Abstract:
In Pakistan, a complex environment has emerged for individuals seeking psychological
services due to challenges such as stigmatization, lack of awareness, absence of regulatory
bodies, and the increasing burden of psychological issues stemming from societal and
economic disruptions. Any deviation from standards of care in this context could have
profound consequences, perpetuating the cycle of suffering and worsening the existing
mental health crisis in the country. This study aims to explore instances of mental health
malpractice by examining the experiences of clients who have utilized mental health
services. Grounded within a Human Rights-based Approach, the study also aims to uncover
the intricate intersectionality between mental health malpractice and human rights
violations. Employing a qualitative approach, the research utilized an exploratory design
and conducted in-depth semi-structured interviews with 15 clients and 4 key informants,
chosen through purposive and snowball sampling. Thematic analysis of the data revealed
five major themes surrounding multifaceted malpractice, barriers to seeking recourse, and
the psychosocial repercussions of malpractice. Many clients reported boundary
transgressions characterized by compromised confidentiality, inappropriate social
interactions, and attempts to leverage personal connections, leading to a breakdown of trust
between practitioners and clients. Moreover, instances of inadequate and unsuitable
treatment were highlighted, where practitioners failed to provide interventions tailored to
clients’ needs and conditions. Various problematic behaviors were identified, ranging from
dismissive and non-empathetic attitudes to verbal and emotional misconduct, representing
another facet of malpractice. The failure to adhere to ethical standards adversely affected
clients' psychological well-being by exacerbating symptoms and fostering negative
cognitions. Despite experiencing psychological harm, clients were hesitant to report
malpractice due to fears of stigma in public disclosure and the absence of robust regulatory
mechanisms. These findings underscore the importance of establishing ethical and
legislative frameworks in mental healthcare to uphold the dignity, integrity, and well-being
of clients.
