Kashmir’s mental health emergency: The crisis nobody is treating

Credit By: Rising Kashmir Special Desk

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• 06 Apr 2026

A generation carries wounds that no X-ray can detect Govt must declare mental health a priority

There is a particular kind of suffering that leaves no visible mark. No broken bone. No fever. No swelling that a doctor can point to and name. It arrives quietly in the sleeplessness of a forty-year-old man in Sopore who watched his neighbour disappear in 1994 and never spoke of it again. In the inexplicable rage of a seventeen-year-old in Baramulla who was born after the worst years but inherited their weight through the silences at his dinner table. In the anxiety of a schoolteacher in Anantnag who flinches at loud sounds and does not know why, or cannot say.

Kashmir is carrying a psychiatric burden of historic proportions. And the institutions responsible for treating it are, in most regions, functionally absent.

The weight of three decades

The numbers, where they exist, are staggering. A landmark study conducted by Médecins Sans Frontières in collaboration with the Institute of Mental Health and Neurosciences in Srinagar found that approximately 45 per cent of the adult population in the Kashmir Valley showed symptoms of significant mental distress, anxiety, depression, and post-traumatic stress disorder at levels comparable to populations in active war zones, including Bosnia and Rwanda.

That study is not recent. The data is from 2006. Which means Kashmir has carried this finding for twenty years without a proportionate public health response.

More recent assessments have not improved the picture. The Global Burden of Disease study consistently ranks India among nations with the highest absolute burden of mental health disorders. Within India, conflict-affected populations carry disproportionate shares of that burden. Within conflict-affected populations, Kashmir stands in a category of sustained, multigenerational exposure that few regions anywhere in the world parallel.

The arithmetic is not complicated. Thirty-plus years of armed conflict. Tens of thousands of deaths. Thousands of enforced disappearances a category of loss so particular, so unresolved, that psychiatrists have developed specific clinical language for its psychological aftermath: ambiguous loss, named and documented by American psychologist Pauline Boss, who identified it as among the most psychologically destructive forms of grief precisely because it offers no closure, no body, no burial, no permission to mourn and move forward.

Half Widows, women whose husbands disappeared and were neither confirmed dead nor found alive, represent one of Kashmir's most invisible psychiatric populations. They exist in a permanent suspension of grief that conventional counselling frameworks were not designed to address.

The infrastructure of neglect

Against this weight of documented need, what has the state built? The Institute of Mental Health and Neurosciences IMHANS in Srinagar functions as Kashmir's primary dedicated psychiatric facility. It is a single institution serving a population of approximately seven million people across an extraordinarily difficult geography. Its waiting lists are long. Its specialist staff is under-resourced relative to caseload. And for the resident of Gurez, of Machil, of Drass, of any of the dozens of remote communities where trauma runs deepest, it might as well be on another continent.

District hospitals across J&K carry psychiatry as an afterthought, with a single doctor, often absent, in a consultation room that offers neither privacy nor adequate time. Primary health centres, the actual frontline of healthcare delivery for rural Kashmir, are almost entirely without trained mental health personnel. The gap between what exists and what is needed is not a gap. It is a chasm.

Bessel van der Kolk, in his essential work "The Body Keeps the Score", documents with neurological precision what trauma does to the human body when it goes untreated across years and decades. The brain literally restructures itself around unprocessed fear. The autonomic nervous system remains locked in states of hyperarousal. The capacity for trust, for intimacy, for learning, and for economic participation is all compromised by trauma that medicine has not reached. Van der Kolk's central argument is both clinical and moral: untreated trauma is not a personal failing. It is a public health emergency. And leaving it untreated is a choice a society makes. Kashmir has been making that choice, through successive administrations and governments, for thirty years.

The generation that inherited silence

There is a dimension to Kashmir's mental health crisis that conventional epidemiology struggles to capture: its intergenerational transmission.

Children born after the worst years of the conflict were not present for the killings, the crackdowns, the disappearances. But they were raised by parents who were. They grew up in households where certain topics were not discussed, where certain sounds produced reactions that were never explained, where grief had been so thoroughly suppressed that it had become indistinguishable from personality.

Psychiatrist Judith Herman, in Trauma and Recovery among the most important clinical texts ever written on the subject, documents how unaddressed trauma transmits across generations not through memory but through behaviour, through emotional unavailability, through the particular silences that traumatised parents maintain around their children. Kashmir's younger generation is not post-conflict. It is the second chapter of the same unfinished story.

What the government must do

The J&K administration has, in recent years, spoken frequently about development roads, connectivity, investment, and tourism. These are not irrelevant. But a population carrying the psychiatric weight that Kashmir carries cannot be fully productive, fully participatory, or fully at peace, regardless of road quality or hotel count.

Mental health must be declared a public health priority, not in policy documents that gather dust, but in budgetary allocations, in recruitment drives for district-level psychiatric staff, in mandatory mental health training for primary health centre workers, and in school-based counselling programmes that reach children before the weight becomes unmanageable.

Community-based mental health outreach reaching villages, reaching Half Widows, reaching former combatants and their families must be funded and deployed at scale. The National Mental Health Programme exists. Its implementation in J&K must be audited honestly and reformed urgently.

The conversation Kashmir has not had

Alongside institutional reform, Kashmir needs something that no government budget line can fully provide: permission.

Permission to speak. Permission to grieve. Permission to name what happened and acknowledge what it did, without that acknowledgement being read as political provocation or institutional threat. Healing is not sedition. Grief is not militancy. A society that processes its trauma openly is more stable, not less.

The most powerful mental health intervention available to J&K's administration costs nothing. It is the decision to stop treating Kashmir's psychological wounds as a security problem and start treating them as a human one.

The wounds are there. They have always been there. The question is whether we will finally look.

If you or someone you know is experiencing mental health distress, contact IMHANS Srinagar: 0194-2401284