Depressing statistics: Mental health care in Kashmir reflects apathy

Srinagar: With 1.8 million (45%) adults having a significant symptoms of mental distress, approximately 1.6 million adults (41%) living with significant symptoms of depression, and 415,000 (10%) meeting all the diagnostic criteria for severe depression, Kashmir Valley has just six psychiatrists posted in peripheries to cater to this huge numbers.

Though the government has sanctioned 9 positions of psychiatrists but on ground only six are available as three posts have not been filled as yet.

Data available with ‘Kashmir Vision,’ states that there are as less as 9 sanctioned posts out of which 3 posts are lying vacant.

“An estimated 1 million adults (26%) in the valley are living with significant symptoms of an anxiety related disorder. Nearly 1 in 5 adults (19%) or 771,000 individuals in the Valley are living with significant PTSD symptoms, with 248,000 (6%) meeting the diagnostic criteria for PTSD,” reads the study conducted by ‘Medecins Sans Frontieres (MSF)’ 2015 study on Mental Health in Kashmir.

The study conducted in 2015, has covered all the 10 districts of Kashmir valley with a response rate of 97.7 per cent, which is regarded as quite high.

Further, high rates of co-morbidity of symptoms of depression, anxiety and PTSD were found in adults living in the valley.

What is ironic is that Kashmir Valley is having only one Mental Health Institute in Srinagar, with the hospital also complaining about the shortage of staff. The lone hospital has been given an additional responsibility of managing the drug de-addiction centre, which is operational at SMHS, Srinagar.

“The lone hospital is also struggling for additional staff for better functioning, and same is the condition in the peripheries,” said a medico.

A strong indicator of mental distress, as per the MSF study, in the population is the “high proportion (12%) who reported having had thoughts of ending their own life in the previous four weeks.

Further analysis indicated that 65% of those identified as a probable case for any mental disorder had experienced suicidal ideation in the previous four weeks, the study reveals.

The study also confirms that the higher rates of mental distress were reported in women than in men for all three mental health disorders.

Amid the alarming scenario, the state is lacking comprehensive Mental Health Policy, with added up feature of not creating more posts in mental health.

Directorate of Health Services, Kashmir (DHSK) had started District Mental Health (DMH) program in January this year, which as per reports, is functioning in only four districts, as of now and which includes:  Ganderbal, Pulwama, Bandipora, and Kulgam.

As per MSF study, the districts of Baramulla and Budgam reported the highest prevalence rates of symptoms for all three mental disorders, with Baramulla having 48 per cent – 54 per cent and Budgam 44 per cent – 47 per cent prevalence of depression.

However, given the deteriorated mental health, DMH has still not reached to these twin districts of Kashmir.

Dr G A Wani, Assistant Director Health Kashmir, who is overseeing the program, refused to comment on the functioning of DMH, providing no apparent reasons.  Director Health Services was also contacted, who said that he was busy in a meeting.

“The situation, when it comes to mental healthcare in Kashmir, is not good like it used to be, now, there, shockingly is no mental health policy as of now,” said a doctor, wishing anonymity.

Pertinent to mention that the study by MSF was done much before 2016 unrest, in which scores of people were injured due to pellets, and as per experts, the pellet victims, with a passage of time, were also observed to have developed psychological disorders.

The study further says that only 0.3% of Kashmiri adults have not experienced a traumatic event during their lifetime.

“On average, an adult living in the Kashmir Valley has witnessed or experienced 7.7 traumatic events during their lifetime,” it said—the events of 2016 will be add on.

It states that the gap between treatment, need and provision in Kashmir is multifaceted and complex, which as per the study, is not just a question of physical access—other challenges include a shortage of Kashmiri psychiatrists and psychologists, limited counselling services at district level.

“A largely centralised model of care that requires people to travel to Srinagar, find accommodation and make the journey back home; a journey further complicated at certain times of the year by extreme weather that completely cuts access to some areas,” it states.

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