As per the World Health Organisation (WHO), mental health is a state of well-being in which the individual realizes his or her own abilities, we cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.
In this positive sense, mental health is the foundation for individual well-being and the effective functioning of the community.
According to WHO only one percent of the global workforce works in mental health and the median public expenditure on mental health per person is 2$ in low and middle-income countries compared to 50$ in high-income countries.
Similarly, there are only five mental health beds per 100,000 population in low and middle-income countries compared to 50 mental health beds per 100.000 population.
The State of Jammu Kashmir consists of three regions: Jammu, the Kashmir valley, and the Ladakh.The continuing armed conflict in the state during the last 28 years and the center of the conflict remained in the Valley, where the highest rates of mental illness are now reported.
In 1989, the year I which conflict started around 1700 people visited Kashmir’s only psychiatric hospital and last year, that number topped 100,000.
Before 1989, there was no Post Traumatic Stress Disorder (PTSD) cases, but now there has an epidemic of disorder in Kashmir valley.
One in every five adults in Kashmir is living with PTSD.As per the survey conducted by MedecinsSans Frontiers(MSF), in association with the department of psychology, Kashmir University and the Institute of mental health and neuroscience, Kashmir nearly 1.8 million adults, equalling 45 percent of the Kashmir’s adult population suffers from show significant symptoms of mental distress.
Due to continuing conflict in Kashmir during the last 28 years, there has been a phenomenal increase in psychiatric morbidity. The results reveal that the prevalence of depression is in the majority of the youth of the Valley.
The prevalence of depression is highest among youth 15-25 years age group. The difference in the prevalence of depression among males and females is significant.
Also, depression is much higher in rural areas as compared to urban areas. In rural areas, the prevalence of depression among females is higher as compared to males.
The report added that approximately 1.6 million adults (41 percent) in the Valley were found to be living with significant symptoms of depression. And a majority of people has experienced conflict-related trauma.
The report further added that the uprising of July 2016 aggravates and added the number of patients in the Valley.The physical and psychological impact of seeing near and dear ones bloodied, maimed, blinded and killed is devastating.It sears the mind and soul. The wave of this pain travels across the miles in towns and villages of the Valley. Majority of Kashmiris have experienced conflict-related trauma and witnessed the sudden and violent death of their dear ones, which leads to trauma. Kashmir witnessed the strict curfew, non-functioning of cell phones and blanket ban of the internet, even local cable services were snapped at times and gagging of print media. All together these things turn Kashmir into a fortress.
In such a sever clampdown, people were cut off from rest of the world and even from their own people from Kashmir, which leads nothing but psychological trauma.
The vicious nature of events has been created comprising torture, blinded, disappearances, displacement, killings, ballistic trauma, etc. paralleled by a state of mind wherein grieving, insecurity, oppression, poverty, uncertainties of career and relationships etc. are the major themes.
It can’t be wrong to say that if we call the present situation of Kashmir as “low-intensity war”. What predominates in such conflicts is the use of terror to exert social control, if necessary by disrupting the fabric of grassroots; social, economic and cultural relations; the main target of the combatants is often the population rather than the territory and psychological warfare is a central element.
As can be expected, the consequences for mental health can be substantial. Kashmir is not merely a law and order problem but there are social, emotional, political and psychological aspects involved.
A recent survey by MSF highlights the effect of stress on residents of Jammu Kashmir and the findings are: (Sample space:5428 households,399 villages,10 districts of the State).
- Over 18 lakh people in the state showed some signs of mental distress and depression
- More than 04 lakh people surveyed suffer from severe depression
- 41 percent of people in the Valley exhibit symptoms of depression
- 26percent shows symptoms of anxiety
- 19percent shows symptoms of PTSD
Since 2014, the Kashmir valley witnessed the most dangerous incidents, which leads the people of the Valley to the mental illness and these incidents were:
Floods of 2014:The flood of 2014 has claimed over 300 human lives and billions of rupees in terms of damage to private property, businesses and government infrastructures.Kashmir has already recovered these losses to some extent but will not recover from the shock and trauma that this land underwent during the flood.
PTSD was on the rise in the Valley after the worst ever flood hit the state. Psychiatrists of the valley state that there has been a remarkable increase in the number of patients who were suffering from early symptoms of PTSD.
Unrest of 2016:It started in early July of 2016, Kashmir witnessed the curfew, pallets, shutdown, and deaths during the period of 100 days of unrest. The turmoil effects mental health of people in the valley.
Doctors of the Valley, state that the stress of conflict leaves a definite impact on the psyche of the people and most affected persons were children and women.The people who see somebody dying in front of them in explosions, firings, pellets were the sufferers from a post-traumatic stress disorder.
Braid-chopping in 2017:In the middle of 2017, a wave of fear has gripped Kashmir valley after a series of braid-chopping attacks that have resulted in protests across the region and resulting in more patients of post-traumatic stress disorder.
At least 200 women in the valley have reported being attacked by masked assailants.The victims claimed that that the attackers sprayed chemicals on their faces and left unconscious, upon wakeup, they found their hair had been chopped off.
World Health Organisation (WHO ) has recommended various programme in the field of promotion and prevention and which we need to adapt and work on in our settings which include mental health awareness/anti-stigma campaign, maternal mental health promotion, school-based mental health promotion, parental/family mental health promotion, violence prevention, workplace mental health promotion and suicide prevention.
Besides government, NGO’s, Social activists and respectable citizens should come forward for the restoration of mental health and rehabilitation processes.
Er. Arafat Ashraf Kakru
Author works in National Industries Company,Kuwait.