A comprehensive mental health project providing quality psychological counseling, social interventions, substance abuse management and de-addiction in Kashmir Valley.
- quality psychological counseling,
- -socio-economic interventions,
- substance abuse management and de-addiction in Kashmir Valley
Around the world, psychiatric disorders are among the leading causes of illness and disability. Annually, over 450 million people globally experience mental health disorders, but few seek access to services.
IMHANS, in Srinagar, has experienced an increase in outpatient presentations, from an average of 100 per week in 1980 to 850 per week in 2016.
Kashmir Mental Health Survey 2015 conducted by Médecins Sans Frontières in collaboration with Institute of Mental Health and Neurosciences, Kashmir and Kashmir University was the first mental health survey conducted in all 10 districts of the Kashmir Valley.
Key Findings of the KMH Survey
- 8 million (45%) adults in the Kashmir Valley have significant symptoms of mental distress.
- Approximately 1.6 million adults (41%) in the valley are living with significant symptoms of depression, with 37% of adult males and 50% of females suffering from probable depression and 415,000 (10%) meeting all the diagnostic criteria for severe depression.
- An estimated 1 million adults (26%) in the valley are living with significant symptoms of an anxiety related disorder.
- Nearly 1 in 5 adults (19%) or 771,000 individuals in the Valley are living with significant PTSD symptoms, with 248,000 (6%) meeting the diagnostic criteria for PTSD.
- High rates of co-morbidity of symptoms of depression, anxiety and PTSD were found in adults living in the valley.
- The districts of Baramulla and Budgam reported the highest prevalence rates of symptoms for all three mental disorders.
- Bio-medicalisation of mental health care and treatment is supported by findings from the survey which showed that 11% of Kashmiri adults were taking benzodiazepines.
Their findings confirm a serious mental health situation, with highly prevalent common mental disorders and distress having continued to increase to reach epidemic levels.
Common Substances of Abuse:
Medicinal opioids 65.7%
Benzodiazepines 45.5%, other prescription medications 43.4%
Poly-substance abuse was found in 91.9% of the studied patients. Inhalant use was seen pre-dominantly among adolescents 54.5%; whereas nicotine 50.2%, cannabis 49.2%, alcohol 51.1%, opioids 58.4%, and benzodiazepines 53.48% were more pre-dominant in the age group of 21 to 30 years.
According to the database of GMC, Srinagar and Associated Hospitals, the number of patients with substance use visiting OPD in the year 2016-2017 was 6157 and between Jan 2017 and Dec 2017 it was 6550. At the Community Centre, SMHS Complex, the number of patients with drug dependence admitted in the year 2016-2017 was 535 and between 2017-2018 it was 710. The number of admitted patients from Srinagar were 185, followed by Budgam(43), Baramulla(40), Anantnag(39), Kupwara(25), Pulwama(24), Shopian(15}, Bandipora(14), Kulgam(11) and Ganderbal(11)
KASHMER, in association with its ground partner, HELP and an advisory team of local and international experts, including psychiatrists, clinical psychologists, public officials, will create a network with a central hub and satellite centres, providing comprehensive psychologic and behavioral health services, such as quality counseling, psychotherapy including cognitive behavioral therapy, stress management techniques, among others.
Also an outpatient hub will be set up at for detoxification, relevant counseling, support and rehabilitation.
These centres will work closely with existing secondary and tertiary facilities in place in the Valley for the maximum benefit to the patient.
- Working with local partners, we aim to decentralise nonpharmacologic psychiatric care and strengthen existing mental health care services to address the gaps in availability and access to care at a community level.
- We will provide much needed alternate, affordable-free of cost, accessible psychologic counseling, therapy-individual and family, socioeconomic intervention in various districts, starting with a pilot that will then help formalize a design for the larger district wise project in Kashmir Valley. This will be implemented on a schedule and a plan as worked out with the local partners and would vary from time to time depending on the size and ease of access of the district being served at the given time.
- Promotion of collaboration amongst stakeholders to create a holistic response for the prevention and care of mental distress.
- Investment in human resource development through robust processes of recruitment and training for quality and expert psychological counseling, and therapy.
- Cross referral and collaboration at all levels and functions of the existing health structure, specifically referral to the existing primary, secondary and tertiary MHS in place
- Increased awareness and sensitization among the community
Devise rehabilitative measures, including vocational skill training, for people recovering from drug addiction.
- Encourage health promoting activities which decrease substance use. These are on decline in general among the younger generation in comparison to the past but especially in Kashmir, particularly outdoor sports.
- Increase awareness about the harm and addictive potential of various substances like solvent, cannabis, smoking etc. in the young and in the communities for easy identification for early intervention.
- Create a preventive model, to address substance use including the involvement of community personnel especially targeting educational institutions.
- Education is an important part of any KASHMER project. We will make new partners on the ground and long term be involved in Education efforts through ERT with local doctors for sharing of expertise in this and other specialties.