Baring the Closet

Javid Rather from Baramulla discusses a very unfashionable topic in a society obsessed with politics


Mental Health in Kashmir

In Kashmir, the prolonged exposure to stress that the insecure situation has engendered means that the coping mechanism of individuals is impaired or dysfunctional. This raises the issue of structural support for the community. The substantial need for psychological and psychiatric support can only be addressed through a strong community - based mental health system.

Regretfully, though this type of service is clearly advocated in the Indian Mental Health Program, in Kashmir, community psychosocial services are absent and psychiatric services outside Srinagar remain almost non-existent. Culture certainly impacts how individuals from a given society perceive, communicate and manifest their symptoms; how they cope with the illness; how their family and community supports the individual; and finally how willing the individual is to seeking treatment. Source? Or is this an opinion from the writer? If so it should be clear that this is an opinion! Cultures also vary with respect to the meaning they impart to illness, their way of making sense of the subjective experience of illness and distress .The meaning of an illness refers to deep- seated attitudes and beliefs a culture holds about whether an illness is “ real” or “ imagined,” whether it is of the body or the mind ( or both), whether it warrants sympathy, how much stigma surrounds it, what might cause it, and what type of person might succumb to it.

Cultural meanings of illness have real consequences in terms of whether people are motivated to seek treatment, how they cope with their symptoms, how supportive their families and communities are, where they seek help ( mental health specialist, primary care provider, clergy, and/ or traditional healer), the pathways they take to get services, and how well they fare in treatment.Before the conflict in Kashmir erupted on to the main stage in the late 1980s, there was little awareness in the state of what mental health constituted or how this could impact on the individual’s physical well- being.

A good pointer would be the number of patients registered in the outpatient department of the only government psychiatric hospital in Srinagar. While before 1989, there were only a few hundred patients registered with the department, since the 1990s, this number has risen to several thousands. Mental health and physical well- being are deeply interwoven, affecting the functioning of the individual and his/ her place in society. In traditional societies, cultural influences often mean that the very idea of admitting to a psychological problem is anathema. A person suffering from a bipolar disorder or schizophrenia would more likely be dubbed as insane than as someone with a treatable mental disorder. Besides, mental illness is often stigmatised as bringing shame.