মানসিক স্বাস্থ্য সমস্যা রয়েছে এমন ৯২ শতাংশ মানুষই কোন ধরনের সেবা বা পরামর্শ নেন না।
সামাজিক কুসস্কারের কারণে অনেকেই মানসিক স্বাস্থ্য সমস্যার বিষয়টি চেপে যান।
বাংলাদেশের রাজধানী ঢাকায় একটি মানসিক হাসপাতালে একজন উচ্চ পদস্থ পুলিশ কর্মকর্তার মৃত্যুর পর মানসিক স্বাস্থ্য সমস্যা নিয়ে চিকিৎসার বিষয়টি আবারো আলোচনায় এসেছে।
বিশেষজ্ঞরা বলছেন, দেশটিতে যারা মানসিক স্বাস্থ্য সমস্যায় ভোগেন তাদের বেশির ভাগই কখনোই চিকিৎসা নিতে যান না।
জাতীয় মানসিক স্বাস্থ্য ইন্সটিটিউটের এক হিসাব বলছে, সবশেষ ২০১৮ সালে তাদের যে গবেষণাটি পরিচালিত হয়েছে সে অনুযায়ী, বাংলাদেশে ১৮.৫ শতাংশ প্রাপ্তবয়স্ক এবং প্রায় ১৩ শতাংশ শিশু-কিশোরদের মধ্যে মানসিক স্বাস্থ্য সমস্যা রয়েছে।
কিন্তু এদের মধ্যে ৯২ শতাংশ মানুষই কোন ধরনের সেবা বা পরামর্শ নেন না।
বাকি মাত্র ৮ শতাংশ মানুষ মূল ধারার চিকিৎসা নিচ্ছেন। আর সেখানে শুধু মানসিক রোগের চিকিৎসক নন বরং অন্যান্য চিকিৎসকও রয়েছেন।
আর যারা চিকিৎসা নিতে যান তারাও সমস্যা দেখা দেয়ার প্রথম দিকে নয় বরং একেবারে শেষ মুহূর্তে চিকিৎসকের শরণাপন্ন হন।
“কাছের মানুষরাও বুঝতে পারেনি”
প্রাপ্তবয়স্কদের পাশাপাশি শিশুরাও মানসিক সমস্যায় ভুগে থাকেন।
বর্তমানে এক সন্তানের মা নাসরুন নাহার। বরাবরই প্রচণ্ড আত্মনির্ভরশীল আর চাপা স্বভাবের মানুষ।
তবে হঠাৎ করেই ২০১৭ সালে একবার আত্মহত্যার চেষ্টা করে বসেন তিনি।
নাসরুন্নাহার বলেন, এই ঘটনার আগে তার কাছের মানুষজনও বুঝতে পারেননি যে, তিনি বিষণ্ণতার মতো মানসিক সমস্যায় ভুগছেন।
“কাছের মানুষ এমনকি আমার বেস্ট ফ্রেন্ডরাও জানতো না।”
জানালার কাঁচ ভেঙে সেটি দিয়ে হাতের রগ কেটে আত্মহত্যার চেষ্টা করেছিলেন তিনি।
তিনি বলেন, “যেদিন সুইসাইড অ্যাটেম্পট করি তার আগের দিনও আমি কাজিনদের সাথে ট্যুর দিয়ে আসি।”
নাসরুন নাহার বলেন, একেবারে শেষ স্তরে পৌঁছানোর পর যখন তিনি আত্মহত্যা প্রবণ হয়ে উঠেন তখন তাকে হাসপাতালে নেয়া হয়।
প্রাপ্তবয়স্কদের পাশাপাশি শিশুরাও মানসিক সমস্যায় ভুগে থাকেন।
“আমাকে দুই দিন পাহারা দিয়ে রাখে যাতে আমি মরতে না পারি। একেবারে লাস্ট স্টেজে গিয়ে আমাকে হাসপাতালে ভর্তি করে।”
ছয়-সাত বছর আগে দ্বিতীয় সন্তান জন্ম দেয়ার পর পোস্ট পার্টাম সাইকোসিস নামে মানসিক সমস্যায় ভুগেছিলেন উন্নয়নকর্মী নাদিয়া সারোয়াত।
তিনি জানান, দ্বিতীয় সন্তান জন্ম দেয়ার ১৪-১৫ দিনের মাথায় তার যে সমস্যাটি দেখা দিয়েছিল সেটি হচ্ছে, নিজের সন্তানকেই চিনতে পারতেন না তিনি। খুঁজে বেড়াতেন তার প্রথম সন্তানকে।
নাদিয়া সারোয়াতের সাথে যখন কথা হচ্ছিল তিনি জানান যে, অসুস্থ থাকার সময়টার অনেক বিষয়ই তিনি এখনও মনে করতে পারেন না। মানসিক সমস্যার জন্য ১০ দিন একটি হাসপাতালে ভর্তি ছিলেন।
তিনি অভিযোগ করেন, সেসময় হাসপাতালের নার্সের হাতে মার পর্যন্ত খেতে হয়েছিল তাকে।
“আমার ঘুম আসতো না। পুরো হাসপাতাল ঘুরে বেড়াতাম। আর আমার বাচ্চাটাকে খুঁজতাম।”
নাদিয়া সারোয়াত বলেন, বাংলাদেশে মানসিক রোগীদের ভালভাবে দেখা হয় না। বিভিন্ন ভাবে তাদের হেনস্তার মুখে পড়তে হয়। হাসপাতাল কর্মী বা যারা এর চিকিৎসার সাথে জড়িত তারাও মানসিক রোগীদের সাথে ভাল ব্যবহার করেন না বলে অভিযোগ করেন তিনি।
“আমাদের দেশে তো মানসিক রোগী দেখলে পাগল বলে একটা বাচ্চাও ঢিল ছুঁড়ে মারে। তাদের অপদস্থ করার এক ধরনের মানসিকতা রয়েছে।”
মানুষ চিকিৎসা নিতে যায় না কেন?
