Kashmir faces mental health crisis

Samaan Lateef

Tribune News Service

Srinagar, January 10

Kashmir is facing a mental health crisis with the cases of depression-related illnesses being almost double than the national average. The situation is compounded by inaccessible mental healthcare system.

Experts said mental health services need to be expanded and integrated into the primary healthcare system to contain the growing number of people with mental illnesses — the most stigmatised health issue.

Due to the lack of awareness and non-availability of professional care, they said the treatment gap was very high in Kashmir, where depressive and anxiety-related disorders constitute most of the mental illnesses.

“The 11.3 per cent morbidity of severe mental illness in adults is very high, almost double than the overall national picture, much of which is undetected and untreated,” said a recent study conducted by psychiatrists of Institute of Mental Health and Neurosciences, Kashmir, in collaboration with ActionAid India.

“Only 12.6 per cent of the people with mental illness sought help from health services and 6.4 per cent consulted a psychiatrist,” added the study.

However, psychiatrists attributed the low treatment levels to “very high stigmatisation” of mental illnesses and inaccessible treatment at the community-level.

Noted psychiatrist Dr Arshad Hussain said there was no health without mental health. Hussain advocates “pyramid of care and pyramid of change” with psychosocial workers forming an important link between primary secondary and tertiary levels.

“Treatment should be based on principles of comprehensibility, universality, equity, effectiveness, decentralisation and sustainability,” he said.

Hussain stressed the screening processes for mental health issues should be started at all primary and community health centres by involving the Accredited Social Health Activists (ASHA) and anganwadi workers. He said the MBBS doctors should be trained in dealing with common mental health illnesses during their training.

He said the chain of referral system from the community up to tertiary hospitals needed to be strengthened. “There is a need to decentralise the mental health service system to make quality services available down to the district and block level, which also helps in reducing the stigma attached to mental illness,” Dr Hussain said.

The state government should consider strengthening and modifying the District Mental Health Programme (DMHP) according to the local needs. Hussain said the mental health needed to be integrated with general health at all levels.

The state government should “consider expanding” DMHP— the flagship mental health intervention programme of the Central government — to all districts in Kashmir. The DMHP is presently being implemented in only four districts of the Jammu region, including Jammu, Kathua, Rajouri and Udhampur from 2004-05.