Srinagar Dec 06 (KINS): The multiple lockdowns post abrogation of Article 370 on August 5, 2019 followed by Covid pandemic have taken a massive health toll on an already suffering population. Children in Kashmir are away from schools for over two years which has badly impacted their mental health.
Kashmir Indepth News Service (KINS) spoke to Dr Zaid Ahmad Wani, who is an eminent psychiatrist of Kashmir and also in-charge of the Child Guidance and Wellbeing Centre (CGWC) at the Institute of Mental Health and Neurosciences (IMHANS) of Government Medical College Srinagar. He shared that the stigma attached to mental illness is lowering over the years as we see increasing rush in our outdoor patient departments (OPDs).
KINS: If a child is suffering from post traumatic stress disorder (PTSD). How long does it take you to diagnose that child is suffering from PTSD?
Dr Zaid: According to set criteria, the child should have the symptoms of PTSD like nightmares, depression, emotional distress for more than a month to qualify for the diagnosis. A distress after a traumatic event is a normal expected reaction which can wean off over some time that explains a time gap of one month before labeling a trauma-exposed child with PTSD. We can also have delayed onset PTSD in which symptoms do not develop until six months. Cases have also been seen where there is a gap of many years between the trauma and onset of PTSD.
KINS: Are there any guidelines when it comes to prescribing medication for children on mental health.
Dr Zaid: We have broadly three approaches to the management of mental health disorders (MHD). 1: Pharmacotherapy (use of medicines) 2: Psychotherapy and 3: Combined approach. Each patient is individualized and assessed. If the illness is of lesser severity, psychotherapy most of the time suffices. However if it is more severe or psychotherapy fails we resort to drugs.
KINS: Any there are factors that also influence the treatment plan?
Dr Zaid: Many factors influence the treatment plan, like patient/parent preference. They may insist for psychotherapy only because they are skeptical about side effects or can’t afford medicines. Other times drugs may be the only choice because families cannot visit on regular basis
KINS: Are there any most common medications for children and what they do?
Dr Zaid: We use medicines of different classes depending upon the disorder of the child, so it’s not any specific drug that we use often.
KINS: Is there still a stigma around mental health in Kashmir? How does it play out for children in their families and surroundings? Are there any changes in mental health over the years?
Dr Zaid: The stigma is still attached to mental health in Kashmir. But we have witnessed the biggest change that is the approach of the general masses towards mental health. The stigmatization of MHD is seen to be lowering over the years as we see increasing rush in our outdoor patient departments (OPDs). People are opening up about their illnesses; their rights are being addressed now, although we have a long way to go
KINS: How has Covid-19 situation changed things, in addition to the conflict?
Dr Zaid: The COVID-19 pandemic has had a major effect on our lives. It has given rise to mental illness. The social distancing is necessary to reduce the spread of Covid-19 but also increase stress and anxiety as people feel isolated. There is a feeling of fear and sadness. The Covid has also impacted physical health in the form of weight gain.
KINS: What percentage of children in Kashmir who need mental health help?
Dr Zaid: The increasing stress and challenges in day to day is taking a toll on mental health and hence there is an overall rise in MHD who need help.
KINS: Can one say mental health for children in Kashmir is worsening or is it just that more are seeking help?
Dr Zaid: There is a rise in cases of mental illness. They are not just seeking help but suffering from various ailments. Now there is a change that people suffering from mental health ailments do not shy away from visiting a doctor and people take it like any other ailment. (KINS)