Practical and ethical challenges in conducting research on Pakistani adolescent mental health
Recent endeavours to increase the flow of research in the field of mental health in developing countries such as Pakistan are faced with serious practical, cultural and ethical issues. Despite adolescents comprising of about one fourth of the total population in Pakistan (Caskey, & Rosenthal, 2005; UNICEF, 2012) there is limited published data that documents mental health issues such as depression, anxiety and self-harm within the population. In order to improve adolescent mental health in Pakistan, well designed studies exploring prevalence, risk, resilience, prevention, and intervention strategies are vital. Nevertheless there are a few major hurdles in this regard. This paper highlights such pitfalls faced during two parallel and methodologically similar studies exploring depression, anxiety and health risk behaviours among Pakistani adolescents in community settings. Initially, the paper highlights the need to build human resources within research and outlines the efforts which are formally made by the Government. It will also introduce the ways in which the desired outcome can be acquired. Subsequently, it focuses on the lack of awareness with regard to research in the country and presents strategies for developing a research friendly culture, by reducing the undervaluation of research and introducing a supportive environment (Provincial Health Services Academy Peshawar Pakistan, 2010). It identifies the socio-cultural sensitivity of the constructs pertaining to mental health among adolescents (such as drug abuse, sexual abuse, suicide and para-suicide) (UNICEF, 2012). This paper will also discuss issues involved in gaining access to the field. Lastly the paper will point towards ethical dilemmas, such as risks that the study participants may face in gaining ethics clearance, informed consents, and biases within the data. Possible solutions and recommendations required for major obstacles faced during the two studies, as well as the induction of filling the void within literature regarding field work in Pakistan will be put forth.
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