STC EXCLUSIVE: The Cassandra of Kashmir – Trauma, Toxins and Tragedies!
11 districts without a psychiatrist, 150 new addicts daily, 1 suicide every day—where are the healers when Kashmir needs them most?
Dr. Fiaz Maqbool Fazili
The engine idles. The handbrake is engaged. But the man inside the car cannot engage the one thing he needs most—courage. Outside the State-run Mental Health Clinic in one of Srinagar’s hospital, the morning rush is a spectacle of quiet despair. Patients spill onto corridors. Overworked doctors, drowning in files and prescriptions, summon the next name before the previous patient has even finished describing his nightmare. Inside that car, our man watches. His cousin works here as a clerk. His neighbour’s wife volunteers at the OPD. “Pagal khana,” they will whisper. The stigma is a straitjacket tighter than any illness. He needs time—an hour, or minimum half an hour not five or fifteen minutes. He needs privacy, not a fishbowl. He needs a healer who sees his face, not just his file number. He reverses the car. He drives away. This scene, repeated thousands of times across the Valley, is the defining metaphor of Jammu & Kashmir’s mental health collapse. We are not suffering a crisis; we are suffering a genocide of the spirit—and we are watching it happen in slow motion.
The Arithmetic of Abandonment: Let us speak the language the administration understands – numbers. As I started penning down looking for inputs what got from what is available in public domain. The government recently informed the Legislative Assembly that J&K has around 120 psychiatrists and 40 clinical psychologists. On paper, this sounds like infrastructure. Scratch the surface, and the paper turns to ash. Under the National Health Mission—the very arm meant to deliver grassroots care—the total number of deployed mental health professionals across all categories stands at a shocking 65. Worse, 11 districts—including Shopian, Bandipora, Kupwara, and even the winter capital Jammu—do not have a single psychiatrist posted. Zero. Meanwhile, the Institute of Mental Health and Neurosciences (IMHANS-K) dropped a bombshell in 2025: over 45% of adults in Kashmir are suffering from mental distress. At least one in five is clinically depressed, anxious, or trapped in the quicksand of PTSD. We carry three decades of conflict-induced intergenerational trauma, and we are trying to heal it with a homeopathic dose of healers.
The Poison Pipeline: When there is no one to listen, the wounded turn to poison. The drug addiction rate in J&K has metastasized into a parallel pandemic. Official estimates place the number of addicts at a staggering 13.5 lakh. Among them, over 1.68 lakh are minors—children who should be playing cricket, not chasing a vein. The ground reality is even more terrifying. IMHANS is reporting 150 new drug addiction cases every single day. Not a month. Not a week. Every day. As Prof. Dr. Mushtaq Margoob has hammered home in every seminar, conference, and podcast for the past two decades—untreated trauma and undiagnosed mental illness are the primary engines driving this addiction. We are not arresting a drug problem; we are witnessing a mass coping mechanism. And with only 40 clinical psychologists to counsel this avalanche, who will pull them back from the brink?
365 Reasons to Act: The ultimate tragedy is written in the obituary pages. In 2023, J&K recorded approximately 365 suicides. That is one life lost every single day. The leading cause? Unemployment and hopelessness, accounting for 178 deaths—a staggering 48% of the total. The administration’s response? Fencing bridges. Installing nets. How macabre is that? We are spending crores to catch bodies mid-air while doing nothing to heal the minds that walk towards the edge. A fenced bridge does not treat depression. A net does not generate self-worth. Only a trained psychiatrist, a compassionate psychologist, and a dignified livelihood can do that.
Invisible Epidemic, Empty Chairs: Is Kashmir facing a mental healthcare workforce crisis? The WHO Ratio vs. The Valley’s Reality: What The World Health Organization prescribes a minimum of three psychiatrists per 100,000 population. India, as a nation, limps at 0.75. But J&K, with its unique burden of trauma, demands double that standard. We need at least six per 100,000. We need clinical psychologists in every block, not just every district. We need psychiatric social workers who can follow up with families, not just take notes in an over-airconditioned office.
Instead, what do we have (data collected after careful search using reliable search engines? In one leading Srinagar hospital, 35 psychiatrists are propped up by just two clinical psychologists. These two are expected to mentor 16 M.Phil. scholars while simultaneously seeing patients. It is a factory of fast-food medicine, and mental health cannot be served in a drive-thru.
