Like thousands of families in the Kashmir Valley consumed by decades of bloody violence, their efforts at rebuilding their lives have been met with failure, disappointment and hopelessness thanks to trauma and post-traumatic stress disorders (PTSD).
Looking At The Numbers
As per the Kashmir Mental Health Survey (KMHS), nearly 1.8 m adults (45% of the adult population) in the valley are experiencing symptoms of mental distress with 41% exhibiting signs of probable depression, 26% probable anxiety and 19% probable PTSD. Subjects of the study reported that the gap between treatment need and provision in Kashmir is multifactoral and complex. Moreover, it was pointed out that the barriers to seeking treatment, included, lack of awareness of psychiatric services and therapies, travel time, cost and distance to services and poor and inadequate physical infrastructure.
While the research was conducted in the year 2015, the picture has not de-escalated, but deteriorated, only because of the number of casualties, the intensity of conflict, army occupation, and the aspirations of demanding freedom have overall increased.
Doctors predicted a rise in the number of cases presenting with stress and anxiety, as a consequence of the removal of Article 370 and the internet and communication blockade that has prevented many from talking to their families, or stepping out of home for fear they will be unable to contact their families when out. IndiaSpend reported on the health crisis that has ensued, as well as the impact on Kashmir’s economy, of the events following August 5, 2019.
The blockade has also resulted in fewer people accessing mental health care in August 2019. Médecins Sans Frontières (MSF, or Doctors Without Borders) has shut down mental health services in four districts of Kashmir valley as they are unable to reach their staff.
Between April 2018 and March 2019, 366,906 people received treatment in a government psychiatric hospital in the city of Srinagar alone – just under three per cent of the entire population of the state. And children are bearing the brunt of the crisis.
One report also highlighted the spiking sales of antidepressants and similar mental illnesses medications after the constitutional status of the state was amended.
Consequences And Impact On Children
A report in The Telegraph spoke to Muneera Maqbool, whose 8-year-old son has taken a huge mental toll after the arrest of his father.
“It began the day after his father was arrested last August,” Muneera recalls, turning her attention to her youngest son Zeeshan, who is eight. “He hasn’t stopped screaming and shouting and he keeps having hallucinations that his father has come back to him.”
After his symptoms continued for several weeks, Muneera took him to a specialist in Srinagar, the state capital, where a psychiatrist diagnosed Zeeshan with post-traumatic stress disorder, obsessive-compulsive disorder and depression.
This diagnosis was unsurprising considering Zeeshan's family history. Last year his father was detained by local police who claimed he had allowed Islamic militants to hide in their family orchard. Muneera denies the accusations levelled at her husband and says he was set up by members of the police he had fallen out with.
Zeeshan’s story note a one-of instance, in a state that is battling a mental health epidemic among its children it's only one of millions.
The Kashmiri state government does not record the exact number of children being treated at any time. However, according to a study by IMHANS, the number of children treated in the psychiatric ward of the Srinagar hospital almost doubled between 2016 and 2019, from around 17,000 to 30,000.
“The study published by ActionAid in 2016 reveals that the incidence of mental health issues in Kashmir is higher as compared to that in other parts of India,” said Dipali Sharma, a director at ActionAid.
Unemployment's Role In The Crisis
Currently, people are unable to resume work and there is little distraction or entertainment. Even outside of times of peak conflict, the unemployment rate in Jammu & Kashmir has been high – in 2015 it was 22.4% in the 18-29 years age group, almost double the India average of 13.2% for this age group, according to the 2016 Economic Survey.
The lack of income to feed their families for no fault of their own has lead to a considerable spike in the anxiety levels of the state. There has been very little to no business in Kashmir in the last few months leading to a falling economy, which has been a cause of anxiety throughout the nation.
Lack Of Mental Health Care
Since August 5, 2019, it has been difficult for people to access health facilities, and hospitals have reported a drop in patient numbers, as IndiaSpend reported on September 6, 2019. Even in a normal situation, few people access mental healthcare, in particular.
Every day more than 170 patients visit the four-room psychiatry clinic – the only one serving the Shopian and Pulwama districts of south Kashmir. It is likely that far greater numbers need treatment, but many patients cannot reach the hospital because there is no public transport.
Patients from the district hospital are often referred to the psychiatry clinic of the Shri Maharaja Hari Singh (SMHS) hospital in Srinagar, where patients have been attending in higher numbers in the last few months.
Dr Aijaz Ahmad Khan, a clinical psychologist at the SMHS mental clinic, believes the situation is getting worse. “A week after August 5, we saw a change in the patients. We started having patients who had psychological disturbances. It is increasing since then,” he said. “There is emotional numbness and it is increasing.”
He said at least 10% of patients have complaints directly related to the clampdown. A year ago, about 70 to 80 patients visited the Srinagar clinic, but Khan said it was now seeing 130 to 150 a day.
The Psychiatric Hospital in Kashmir named ‘The Institute of Mental Health and Neurosciences’ (IMHANS) in Srinagar, has only 6 doctors, who purvey services in another hospital, like SMHS, on a rotational basis. The hospital has the manpower of 4 staff which has affected mental health care in the state in a huge way.
The situation doesn't look like it will be getting better anytime soon, considering that the Valley has been subject to so many horrors. The valley is in need of mental health professionals and care, and it is heartbreaking to know that so many can't reach out for help.