Dr. Abdul Majid & Dr. Aijaz Ahmad
Every year World Mental Health Day is being observed on10th October for the awareness among common masses in view of stigma and discrimination faced by patients with mental illnesses.
Mental health has gained more importance in present times in view of rising number of mental health issues across world especially due to natural and man made disasters . More than 10 billion people in world are suffering from mental health issues, but these figures become more complex as only 15-20% of these patients have easy access to treatment services. In view of COVID-19 and its implications and recent Russia Ukraine war, mental health issues have multiplied.
Every year it is observed with a specific theme in order to promote and encourage patients and their families to The theme for this year, as set by the World Federation for Mental Health, is ‘Making Mental Health and wellbeing for all a Global Priority’.
Change is an inevitable ongoing process in society and people undergo changes in their lives involving various aspects including their attitudes, opinions, behaviour etc. No matter whether people readily accept or resist some changes, the people desperate in making human health/life better keep on persevering in their respective fields and thereby bring those changes which eventually are for the betterment of the humanity.
Often we come across the term “mental health” nowadays and as most of us perceive life to be surrounded and driven by stresses and strains. The Mental health starts with us, so it is very important to take care of it. How we can handle stress, behave in situations and make choices, speaks volumes about our mental health. Mental health is cardinal to human beings both in their individual as well as collective capacity because it is much more than simply the absence of psycho-pathology.
The World Health Organization (WHO) defines mental health as ‘a state of wellbeing in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can make a contribution to his or her community. Although these changes are slow as compared to the other fields owing to the various stigmas associated with mental health problems but if we analyze the struggle, this field had undergone since its very beginning and then we can clearly say that the situation is getting better and the efforts are appreciable.
Kashmir has witnessed man-made and natural disasters and not to forget the recent natural disaster of COVID-19, which brought life to stand still and we felt the scarcity of mental health services, lack of trained personals, treatment gap and stigma. The disasters, unemployment and COVID pandemic destabilized the economic and social milieu and has resulted in increase in the proportion of the mental illnesses/problems in Kashmir.
As per the reports of the Kashmir Mental Health Survey, “nearly 1.8 million adults (45% of the adult population) in the Kashmir Valley experience symptoms of mental distress, with 41% exhibiting signs of probable depression, 26% probable anxiety, and 19% probable Post-Traumatic Stress Disorder (PTSD).”
Mental health disorders have affects on all spheres of life, races, cultures, regions and religions. It has devastated developed, developing and underdeveloped countries. As is found in most of literature nationally and internationally, mental illnesses are prevalent in all age groups.
Children have been found to be more vulnerable and in fact one of the studies was conducted by department of Psychiatry SKIMS Medical College in three districts of Kashmir valley (Srinagar, Bandipora, and Pulwama) to find out the prevalence of psychiatric morbidity among school going children in Kashmir.
The study revealed that female students had significantly higher prevalence of psychiatric morbidity than male students. Students from district Srinagar had higher rate of psychiatric morbidity followed by students from district Bandipora and it was lowest among students from district Pulwama. Students who had faced violence/ abuse directly had higher prevalence of psychiatric morbidity than students who had faced indirectly.
Indian has more than 6 crore patients suffering from drug addiction and its related problems. Jammu and Kashmir as per latest survey has more than 6 lac patients suffering from drug addiction. There has been shift in the pattern of drug use in past two decades in particular from cannabis in 90’s to pharmaceutical preprations in early part of this century to inhalents from 2010 to 2014 and herion from 2015 onwards as per the series of research papers from Kashmir valley.
Currently the alarming rate of opioid dependence (particularly heroin IDU), emerging complexities/ diseases because of IDU (likehepatitis, HIV) and deaths due to overdose in the youth is a big challenge for the health sector and the society in general to handle, owing to the number of hurdles that come up in the implementation of the various measures to curb this issue.
During past decade the increase in prevalence of drug abuse has taken toll on the mental health of family members of these patients. It has been seen that family members of these patients are developing mental health disorders and patients are deteriorating due to lack of social support, economic downslideand many other implications like physical health, legal, political, educational etc.
A study from Department of Psychaitry SKIMS Bemina found that the prevalence of HCV in substance abuse patients among IDUs is on the rise in India particularly in Kashmir. One of very worry trend found among opioid users was 32.0% of patients were HCV Positive and 2.4% patients were found both B & C Positive. To curb this drug menace the department of Psychiatry, SKIMS Medical College Bemina is providing services in three ways in the form Out Patient (OPD). Community clinic is also being run by the department in the central jail Srinagar for inmates who are suffering with drug addiction related problems.
Another important nuero-psychiatric disorder which has shown upward trend is the Dementia. It is estimated that about 47 million people are suffering with dementia worldwide currently, andnthis might increase by doubling the number of people affected by dementia every 20 years as the life expectancy is slowly but steadily increasing thus adding more elderly population to the pool.
According to WHO, global number of individuals with dementia will increase from the current 50 million to 82 million in 2030 and 152 million in 2050. In an epidemiological study in Kuthur Valley of South Kashmir in 1986, a noted neurologist reported that “Dementia was an uncommon disease in Kashmir”.
However, in an epidemiological study conducted in 2006 in Hazratbal block of Kashmir valley prevalence of dementia was found to be 100.57/100000 population.
In a study conducted in SKIMS Bemina recently to determine the prevalence of dementia in Kashmiri population aged 60 years and above. In this study, the prevalence of dementia for those above 60 years of age was found to be 2.21%. The scenario for these elderly people with dementia is complicated by decimal mental health services.
There is surely a need for improving mental health services in this part of the world and this can be accomplished by:
- Increasing urgency for providing the responsible care to patients seeking help for their mental health problems.
- Improving mental health literacy.
- Education and the role of mass media for creating awareness about mental health problems and their possible interventions.
- Psycho education/awareness for patients/ masses/ family members.
- Promote activities which would help to reduce the stigma.
- Care for rights of persons with mental illnesses.
- Awareness/ knowledge/ accessibility/ use of modern technology for the welfare of the patients and their care givers.
- The humanistic behaviour of the mental health care professionals towards the patients is also responsible for this changing scenario of patients.
- Provide empathy to patients.
Changing our attitude and our perspective about mental health can make the difference and can play significant role in bringing down the alarming rate of the mental illnesses and disability. People should give preference to mental health as they give to their physical health, as they say that there is no health without mental health.
As there are voices emerging from all quarters to priortize mental health for all, it should not just be a slogan to remembered on this very day or a week, it must be a continuous process and campaign so that the needy patients and their families’ miseries are addressed at the earliest.
