It is estimated that at some point in their lives, one in four people will experience mental illness. In 2017 alone, it was shown that worldwide, 792 million people, or 10.7% of the world’s population, lived with a mental health disorder. Despite these statistics revealing the immense prevalence of mental illness, there is still a lot of stigma surrounding it.
Dr. Akmal Makhdum, a psychiatrist with over 35 years of experience, says that there are many reasons that people don’t seek help regarding their mental health or substance abuse. Whether it be out of fear, shame, or worry that others will find out about their condition, many people do not get the help they need.
Dr. Akmal Makhdum is the son of Dr. Muhammad Ajmal, who is frequently credited as the founder of psychology in Pakistan. In 1962, Dr. Ajmal established the first psychology department at Government College, Lahore and the first psychological counseling center in the country. Dr. Akmal Makhdum’s mother Akhtar Sultana was also a scholar of literature, languages, and religion.
Based on his upbringing and esteemed family lineage, Dr. Akmal Makhdum was highly influenced to become a useful member of society who contributed to the well-being of people. Following his basic medical education, Dr. Makhdum spent two years training in psychiatry and emergency medicine. After completing his medical degree and basic training in psychiatry, Dr. Akmal Makhdum established the first Heroin detox and rehabilitation center in Islamabad. After the Soviet Russian occupation of Afghanistan, there was massive influx of heroin into Pakistan and resultant dependency in the country. Pakistani youth was unsuspecting and unaware victim of this socio-chemical force. Dr. Makhdum dedicated his time to stopping it through educational, mass awareness and clinical initiatives. After five years of working on this effort, Akmal gained entrance to the prestigious University of Cambridge in the U.K. as a psychiatric trainee, sponsored and supported by Dr Phillip Rack, the great academic and clinical psychiatrist, a scholar and founder of Transcultural psychiatry in Britain. Throughout his attendance, he also earned both his post-graduate, advanced-graduate degrees, in Psychological Medicine from Ireland and went on to obtain his diploma of Membership from the Royal College of Psychiatrists in London, England. After establishing the first department of psychiatry in Capital Hospital Islamabad, and private practice clinic in Islamabad. Akmal returned to England when invited to become consultant psychiatrist for the psychiatry of learning disabilities services in Ipswich. He worked as a successful psychiatrist in public and private sectors for almost two decades in Ipswich and in Kent, establishing new services and new treatment centres for adolescents and adults, working with special schools for autism and families in crisis. Now, he assists in the guidance and governance of intensive community care models and innovative community-based services in the country.
Dr. Akmal Makhdum is also a published author and has been involved with various associations throughout his career. He founded the BPPA – British Pakistani Psychiatrists Association, and was founding chair of the AGP – A Great Partnership – All Ethnic Psychiatrists Forum in the U.K., and was founding chair of the All British Pakistani Doctors Association – ABPPA and BPDF – British Pakistani Doctors Forum. He is chairman of DDPU – Doctors and Dentists Protection Union.
Why did you decide to become a psychiatrist?
In many ways, I was born into it. I was raised by a family of esteemed scholars and academics. My mother Mrs Akhtar Ajmal, was a talented scholar of literature as well as a master of several languages, including Arabic, Persian, Saraiki, and Urdu. My father was also internationally renowned and was known as the first professor of Psychology in Pakistan as well as a prestigious scholar of philosophy, education, literature, and mysticism. So, I was born into a family of academic excellence. My friends and I were all in pre-med. When I got into medical school, I knew I didn’t want to become an actual, traditional doctor because to me, it was too impersonal. As a child, I was inspired by famous minds like Freud and Jung. I wanted to understand the mind and work closely with people, so becoming a psychiatrist always seemed natural.
Why do you think that society generally has a stigma against mental health?
I think people are threatened by things they don’t understand. If someone has never experienced a mental health illness themselves, seeing it in someone else can be somewhat confusing to them and they may even become fearful of the person. This can still be true in other cultures. Some cultures believe that mental illness doesn’t exist and is a “made-up” condition.
In turn, this fear and misunderstanding causes people with mental illness or those suffering from addiction to become reclusive. They try to hide and try not to acknowledge that anything is wrong, and therefore don’t seek the help they need.
While western society has definitely become more accepting of mental illness as time goes on, the stigma remains. As a psychiatrist, I have tried to do my part to change that.
What encouraged you to get involved with combatting addiction?
I saw what heroin addiction and dependency was doing to Afghanistan and later on Pakistan, in 1980s. There was a huge influx of heroin into Pakistan during the Soviet Russian occupation of Afghanistan in the 1970s. No one in Pakistan knew what Heroin was until it was too late. People thought that it was like cannabis and could be used occasionally and leisurely. That was not the case. Very soon Pakistan found itself as one of the largest host of heroin users in the world with youth affected in millions. That happened within years. There was no education about it, no social awareness. Punitive Laws and law enforcement could not manage it, it never has. How society changed within ten years was shocking to see.
It’s important to recognize that addiction is a mental illness too. Addicts or users are sick and they need help. With more and more drug use, they don’t see a way out and it’s hard to imagine their life being any other way. I wanted to help these people see another way.
Why should professionals get involved with associations?
It should go without saying that being involved with associations helps your career prospects by providing networking opportunities and professional development. But beyond that, being part of an association is about being a part of something bigger than yourself. You can make an impact on your industry as a whole, and this is truly powerful.
Who has been a role model to you and why?
My parents were both big role models for me. They were both talented academics, so that ultimately led me to where I am today. As a youth, I strived for academic success and later I strived for success in my vocation, of helping others. My father was the only leader and the main force in the psychology movement as a whole, in Pakistan. That got me more interested in the human mind as opposed to the body, or in synthesis with the body. My father always encouraged me to seek out more education, so I continued that and also expanded networking by being involved in and creation of various professional associations.
What has been the hardest obstacle that you’ve had to overcome?
My hardest struggle and obstacle has been my father’s death. Before he passed, he encouraged me to continue on with my training and move back to Pakistan and continue the work that he had started. I was proud that he wanted me to carry on his legacy. When he passed, I was absolutely devastated, and the loss caused me to change my plans.
I ultimately decided to return to the U.K. to fill the shortage of qualified psychiatrists. I worked as chief psychiatrist for numerous services in England and went on to become a private consultant.
What advice would you give to other psychiatrists?
Have compassion and strive to be humble. As a professional, you may think that you have all the answers, but in truth, you’re only as strong as the people around you. Lean on your colleagues when experiencing times of uncertainty and downgrade your ego so that you aren’t blind to what’s right in front of you. Not every case is as cut and dry as it may seem.
If you could change one thing about the world today, what would it be?
It would be an enormous feat, but just to end the stigma against mental illness. We have made great strides over time, but we aren’t there yet. A mental illness is nothing to be ashamed or afraid of. As a society, we need to ensure that everyone feels safe and empowered.