Mental Health is on the Brink in Kashmir, say Experts

Kashmir is witnessing an alarming mental health crisis as the suicide rate has escalated over the last two years. Experts claim that the continued political uncertainty and the impact of COVID-19 on the economy have taken a toll on people's mental well-being. 

The people's mental health started to deteriorate in 2019 when the BJP-led government unilaterally revoked the special status of Jammu and Kashmir and divided it into two union territories. The decision was followed by months of restrictions on communication lines, and the movement of people was also restricted, causing a reasonable strain on people's mental health. This impact was reflected in the National Crime Bureau's findings for 2020, which indicate a 13.9% increase in the suicide rate, with 284 suicides reported in the year. The graph has been on an upward trend since then. 

NewsClick talked to a suicide survivor who attempted to end her life while jumping from a bridge in Srinagar. "Police saved my life while I was trying to jump from a bridge. I am thankful to them," she said.

Hopelessness and undeniable anguish drove 29-year-old Sana (name changed) to attempt taking her own life. She was left with no source of income after police arrested her husband, who is a driver by profession, when he was moving from Punjab to Kashmir in 2019. 

"I do not know why he was arrested. I cannot afford to visit him in jail," Sana says. Since then, she says, "Life has been getting harder with each passing day. My in-laws threw me out of the home along with my 2-year old daughter. My brothers also refused to accept me, which forced me to live in rented accommodation alone." She struggled to pay rent and feed her daughter. 

"Some days, I borrowed money from people. But they turned their backs after some months, and I was left to fend for myself. I could not bear this and attempted suicide," she told NewsClick. 

However, her life changed after some people came forward and donated money. "I can now hire a lawyer to get my husband released or at least visit him in jail. I can show him our daughter," she says. 

Life continues to be hard for her, but she has learned to cope with it. "I am living with my father in rented accommodation. Things are still bad, but I now have the will to fight. Support from people changed my mindset. None should take this step," she says. 

According to mental health doctors, rising suicide rates in Kashmir, resulting from underlying concerns about an economic, social, physical, or uncertain political scenario, indicate a dangerous state. Experts believe that higher psychiatric disorders contribute to increased suicide rates in conflict zones, as mental health is often overlooked in focus on the physical aspects of trauma. 

"For the past three decades, we have been through a lot in the valley. Communication blockades, lockdowns, and school closures have all raised the psychological load on the people here in recent years," Sheikh Shoib, a leading psychiatrist, told NewsClick. 

According to a 2015 poll conducted by Doctors without Borders, around 1.5 million Kashmiris suffer from mental illness. According to IMHANS and Action Aid estimates, 11.3% of the population was affected by mental diseases in 2016. 

"From a psychological standpoint, suicide is the most common cause of death. It s a symptom of an underlying mental health condition. According to the study, 90% of people who attempt suicide or die as a result of suicide have underlying mental health issues," Shoib said. 

Experts believe the valley is suffering from the cumulative effect of the region's two consecutive lockdowns over the last two years. According to the Kashmir Chamber of Commerce and Industries, the lockdown imposed when Article 370 was revoked resulted in the loss of almost 4,000 jobs. The COVID-19 decimated the business sector, raising the overall unemployment rate to more than 22%, significantly higher than the national unemployment rate of 7.1%, according to the Centre for Monitoring the Indian Economy (CMIE). 

"Unemployment is at an all-time high because businesses have been in survival mode in this area for the past three years, which has resulted in an all-time high in unemployment. Employment will grow once the private sector is fully engaged. The balance statements of businessmen show that things aren't looking well," Sheikh Ashiq, President of the Kashmir Chamber of Commerce, told NewsClick.

Mental health experts believe that more stringent laws are needed and that strict enforcement of drug dispensing protocols can help reduce the number of incidents. 

"Poverty has been connected to a lot of stress, as well as suicide in some situations. As a result, there is a lot of stress among adolescents, especially students, due to the uncertainty. As a result of COVID 19, there is some doubt. People are losing their jobs, unemployment is rising, and universities are closing their doors. We see suicidal behaviour in adolescents, such as deliberate self-harm. They cut themselves to relieve the stress. It's a bad way to deal with stress, similar to drug use," a mental health professional, who did not want to be identified, said.

Suicide and Substance Abuse are Inextricably Linked

"If you ask me to name two factors that contribute to suicide, I would say substance abuse and severe depression," said Dr Yasir Rather, Associate Professor at the Institute of Mental Health and Neurosciences. He claims that statistics on drug addiction depict a bleak picture. He explains that on average, they see 50–60 drug addicts with mental health complications in OPD every day, with 90% of them taking heroin and the majority of them Intravenous injection (IV).

According to the data, the number of patients seeking treatment for substance misuse has increased by more than 1,500% in the last three years. In 2016, 489 drug users were reported to the IMHANS; in 2019, there were 7,420. Due to the COVID-19 lockout, the number plummeted to 3,536 in 2020.

Similarly, opioid substitution therapy (OST) registrations have increased dramatically at the IMHANS. Between 2012 and 2015, there were 139 patients requesting treatment, which increased to 309 between 2016 and 2019. However, there has been a significant increase, with 495 patients reporting to the IMHANS de-addiction centre in 2020, up from 500 in just the first five months of this year.

Over 47% of the 309 patients reported between 2016 and 2019 came from urban areas, while over 52% came from rural areas.

Mental health services have remained centralised and limited to tertiary institutions, as mental health specialists such as psychiatrists, clinical psychologists, and psychiatric social workers are deficient in Kashmir. 

"Although we are performing better than other states, psychiatrists are available in the district hospital, but are not the answer; we also need additional paramedical services like clinical psychologists, mental health social workers, psychologists, and community councillors," a doctor explained.

While admitting that more has to be done in the area of mental health, Mushtaq Ahmad, the Director of Health Services in Kashmir, claims to have taken numerous steps to address the issue. 

"The first step was to train peripheral doctors in mental health, which I believe would pay off in the long run. Once they have been sensitised, they will be a huge help. Simply discussing the problem might be beneficial. Anyone can be a councillor," he said.