সময়মতো ব্যবস্থা না নিলে মানসিক সমস্যা গুরুতর হতে পারে।
বিশেষজ্ঞরা বলছেন, সমাজে হেয় হওয়ার ভয়, স্বাস্থ্য সেবার অভাব এবং অসচতেনতার কারণে বিশাল পরিমাণ মানুষ মানসিক স্বাস্থ্য চিকিৎসার বাইরে রয়েছেন।
জাতীয় মানসিক স্বাস্থ্য ইন্সটিটিউটের সহযোগী অধ্যাপক হেলাল উদ্দিন আহমেদ বলেন, তিন ধরনের কারণে মানুষ মানসিক সমস্যার চিকিৎসা নিতে যায় না।
এর মধ্যে প্রথম কারণ হিসেবে, সমাজের প্রচলিত স্টিগমাকে দায়ী করেন তিনি।
মানসিক সমস্যা নিয়ে সমাজে এক ধরনের কুসংস্কার প্রচলিত রয়েছে বলে মনে করেন তিনি। বলেন, মানুষ এটাকে প্রকাশ করতে চায় না, লুকিয়ে রাখতে চায়।
মানুষ মনে করে যে, মানসিক সমস্যা রয়েছে এটা প্রকাশিত হলে তারা সমাজের চোখে হেয় হয়ে যাবেন।
“এ নিয়ে এক ধরনের স্টিগমা তাদের মধ্যে কাজ করে।” বলেন তিনি।
দ্বিতীয় বিষয়টি হচ্ছে, মানসিক স্বাস্থ্য সেবার অপ্রতুলতা রয়েছে। মেডিকেল কলেজ কিংবা টারশিয়ারি পর্যায় ছাড়া আর কোথাও এই সেবা পাওয়া যায় না।
বিশেষায়িত হাসপাতাল রয়েছে মাত্র দুটি।
জাতীয় মানসিক স্বাস্থ্য ইনস্টিটিউটের হিসাবে দেশে ১৮ কোটি মানুষের জন্য এই মুহূর্তে ২৭০ জন মানসিক রোগ বিশেষজ্ঞ চিকিৎসক রয়েছে।
আর কাউন্সেলিংয়ের জন্য সাইকোলজিস্ট রয়েছেন মাত্র ২৫০ জন। যেটা অপ্রতুল।
এক বছরে সাত থেকে ১০ জনের বেশি মানসিক রোগ বিশেষজ্ঞ প্রস্তুত হচ্ছে না বলেও জানানো হয়।
যার কারণে অনেকেই এই সেবা নেয়ার সুযোগ পাচ্ছে না বলে মনে করেন বিশেষজ্ঞরা।
তৃতীয় কারণ হিসেবে মি. আহমেদ মানুষের সাধারণ অসচেতনতাকে দায়ী করেছেন।
তিনি বলেন, “অনেক সময় মানুষ বোঝেই না যে, তার আচরণগত সমস্যাটি মানসিক কারণে হয়েছে।”
বিপুল পরিমাণ মানুষ মানসিক স্বাস্থ্য সেবার বাইরে থাকায় পরিস্থিতি আরো খারাপ হচ্ছে এবং তারা এক পর্যায়ে সমাজের বোঝায় পরিণত হচ্ছে। এই পরিস্থিতির উন্নয়নে আরো দক্ষ জনশক্তি গড়ে তোলা প্রয়োজন বলেও মনে করেন হেলাল উদ্দিন আহমেদ।
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