The Cassandra of the Valley: For over 35 years, Prof. Dr. Mushtaq Margoob has provided more than half a million consultations. In every seminar, every podcast, every conference, he has repeated the same haunting refrain: Kashmir is drowning in unaddressed trauma, and we have thrown it a paper straw. He has witnessed the five-minute consults, the stigma-driven dropouts, and the revolving door of drug relapses. He has pleaded for personalized care, for time, for dignity. Yet, his warnings have been treated as academic noise rather than medical emergencies.
The Helpline Illusion: The government points to Tele MANAS—a 24/7 helpline that has handled over a lakh calls. Let us be brutally honest: a helpline is a listening ear, not a healing hand. It cannot provide the long-term psychotherapy that a PTSD patient needs. It cannot substitute for the 30 clinical psychologists we are missing in the districts. It cannot hold the hand of a suicidal teenager mid-panic. It is a digital bandage on a haemorrhaging artery, and the administration knows it.
Parliament at its best—hope reignited—as the recent incisive debate on the escalating mental health crisis and the grievous shortage of trained experts has forged an unshakeable collective resolve. This urgent parliamentary scrutiny has galvanized a renewed determination to confront, head-on, the staggering demand-supply mismatch that has long crippled the nation’s mental healthcare framework, transforming procedural rhetoric into a tangible commitment for immediate action.
A Demanding Prescription for the Administration: If we are to stop the 365 annual suicides and the 13.5 lakh addiction cases, the state must move from symbolism to substance. This means filling the 11 district psychiatrist vacancies within the next 90 days and creating 200 new posts for clinical psychologists and psychiatric social workers, with mandatory rural rotations and hardship allowances to break the Srinagar-centric concentration. It means dismantling the assembly-line OPD rush by mandating 30-minute privacy-assured consultations for every first-visit patient, so that stigma—the greatest barrier to care—loses its power and the man in the car no longer feels the need to drive away.
Furthermore, the government must deploy dedicated mental health counsellors in every cluster of government schools to intercept trauma before it metastasizes into addiction, and commission at least 500 long-term rehabilitation beds with psychotherapeutic wings to match the 150 daily new addicts walking through IMHANS’ doors. Above all, the health budget must reflect this crisis—carving out a separate head with a mandated allocation of at least 5% of the total health outlay (currently languishing below 1%), subject to a public annual audit to track outcomes, not just expenditures.
This is our wake-up call. We need a war-footing recruitment drive—not just for psychiatrists, but for clinical psychologists, psychiatric social workers, and community health workers, with lucrative incentives for rural postings. We need to integrate mental health into every Primary Health Centre. We need massive, culturally-sensitive destigmatization campaigns in mosques, madrasas, and schools. But most of all, we need to admit that we have failed. We have failed the 13.5 lakh addicts, the 365 annual suicides, and the 45% of our population drowning in silence. The healers are missing. The patients are driving away. How many more engines must idle before we finally open the door?
The Verdict: Appreciating the government builds fences to catch bodies; it must now build systems to catch souls. The man in the car didn’t need a bridge—he needed a doctor who knew his name, a clinic that respected his dignity, and a society that didn’t judge his pain. The stigma ends when the healers arrive. The addiction ends when the therapists stay. The suicides end when the government cares as much about mental health as it does about concrete. That is the standard. The valley is waiting. The engine is still idling. The question is not whether we can afford this investment—the question is whether we can afford another year of this negligence. As Prof. Dr. Mushtaq Margoob has tirelessly argued, we are sitting on a ticking time bomb. The intergenerational trauma of three decades of conflict is manifesting as a public health emergency. We need a war-footing response. This is not just about hiring more doctors. It is about breaking the stigma, integrating mental health into primary care, fairly compensating and respecting clinical psychologists and social workers, and creating a system where a person in distress feels safe to seek help, not ashamed.
The valley needs to heal, but we cannot heal a population without healers. This is our wake-up call. Will we answer it, or will we keep driving away from the problem?
(Author is a member of Prof Dr. Mushtaq Margoob team working on preventive mental illness – Kashmir Glory Group program)
