Three decades of conflict, a total shutdown for months in the state since the abrogation of Article 370 on August 19 2019 and two long periods of lockdown during the first and second wave of the COVID-19 pandemic — all of this together has created a serious mental health crisis in Jammu and Kashmir, and led to a sudden spurt in suicides in the Union Territory in recent times. Suicides in Srinagar in particular have risen at an alarming rate, as young boys, girls, women and even elderly individuals are taking their own lives. The city of 1.2 million has been reporting one or two suicides on an average every week.
Data available with the police reveal that in Srinagar district alone, 29 suicide attempts have been recorded since March this year. “Twelve persons including six girls, three boys, and three elderly women died by suicide, jumping into river Jhelum this year,” said a police officer. “A majority of cases were reported in May, June, July and August. This is the first time Srinagar has seen such a rise in suicide cases.”
The Jhelum river, which flows through the city and has seven bridges spanning it, has become a common site of suicides in Srinagar. “In June and July alone we must have saved a dozen youth, including a few girls, who were about to kill themselves here,” says Aijaz Ahmed, a resident of Noorbagh.
20,000 suicide attempts in seven years
According to a report published by the National Human Rights Commission, 20,000 people have attempted suicide during the 14 years of socio-political turmoil in the Valley. About 3,000 of them have died and most of them were in the 16 to 25 age group, the report reads. Latest records from Shri Maharaja Hari Singh (SMHS) hospital, one of the major tertiary care hospitals of the city, reveal that over the past one year the hospital has recorded over 500 suicide/attempted suicide cases from different parts of Kashmir.
A doctor at the SMHS Hospital said that of the total 500 cases, 172 were male and 343 females.
Dr Sheikh Shoib, a consultant neuro-psychiatrist at Jawahar Lal Nehru Memorial hospital, Srinagar has been studying developments related to mental health unfolding in Kashmir post Article 370 abrogation and the subsequent virus-induced lockdowns.
“The valley has been under political turmoil for almost 30 years which has had an enduring psychological impact on the Kashmiri population, who have seen frequent curfews and lockdowns, especially since August 2019,” said Dr Shoib. “Lockdown measures to prevent the spread of COVID have added further to their trauma. Preventive measures like social distancing can lead to increased loneliness and the feeling of being neglected, particularly for the elderly, which can precipitate mental health issues.”
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Dr Shoib said that 45% of Kashmir’s adult population (1.8 million) was suffering from some form of mental distress or the other. “There is a high prevalence of depression (41 percent), anxiety (26 percent), post-traumatic stress disorder (19 percent), and 47 percent had experienced some sort of trauma,” he said. “The prevalence of childhood (8-14 age group) disorders was 22–27%. A retrospective study on suicide recorded an increase of more than 250% in the number of suicide attempts between 1994 and 2012”.
In recent years, 284 suicides were reported in 2019, that is, 2.1 suicides per lakh population, an increase of 13.9% from 2018, according to the National Crime Records Bureau report of 2020.
What’s pushing people to the brink?
“In a conflict zone like Kashmir, suicides are common because of multiple reasons,” says Dr Nisar-ul-Hassan, associate professor (Medicine) at SMHS hospital Srinagar. “Post-Traumatic Stress Disorder (PTSD) is a common reason for suicides in a conflict zone, then comes domestic violence and other factors”. At present, suicides among women have been observed to be more than among men. Dr Nisar attributes this sudden surge in suicides largely to the financial crisis triggered by loss of livelihoods caused by the curfews and lockdowns since 2019.
“Apart from the financial crisis, growing drug abuse has escalated the factors responsible for suicides,” adds Dr Nisar. “Today, more people suffer from depression as compared to the past. Since August 2019, people who needed personal consultations with psychiatrists have had to resort to virtual consultations that added to the stress levels, leading to a rise in suicides.”
A new factor responsible for rising suicides, Dr Nisar said, was “online dating violence. Young teens falling in love through the internet and breaking up later. This ultimately increases depression levels and leads many youth to take the extreme step”. Dr Nisar suggests setting up of local area committees for keeping a watch on youth and trying to revive the age-old elderly-young bonds again.
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Prevention calls for prioritising mental health care
Dr Shoib emphasised that there is an urgent need for the development of mental health services in Kashmir accompanied by community participation, awareness programs, and mental health rehabilitation services. Counselling services have to be available adequately for dealing with the enduring trauma. There is also an urgent need for researchers, clinicians and policymakers for devising policies and interventions given the prevailing mental health status of the Kashmiri population.
Mental Health Helplines for anyone in crisis:
Sukoon: 1-800-180-7159
Kashmir Lifeline: 1-800-180-7020
The Sara (Jammu Tawi): +91 96976 06060
Aasra: +91 98204 66726
Fortis Stress Helpline: +91 83768 04102
“We further suggest establishing a well-equipped tele-psychiatric service system to deal with mental health problems. This approach will boost accessibility and affordability of mental health interventions with timely diagnosis and improve the follow-up for treatment,” he added.
Currently, mental health services are primarily available in only two hospitals in Srinagar (GMC Srinagar and SKIMS hospital Soura), although the National Mental Health Plan and the District Mental Health Program were started in many districts of Kashmir including Srinagar. There are 140 indoor beds in 10 districts of Kashmir, and outpatient services are provided by 16 psychiatrists, 12 psychologists, and one social worker, according to official figures. There are only 5 or 6 professionals working as consultant psychiatrists at the district level (Srinagar, Budgam, Pulwama, Anatanag and Baramulah).
“Psychiatric care is provided by just a few practitioners on a private fee-for-service basis, thus limiting access for those unable to afford it,” Dr Shoib said.
“Suicide is viewed with indifference due to focus on the physical part of trauma (in violence/conflict-ridden areas),” says Dr Shoib. “And the pandemic has exaggerated mental health issues among Kashmiris which can be one of the factors responsible for growing suicides.” He advocates suicide prevention helplines on the lines of the national helpline for prevention of suicides.
Clerics help out
Expressing concern over the steep rise in suicides, Kashmiri clerics have decided to make appeals to the youth every Friday not to take extreme steps, as the same was prohibited in Islam.
Many are uploading their lectures on suicides, causes and prevention on various social media platforms. On August 3rd, Mutahida Majlis-e-Ulema (MMU), an amalgam of Kashmiri clerics and civil society groups met in Srinagar and deliberated on the rising suicides. Senior member of the MMU, Mufti Nasir-ul-Islam, who is also the grand mufti of Kashmir, said directions have been passed to all clerics to speak for 10 to 20 minutes during every Friday sermon on prevention of suicides.
“Apart from this, local area committees headed by Imams (clerics) will be formed in every locality of Srinagar and all villages across Kashmir are to start counselling of youth, women and elderly,” he said. “MMU will also seek fencing of all bridges in Srinagar and urge the administration to set up “emergency helplines on bridges” for suicide prevention.