcomes serve as moving reminders that I have contributed positively to the lives of others.

Q: What do you think is responsible for mental health challenges for immigrants and how can it be prevented?
A: Certainly, relocation itself poses significant mental trauma, and it’s unfair to attribute blame to any single individual. Migrants frequently encounter mental health challenges stemming from displacement. These include cultural adjustment, language barriers, discrimination, inadequate access to basic amenities, sexual harassment, particularly for women, girls and children, and financial constraints.
To address these issues, efforts should focus on tackling the root causes of migration. Implementing policies that protect immigrant rights, foster social inclusion, and ensure access to healthcare and mental health services can mitigate health risks and enhance the well-being of migrants.

Q: Who is more affected by mental health among male and female migrants and what are your reasons?
A:The mental health impact on male and female migrants differs, with females often experiencing more challenges. Factors such as gender specific issues, socioeconomic disparities, caregiving roles, mental health and cultural norms contribute to their heightened vulnerability.
It’s critical to adapt interventions to address these unique challenges faced by female migrants when addressing mental health needs in migrant populations.

Q:Do you have statistics to back this up?
A: Numerous research studies and reports underscore the increased occurrence of mental health difficulties among female migrants in contrast to their male counterparts. These studies, published in reputable research journals, offer references to various online investigations. They delve into the heightened susceptibility of women to mental health issues resulting from migration, outlining the diverse psychological afflictions they encounter. Additionally, these studies provide explanations for these trends, reinforcing the findings of my earlier inquiry. Conducted across different time frames and locations, these investigations offer valuable insights into this topic.

Q:What about children, do they also come with challenges?
A:Migrant children encounter various hurdles like adjusting to new surroundings, language barriers, cultural shifts, family separation, and limited access to essential services. They are at greater risk of child malnutrition, abuse, trafficking, and child labor, as observed among Afghan refugees here in Pakistan.

Q: Do immigrants with mental health challenges have access to health support?
A:In nations such as Pakistan, obtaining fundamental healthcare services, particularly for mental health, can pose difficulties. Mental health is still regarded as taboo, associated with severe illness, which deters individuals from seeking assistance.
This stigma is widespread, impacting not only migrants but also the entire population exceeding 240 million. Despite efforts by some organizations to tackle this issue, ensuring sufficient healthcare facilities, especially in a densely populated country like Pakistan, remains a considerable hurdle.

Q:How do the policies of sending/host countries affect the mental health of migrants?
A:Migration policies play a crucial role in shaping the mental health of migrants. Policies related to immigration, asylum, employment, housing, healthcare access, and social integration can either exacerbate or mitigate mental health challenges. Restrictive immigration policies, extended detention periods, and uncertainty regarding residency status in host nations can heighten levels of stress, anxiety, and depression.

Q:In addition to government policies, do the attitudes of community members affect the mental health of immigrants?
A: In Pakistan, migrants often share the same language and cultural background as the residents of the regions where they settle, known as patroons on both sides. However, living in a tent is challenging compared to living in a secure home, and behavior undoubtedly plays a role in this dynamic.

Q: From your experience, do you think immigrants are more apt to seek mental health help?
A:Certainly, they require assistance in addressing their daily challenges, adapting to the environment of host countries, and coming to terms with the effects of the wars they have endured and the reasons for their displacement.

Q: Are there enough specialists to address mental health challenges for immigrants?
A: Not in my country. Limited resources, language barriers, cultural differences, and mental health stigma contribute to a shortage of mental health specialists for immigrants, exacerbating mental health issues.
Solutions involve training culturally competent professionals, boosting funding for immigrant mental health services, and destigmatizing mental health in immigrant communities.

Q: Do you think the interventions of various international organizations are sufficient to address the mental health challenges faced by migrants or should there be other forms of intervention?
A: While international organizations play a vital role, additional interventions are needed for holistic support. Collaborating with local stakeholders is key to providing culturally sensitive mental health services. Efforts to reduce stigma and increase awareness are also crucial.

Q: It goes without saying that there is a global migration crisis. If it is not addressed, what will be the implications going forward?
A: By the end of 2030 I fear the the world is leading to WW-III world, we will going to witness the human life catastrophic where no human civilization had never witnessed. Efforts to diminish social stigma, enhance awareness, and foster integration are crucial aspects of a comprehensive approach to supporting migrant mental health.
Considering the tragic events that have unfolded since the interview questions were sent, such as the ongoing suffering of innocent children in Gaza and the recent bombing in Moscow, it’s evident that human history continues to witness atrocities. These incidents underscore the urgent need to address humanitarian crises, including the ongoing plight of Gaza residents. Without accepting and embracing our differences, the humanitarian situation may worsen, as hinted at in my previous response. Let’s hope we can prevent such crises from escalating further in the future.
Otherwise, as previously mentioned, I foresee the humanitarian crisis intensifying beyond 2030. Let’s hope we can avoid succumbing to the same fate. (God forbid).

Q: On a final note, does climate change affect the mental health of immigrants? If yes, how and what is the solution?
A: Yes, climate change impacts immigrant mental health due to socioeconomic vulnerability, geographic location, and limited resources. Extreme weather, displacement, and environmental degradation heighten stress, anxiety, and depression among immigrants.
Solutions include culturally sensitive mental health services, community resilience-building, awareness campaigns, trauma-informed care, climate change mitigation, and social justice advocacy. By addressing these factors, policymakers, healthcare providers, and communities can mitigate climate-induced mental health challenges and promote immigrant well-being and resilience.