Despite the huge burden of mental health cases in Kashmir, mental health remains a main concern in the valley and issues such as poor awareness of mental illness, stigma, high treatment gap and shortage of mental health professionals to manage widely prevalent mental illnesses.
As per a research published earlier this year, the primary mental health treatment facilities in Kashmir have not altered much in the last two and a half decades, despite a major increase in the prevalence of mental disease in the region.
The mental health services continue to remain rarely offered in primary healthcare settings. At the secondary and tertiary care level hospitals there is a shortage of psychiatrists.
In the recent past, the Government Psychiatric Disorders Hospital in Srinagar has been remodeled into an Institute of Mental Health and Neurosciences (IMHANS) as part of a push to improve the delivery of mental health services.
However, the only psychiatry disease hospital IMHANS Srinagar is facing manpower shortage despite its up gradation taking a toll on mental treatment in the valley.
As the world celebrated World Mental Health Day on 10 October, in Kashmir doctors raised the many lacunas and failures in mobilizing efforts in support of mental health.
The IMHANS Srinagar, the lone and largest mental health facility in the valley, has been facing many issues ranging from manpower crunch, inadequate accommodation, lack of space for wards and deficiency of basic equipment.
A senior doctor of the Govt. Psychiatric Diseases Hospital said the staff strength needs to be augmented keeping in view the increase in patient load as well as an increased awareness about mental health problems and new challenges like drug addiction.
“The already deficient staff of this hospital is running two hospitals since the establishment of Community General Hospital Unit in SMHS Hospital complex which has further worsened the situation and both these hospitals are being run by skeletal staff. As such there is an urgent need to fill vacancies in sanctioned posts. A proposal in this regard has already been submitted to the higher authorities,” he said.
The doctor said with the expansion of hospital services in recent times, budgetary allocation under various heads need augmentation especially under POL and Outsource & Upkeep heads.
“Outsourcing of sanitation has become inevitable with the expansion of the hospital by construction of a new hospital building as well as the establishment of a Community General Hospital Unit. The number of available sanitation personnel cannot cope with the increased needs on this account. Hence there is an urgent need for augmenting the budgetary allocation under the Outsource and Upkeep head,” he said.
The mental hospital also requires a dedicated essential service electric line as a result of which it faces power outages which causes disruption in smooth functioning of hospital and causes interruptions during various investigational and therapeutic procedures like ECT.
Officials said the building constructed under NMHP caters only partially to the needs of the hospital and further expansion of the hospital needs to be planned and taken up.
As per officials there is need for involvement of agencies like the Social Welfare department to ensure proper rehabilitation of the treated and discharged psychiatric patients and their re- integration into the community.
The hospital faces many difficulties on this account as patients’ families and the community at large are not willing to accept the patient even when further hospital admission of these patients is not required.
Officials said there is a requirement that many equipment have been submitted repeatedly and need to be procured on immediate basis. The equipment include ECT including Anesthesia Station, electrolyte including lithium analyser, fully Automatic Biochemistry Analyser, CBC part 5 analyser, Urine Analyser, RTMS (repetitive trans cranial magnetic) Machine and psychological assessment tools.
Officials informed that they are planning new measures to improve services at the Child Guidance and Wellbeing Center (CGWC) IMHANS.
The hospital plans to have tertiary care specialised services including construction of wards and child friendly spaces near the community centre.
It aims capacity building programs to be conducted at district levels. The training will be conducted in phases like basic and advanced.
“For improving compliance to treatment and counselling sessions for children and adolescents residing in districts other than Srinagar, mobile mental health units would be put in place,” the official said.
Further, Clinical Psychologists and Counsellors from CGWC-IMHANS will be available at the designated mobile mental health units to provide psychological assessments and counselling sessions to the children/adolescents.
As per a research published by The Lancet, mental health in India remains a major concern with the country facing numerous challenges such as poor awareness of mental illness, stigma, high treatment gap and shortage of mental health professionals to manage widely prevalent mental illnesses.
It said the National Mental Health Survey of India reported that the point prevalence of any mental illness was 10.6% while 5.1% of the adult population was estimated to have some level of suicidality.
The Global Burden of Disease Study 1990–2017 estimates the number to be 197.3 million people (95% uncertainty interval:178.4–216.4). Between 2012 and 2030, mental illnesses would cost India 1.03 trillion US dollars.
The scenario is complicated by a very high treatment gap of 83% along with only 0.75 psychiatrists per 100,000 population, even though the WHO desires at least three psychiatrists per 100,000 population.
Having a population of 1.38 billion, a low number of overall mental health professionals in India, especially in rural areas, is not surprising as most of these are concentrated in urban areas.
