According to WHO website, “Given past experience of emergencies, and pandemic of Corona Virus in 2020, it is expected that the need for mental health and psychosocial support will substantially increase in the coming months and years. Investment in mental health programmes at the national and international levels, which have already suffered from years of chronic underfunding, is now more important than it has ever been.” This is why the goal of this year’s World Mental Health Day campaign is increased investment in mental health. Regarding Jammu and Kashmir, help of government is welcome, but rich, influential members can also play a vital role in sustaining such projects. It is high time that we not only express ideas on social networking sites but implement some of these novel ideas.
The key lies in supporting grassroots workers in their activities in the field regarding general health which included mental health in various proposed projects. The most suitable location for such project on Wellness and Holistic Health is Srinagar, the capital city of J&K. Most of the rural population visits Srinagar for one or the other reason. Srinagar is the place where patient from any place can reach easily and stay if needed. All specialty hospitals, quality medicine shops are situated in Srinagar, so referrals of patients can be done easily.
It can start with two rooms, one for counselling, where a full time mental health officer, counsellor, and office assistant can be employed.
Following points can prove harbingers for change in JK, or any other place.
1. Social Wellness is the ability to relate to and connect with other people in our world. Our ability to establish and maintain positive relationships with family, friends and co-workers contributes to our Social Wellness. In Kashmir the conflict has impacted social relationships and wellness.
2. Emotional Wellness is the ability to understand ourselves and cope with the challenges life can bring. The ability to acknowledge and share feelings of anger, fear, sadness or stress; hope, love, joy and happiness in a productive manner contributes to our Emotional Wellness.
3. Spiritual Wellness is the ability to establish peace and harmony in our lives. The ability to develop congruency between values and actions and to realize a common purpose that binds creation together contributes to our Spiritual Wellness
4. Physical Wellness is the ability to maintain a healthy quality of life that allows us to get through our daily activities without undue fatigue or physical stress. The ability to recognize that our behaviours have a significant impact on our wellness and adopting healthful habits (routine check-ups, a balanced diet, exercise, etc.) while avoiding destructive habits (tobacco, alcohol, and other drugs etc.) will lead to optimal Physical Wellness. The proposed centre would offer activities aimed at all these aspects of physical wellness.
While acknowledging the manifestation of mental disorders and their treatment for affected individuals, the attempt will be to involve populations at risk in positive wellness activities.
Review of the available expertise within the investigation group/institution. The proposed project should be manned by a team of locals, familiar with the conflict and the population.
Rationale for the project
Up to late eighties psychiatric disorders were a rarity in Kashmir, specially suicides. (Krishna Murty,1983) From a low of 0.1 to 0.2 per 100,000 persons, now in same Kashmir the rate is 18-22 per 100,000 per year. Overall females have been found to be mentally disturbed and males are prone to suicide and drug-addiction, also known as drug abuse. They suffer from many forms of depression, which in majority of cases gets masked by other diseases. A great percentage of women in Kashmir are physically abused, there are dropouts from school, and adolescent girls who are in conflict with their families.
Now, like other parts of the world, Covid pandemic will add to the already existing problems of mental health.
The common population in the valley finds life meaningless. There is a deep sense of constant uncertainty and at one level it leads to the creation of stressed out individuals who are aimless, rudderless and on the other extreme it can lead to phenomena like anomic suicide. Anomic suicides are the result of a lack of meaning with one’s life. In other words, no moral regulation makes it impossible for a man to establish his/her own place in the universe. A meaningless world would leave a man confused, life a mystery, and the value of his/her own life worthless.
Home visits to psychiatric patients who are suffering from serious psychotic ailments like schizophrenia and are reluctant to visit a doctor or a hospital, same for old age patients, such unique initiative first in Kashmir can be a big success
School awareness programmes: Suicides, childhood depression and conversion disorders like pseudo-seizers are now quite common in Kashmir. Only few schools in Kashmir have a full time qualified counsellor, in spite of living in one of the most stressed part of world. If we interact with 1500 students and teachers, which means we can spread our message to at least 1000 families indirectly. School mental health awareness programmes is going to help our future generations too as well as save our present one from going disarray and being labelled as “lost generation”
Work with ICDS Asha workers in Kashmir. This wonderful initiative aims at giving awareness on female hygiene, breast cancers, reproductive health of females, breast feeding and common childhood ailments which can become serious if untreated.
Work with primary care takers of cancer patients as well as the cancer patients. This again can be first such initiative in Jammu and Kashmir. Kashmir has about 2.14 lakh orphans according to a UN report, large numbers of them are living in orphanages. Except few orphanages the condition of children in most of orphanages is pathetic, after COVID Pandemic how many visits were made by civil society members and government officials to check condition of children there remains a mystery.Such projects run by professionals can also providing capacity building training to school teachers, students, community leaders as well as social workers. In my experience with so much grassroots activity has led me to conclude that in order to break the cycle of Stress induced mental health problems it is important to break the linkages of stigma with psychiatric ailments. It is important to convert stigma and stress to dignity and honour and belonging. This can only be done by constant positive exposure to practices of Mental and Physical health. Since I always promote scientific techniques along with spirituality, I end from a message of spirituality. We have incorporated various thoughts which we say its normal, we say it’s OK to be angry, shout, get stressed or take revenge, while the fact is when we were born, we were loving in nature with all and blissful, the habits of anger, revenge, jealousy we acquired slowly while we were growing up. Let’s take example of stress; we proudly say “In this materialistic world stress is natural”, while the fact is that it’s not natural. Our mornings are like blotting papers, absorb all be it prayers or reading/watching newspapers/TV shows. In the morning when we wake up, we already possess and use ingredients for a stressful day. Gone are the days when in any family the home was reverberating with religious hymns, and then working in our gardens. Nowadays the first thing we do, while taking tea or breakfast is watch TV, which imprints our fresh mind with news of Covid, killings, building or bridge collapses, rapes, fake medicine or adulterated eatables being sold. No, I am not saying don’t watch TV or read newspaper as the first thing in morning, I just say start your day with prayers or reading translation of your holy books or books on life of Prophets, or starting day with reading religious hymns for just 5 minutes. Then in a place like Kashmir, it becomes necessary to read newspaper to know situation of the place you are going for work. But five minutes will do wonders, like the balanced breakfast for your body, five minutes of religious or spiritual hymns will be food for your mind, whether you are going to school or office.