It was a call at midnight. A counsellor psychologist at the Tele Mental Health Assistance Centre Srinagar picks up the call.
"The caller had irresistible ideas to self-harm. He wanted to end his life and before that, he wanted to talk to someone about it,바카라 says Areej Khalid, the counsellor at the Tele Mental Health Centre in Srinagar.
The Centre is located at the old building of the Institute of Mental Health and Neurosciences in Srinagar (IMHNS), previously called the Psychiatric Disease Hospital. The toll-free phones at the centre are buzzing, counsellors picking them up, some talking to them in Kashmiri and some in Urdu, advising the callers what to do.
That night Khalid heard the caller. 바카라He was in terrible pain,바카라 she says during her 30-minute break.
"I used techniques I learned during my training to achieve pause in him. I tried to create a momentary interruption to break the cycle of self-harm thinking. I am grateful that I succeeded," she says.
"I was able to take him to the safety of his family's supervision," she says. She guided him to a nearby mental health facility for further treatment and it all happened on through a call.
Later when the person called again, the crisis was over and he had started following a psychiatrist and is on weekly cognitive behavioural therapy sessions with the centre.
바카라The midnight calls are mostly about crisis situations with many youngsters talking about self-harming or having such thoughts,바카라 says Khalid.
The Tele Mental Health Centre Srinagar since its establishment in October 2022 has received nearly 12,500 calls related to mental health disorders. These include around 500 바카라crisis interventions" in people having self-harming ideas.
The centre has a three-tier system in place. The first line is of counsellors, who receive calls from people having depression, anxiety disorders, substance abuse disorders, exam stress and other anxiety issues.
The counsellors are all psychologists. The typical session lasts around 30 minutes but some sessions take more time.
In case the counsellors feel that any caller needs a psychiatrist바카라s advice, they transfer a call to a psychiatrist or a clinical psychologist on call. The third tier of the system is the Institute of Mental Health and Neurosciences in Srinagar (IMHNS).
바카라It started slowly but now we receive around 100 calls in a day and most of these calls are from women,바카라 says Khalid, who like other counsellors has been trained at the National Institute of Mental Health and Neuro-Sciences Banglore and IMHANS Srinagar. She says if the counsellor comes to the conclusion that the caller needs medicine, or having a recurring panic attack, the counsellor transfers the call to the psychiatrist or clinical psychologist on the call.
While 70 per cent of mental health distress calls are handled by the counsellors themselves, 30 per cent of calls are escalated to the consultants.
바카라Most of the calls are stress related. We also get calls from those persons already diagnosed with mental disorders like anxiety and OCD,바카라 says Suriya Sanam, another counsellor.
The calls also reflect the prevailing mental health situation in Kashmir. There has been a rise in mental health cases in Kashmir in the past thirty years of conflict.
According to a study 바카라Mental health in Kashmir: conflict to COVID-19바카라 45% of Kashmir's adult population (1.8 million) is suffering from some form of mental distress. There is a high prevalence of depression (41%), anxiety (26%), post-traumatic stress disorder (19%), and 47% had experienced some trauma.
바카라Our counselling is affordable and we are just a call away. That might be the reason people feel it much more secure to call and confide to us,바카라 Sanam says. She says that the highest number of calls revived in a day was 160 when an advertisement about the Tele Mental Health services had come up in widely circulated local English daily of Kashmir.
바카라We also get calls from persons involved in substance abuse. We receive such distressing calls during the night hours,바카라 says Sanam.
Over the years Kashmir has seen a spike in substance abuse cases and the government is considering drug abuse as one of the serious issues.
According to the latest survey, 바카라Prevalence and Pattern of Substance Use Disorders in Ten Districts of Kashmir바카라 carried out by the IMHANS, Kashmir, the Valley has an estimated sizable population of 67 468 substance-dependent individuals. While opioid dependence prevalence in all the 10 districts of Kashmir is 2.23% and the total number of opioid dependents is estimated to be 52 404 in the Kashmir valley making it an epidemic.
At the Tele Mental Health Assistance Centre of Srinagar, 19 counsellors are on the job in different shifts throughout the week catering to different calls. All these counsellors are women.
Dr Patley Rahul, an Assistant Professor at the NMHANS Banglore, says people who call the centre and open up about their self-harm thoughts are the most important calls. 바카라These are the kind of patients who need attention and care. The suicidal thoughts are fleeting thoughts. These thoughts stay unless there is some intervention done,바카라 he says.
바카라In this respect, Srinagar centre is doing exceptionally well,바카라 he says.
바카라When someone is in distress they want a listening ear. This calms them down and also motivates them to avail the psychiatric services. That is the whole idea of Tele Mental Health services,바카라 he adds.
The Srinagar centre is now considered a model centre among 22 centres. These centres are coordinated by the National Institute of Mental Health and Neuro-Sciences a medical institution in Bangalore.
Dr Rahul says the data of Srinagar Centre is impressive. 바카라How the counsellors have handled nearly 500 suicide calls shows their competence,바카라 he adds. 바카라We are thinking to replicate this model in other centres of the country,바카라 Dr Rahul says.
The Tele Mental Health service concept came after Covid-19 in 2020 lockdown when everything was shut and availing of medical facilities became a tough challenge. In October 2023 the concept took shape after the government of India under NHRM opened these centres in 22 states across India. Of 22 centres, the Centre at the IMHNs is the only centre that is fully functional.
Dr Arshad Hussain, professor at the Institute of Mental Health and Neurosciences in Srinagar (IMHNS), says the past six months' performance of the Tele Mental Health Service has two messages, quantitative and qualitative.
바카라The quantitative statement is nearly 12500 people have sought help regarding mental health issues second highest in the country meaning thereby that this mode of Mental Health delivery has acceptance in our society. And qualitatively these calls have a life-saving potential statement as pause has been achieved and these people have been linked to mental health services," he says.
"They definitely have chances of better outcomes if comprehensive safety plan and treatment is done following a pause," he says.
While he concedes that the tendency to self-harm is a very complex problem and a mere pause is not enough, he says, "We need to treat underlying mental health issues in many of them to save lives.바카라
"We have been able to link most of them to the nearest mental health service and pause can act as mental health first aid for such people," Dr Hussain says.
바카라We are able to give first aid. We are able to achieve linkages. There are people who don바카라t know where to go. We guide these people to avail mental health facilities. Thus we create linkages,바카라 he says.
Dr Hussain says initially women callers outnumbered men but now men are catching up as well. "Our centre is unique in the whole of India with more female callers. It is in sync with what we see at OPD at the hospital. Most of our patients are women,바카라 he says.
Besides, as the counsellors are women, women prefer to call them. 바카라Maybe they feel more empathy and maybe through word of mouth they ask others to avail of such services,바카라 says Khalid smiling.
