A centrally-sponsored mental health programme meant to improve access to diagnostic and treatment services has failed to take off in Kashmir even as various studies have established the high incidence of mental health issues here.
In 2016, the centrally sponsored district mental health program (DMHP) was launched in four districts of Kashmir viz. Pulwama, Kulgam, Bandipora and Ganderbal, by directorate of health services Kashmir.
The program was meant to improve access to diagnostic andtreatment services for psychiatric disorders by providing a team of experts aswell as infrastructure at district hospitals. However, three years on, exceptfor district hospital Pulwama, the program has remained confined to OPDservices only.
Consultant psychiatrist at district hospital (DH) PulwamaDrMajid Shafi, said the lack of manpower in these centres was a major impedimentin making them functional. “The psychiatrist is paid less than a residentunder Kashmir DMHP. How is that supposed to work?” he asked.
This apathy towards mental health can be gauged from thefact that while newly established Government Medical Colleges (GMC) of Anantnagand Baramulla have a department of psychiatry, the affiliated hospitals have noprovision for improved mental health services.
At DH Baramulla, the psychiatry department is restricted toa small shared room that functions both as OPD and counseling room. At DHAnantnag, affiliated to GMC Anantnag, the scenario is no different. A singlechair OPD is all that functions in the name of psychiatry at the hospital, ahealth official said.
In the past different studies have talked about the severityof mental health illness in Kashmir. As per a 2016 study by Medecins SansFrontier (MSF), as much as 45 percent of Kashmir’s population “was experiencingsymptoms of mental distress, with 41 percent exhibiting probable depression”.
A year later, Action Aid India, in collaboration withInstitute of Mental Health and Neurosciences of Government Medical CollegeSrinagar, released findings of an extensive study about prevalence of mentalhealth illnesses in Kashmir’s 10 districts.
The study revealed that in Kashmir “12.3 percent of people had witnessed traumatic events intheir families in terms of losing a family member, having a member disappeared,detained, tortured or disabled due to conflict related reasons”. Expectantly, asignificantly higher proportion among these, about 24.3% had developed somekind of mental health disorder. In general population, the prevalence was muchlower and stood at just 9.4%.
The mental health experts rue that adequate attention hasnot been paid to addressing this mental health illnesses in Kashmir. As aresult, diagnostic and treatment services have remained centralized toSrinagar’s tertiary care hospitals, thus posing hurdles in access and treatmentseeking.
“Mental health cannot be addressed by a centralized serviceonly and there is a dire need to improve awareness as well as outreach in thisarea,” said a senior psychiatrist at GMC Srinagar. He added that although theGMC alone produced as many as eight psychiatrists every year, there was noinfrastructure available in peripheries where these experts could render theirservices.
DrTajammulHussain, Assistant Professor Psychiatry at GMCBaramulla said that location of a psychiatry facility was a major factor intreatment seeking. “I have patients who cannot afford to travel and then getadmitted far away from their homes in Srinagar,” he said adding that suchpatients usually give up on treatment as travelling to the GMC’s mental healthfacilities was too hard on their pockets.
Director health services Kashmir, DrKunzes Dolma agreed thatDMHP had not taken off, thus reducing the ambit of mental health facilities inKashmir. She said that her department was cognizant of the magnitude of mentalhealth issues in Kashmir and improving the infrastructure and manpower indistrict hospitals for psychiatry was the “need of the hour”.
“We have submitted a proposal to Government seekingextension of DMHP to all districts. We hope it will be approved soon,” shesaid.