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Conflict And Care In Kashmir: A Conversation On Mental Health Services With Ufra Mir

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On the evening of August 2, 2019, my college administration put out a circular asking students to leave the campus immediately, without offering us any explanation.

The very next day, I made my way back home, not knowing what the future had in store for usthere were only rumors of what was to come next.

Two days later, Article 370 of the Indian constitution, which gave the people of Jammu and Kashmir a degree of autonomy, was abrogated. Soon, the whole region was trapped under curfew with the Internet and phone services being blocked.

A deserted road in Srinagar during a curfew. Representational image. Photo credit: Daily Excelsior

This forced everyone to be locked up in their homes, with no contact with the rest of the world whatsoever. Not knowing how my family and friends were doing, and not being able to step out of my house, severely impacted my mental health and the mental health of many, many Kashmiris like me.  

People Don’t Know Enough

I reached out to Ufra Mir, the founder of Paigaam and the International Center for Peace Psychology. Mir is the first peace-psychologist from Kashmir and South Asia. She has been working on mental health, among other issues, in Kashmir for over a decade now.

The gravity of the mental health crisis became obvious after my conversation with her.

She spoke about how Kashmir is a place where being able to have a conversation about mental health is a privilege, as most people are forced to focus on daily survival due to the ongoing conflict. “There are people who have been living with mental health issues for years now and don’t even know about it,” she regretted.

Ideally, when people are struggling with mental health issues, they start their treatment with counseling or by visiting a clinical psychologist. Then, they might get referred to a psychiatrist, if needed.

However, this modus operandi, as Mir explained, is not the case here. 

“In Kashmir, there is still a lack of awareness about whom to seek support from. The mental health space is dominated by psychiatry and medicinal approaches. Most people go to psychiatrists first, hoping they will listen to their stories, but what they end up with is a three-minute session with a psychiatrist, who is overburdened by an ever-increasing number of cases.”

Mir added:

“I have, at times, been the first person to hear a person’s story despite them going to a psychiatrist for several years. These people have been taking anti-anxiety or anti-depression drugs, when they could have been helped with psychotherapy. This, along with stigma, prevents many from seeking professional support. People are worried that others from their community might find out.”

She elaborated saying that this also influences how psychology and psychiatry are taught to students in Kashmirthe understanding of ethical guidelines and confidentiality is not always properly integrated into their curriculum.

Role Of Conflict In Kashmir

In her memoir “Rumours of Spring”, Kashmiri writer and former photojournalist, Farah Bashir, narrated how “normal” activities become life-or-death situations in the valley.

An incident from Bashir’s childhood mentioned in the book talks about how an outing to get a haircut for Eid, turned into an attempt to escape a shoot-at-sight-curfew. Such situations are common experiences and have a drastic impact on the mental health of Kashmiris. 

As Mir said, “Mental health doesn’t exist in a vacuum, it exists in relation to everything that is happening around us. Conflict has a huge role to play.”

According to a study conducted by Sheikh Shoib and SM Yasir Arafat:

“About 45% of Kashmir’s adult population (1.8 million) suffers from some form of mental distress. There is a high prevalence of depression (41%), anxiety (26%), post-traumatic stress disorder (19%), and 47% of the population has experienced some sort of trauma. Additionally, there has also been an increase of more than 250% in the number of suicide attempts between 1994 and 2012.”

With an increase in mental health issues among Kashmiris due to the worsening political situation, the shortage of trained professionals and clinics is also becoming more evident.

According to the 2011 census of India, Jammu and Kashmir has a population of around 12.5 million, with only about 41 psychiatrists, who are mostly affiliated at teaching hospitals in two cities of Jammu and Srinagar.

While the numbers are bound to have increased since then, there still remains a gap between the mental health service providers and the general population. 

Moreover, there are fewer psychological services offered in the valley, as hospitals are still dominated by the psychiatric narrative.

Moving Towards Solutions

Talking about the wide disparity that exists in offering mental health services, Mir said that while people around the world are asking for integration of mental health in health insurance packages, Kashmir is yet to build a stable foundation that would include awareness, adequate number of professionals, efficient infrastructure and proper resources.

Kashmiris are still suffering from basic human rights violations due to the ongoing conflict. 

Mir also highlighted the necessity to understand that mental health in Kashmir is a multilayered issue. It cannot be addressed in a silo.

She asserted that, “Communities form a major part of the psychosocial social support systems for Kashmiris. Western approaches may not always work. Mental health care needs to be contextualized according to the needs of the people of the valley.”

This is exactly what she has been trying to do with her intersectional and multi-sectoral practice on the ground.

 Zuun-e-Daeb: Community safe space initiative on mental health organised by Ufra Mir on World Mental Health Day
Zuun-e-Daeb: a community, safe space initiative on mental health, led by Ufra Mir on World Mental Health Day. Photo credit: Ufra Mir.

There is, thus, an immediate need to take steps to increase the mental health services in Kashmir consisting of: community participation, awareness programs, and accessible psychotherapy sessions.

“Mental health needs to be integrated in our daily lives… It is as much political as it is personal. Hence, there is an urgent need to address the issue of human rights violations in Kashmir, to bring in reforms for the mental healthcare issues that Kashmiris currently face,” explained Mir.

Featured image is for representational purposes only.

Note: The author is part of the current batch of the Writer’s Training Program

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