ccccccccccccccccccccccccccccc
cccc

c c
cccccccccccccccccccccccccccccccccccc
c c
 
c c
c 
ccc

ccccccc c
 c

Global community celebrated 18th world mental health day on Sunday 10 th October 2010.
Started in 1992 through the initiative of world federation of mental health (WFMH) it
provides an opportunity for a global & unified effort in promoting greater public awareness
& understanding of mental health disorders.

This year the theme for mental health day was^c c 


cc c c
 
cc c ͟ therefore urging increased availability of opportunity &
equitable treatment through primary health care services & facilities for those experiencing
mental health problems & chronic illnesses. As we identify non communicable diseases like
heart diseases, diabetes, cancer & respiratory diseases the new scourge, the relationship to
mental health is both intimate & unavoidable. The WHO (world health organisation) in a
recent report (Sep 2010) titled  ccc  ͟ propounds for integration
of mental health in development efforts like education & human production.

The bottom line is that c
c cc

c cccc
c c
  c
ccc c^

The mental health day 2009 focussed on the integration of mental health treatment
services with primary care, the major theme being to improve the capabilities of mental
health care system to detect & treat mental illnesses. This year it has been extended &
elaborated to the notion of integration of care focussing in the connection & relationship of
mental health & chronic illnesses. This year͛s theme comes in light as WHO has noted four
chronic illnesses cardiovascular, diabetes, cancer & respiratory illnesses responsible for 60%
of world͛s deaths. This has been the result of drastic increase in understanding the
relationship between these chronic illnesses & mental illnesses in the last two decades. The
outcome of the understanding is that we now know that persons with these chronic
illnesses have much higher rates of depression & anxiety than the general population. Major
depression among the persons suffering from chronic me dical conditions increases the
burden of their physical illness & somatic symptoms, thereby increasing functional
impairment & medical costs. The presence of mental health illnesses with long term
illnesses further impairs self care & adherence to treatment regions causing increased
mortality.

The bottom line here is that ͞many patients with chronic illnesses also suffer with
mental illnesses thereby leading to significant role impairment & work loss. They also
worsen the prognosis for heart dise ases, stroke, diabetes, HIV/AIDS, cancer & other chronic
illnesses.
 As per the mental health care proponents since physical health & mental health are
intertwined they have to be treated simultaneously through comprehensive health services
that address complicated medical issues.

While the theme for this year͛s mental health day has its own importance this only is not
the wholesale motive for the day. Apart from it the advocating on the access to issues of
facilities for treatment of mental health illnesses, awareness generation continue to be
pushed globally in order to minimize the number of people living with mental health
conditions and remove stigma; covering both preventive & curative aspects. Today world
over around 450 million people liv e with neurological or mental illnesses- 121 million live
with depression-3 in every 100 of every year. We have 1 million suicides & 10 million
attempts every year-while 1 in 3 of us visiting a primary care provider may have mental
health problem, only 1 i n 6 may be diagnosed as such. Such figures & conditions should
surely push policy makers to give mental illnesses & mental good health the priority it
deserves. However it only may not be enough, surely it is time that we give people with
mental health problems the respect, sympathy & the care that we would not hesitate to
give when the problems are physical. The people living with such conditions need to be
provided with essential social, moral & emotional support as well as the economic support
wherever the need exists. They need to be encouraged & informed about that mental
illnesses can be treated. Apart from it the general population & key contributors need also
be included more & more in the process. With advancement in medicine, science &
psychology and great support of family, friends & community today many mental health
problems can be treated. The message needs to be spread wherever needed & there can͛t
be a better day than this to plead for that. Similarly advocating on the requisite aspects for
concern at infrastructure & policy making level as well as awareness to general masses & for
removing stigma needs to be continuously pushed towards further development.

On mental health day the need to plead for a unified effort in area of mental health is
also very significant & important to our valley. The valley of Kashmir known for its tradition
of brotherhood, share & care religious & traditional practices, which was probably the
reason that the mental health problems were not too prominent here in the past. But the
two decades of turmoil & unrest left it changed drastically in every corner which not only
gave birth or increase to many other problems but also resulted in huge increase in number
of people living with mental health problems. On the one hand it brought a drastic increase
in the number of such people, on the other it either engulfed or declined equally the
traditional & cultural practices, structures and ways. This resulted in continuous encounter
of people of paradise with existing stress & psychological instability on the one side &
decline or extinction of such ways, practices & structures, which used to exist as copings and
promoters of social & psychological well being. Today due this condition accompanied with
problems of family, unemployment, relationship & marriage problems etc we see all sorts
mental health problems found among Kashmir population from schizophrenia to PTSD (Post
traumatic stress disorder), depression to anxiety disorders & an increase in level of suicid e
attempts. The theme for this year͛s mental health day does have importance in our context
as well as we also witness number of people suffering with such chronic physical illnesses.

All this messages us simply to continue the unified effort not only at the policy &
provider level but also at the society, community & individual level. Be it the need of
implementing NMHP (national mental health programme) properly & effectively, increased
efforts at the mental health care provider͛s level or incre ased awareness at the community
level. The much efforts are needed at the grass root levels for awareness on the causative,
promotive, preventive & curative aspects as well as in removing the stigma of mental health
with people as well with those who can act as stakeholders in the same. While the efforts at
policy and provider level are of crucial importance and must be pushed at all levels similarly
at community & individual level we must work to try to aware everyone about the
psychological & social well being so that not only the message is spread but also everyone
becomes equipped with such mental health education that tomorrow he must be able to
ask himself ͞
ccccc ^ whenever one feels the need, to deal with it
adequately & seek help adequately.

To help people come out of mental illnesses poses greater challenges to mental
health professionals as well as to people in Kashmir amidst an environment where the larger
stressor in the form of unrest continues to shadow us. The p resent unrest from June this
year is concerning in mental aspect arena as well. Within India the highest mental health
problems are found in Kashmir. Under an environment where people are continuously
losing their dear ones, people are getting injured and turning handicapped due loss of limbs
& eyes the fight with mental health becomes obviously more difficult for everyone. But
under such condition whatever can be possible we need to collectively work towards
helping people turning mental health to mental g ood health. In such case while the need at
policy maker and provider level is larger, on the community, society & family level
strengthening and reviving cultural and traditional practices and structures as well as other
promoters of total well being posses͛ equal importance in itself. Voluntary sector which has
been a significant contributor in this regard in the form of certain NGO͛s needs to come
forward with more coverage & much innovative ways in this regard. The need of the hour is
to spread the awareness & increased coverage in offering psychiatric & psychological
support. However where the need of rehabilitation or practical help exists mere psychiatric
& psychological assistance may not be enough, therefore allocating certain resources in
form of practical help or some level of livelihood will be of equal importance towards the
larger benefit of beneficiary-highlighting importance of integration of psychiatric &
psychosocial with economic & practical support . The organisations with such resources &
work need to come forward & work in a collaborative way for the larger benefit of the
beneficiary. The world mental health day appeals for such efforts from all those who can be
contributors.
 Owing to the continuous lack of awareness & stigma towards mental health the
education or awareness still holds the primary importance. For the dream of realising a
society of mental good health the first & foremost important will therefore be to continue
aware every individual about symptoms, causes, and ways of dealing and treatment of
mental health issues so that we all in time of need will be able to ask º
cccc
c
 ^