Violence has fallen in revolt-hit Indian Kashmir, but people are starting to show signs of serious trauma after nearly 20 years of insurgency against New Delhi's rule, doctors say.
Increasing numbers of people are complaining of mental health problems, say doctors in the breathtakingly beautiful region, known as the "Switzerland of the East" before the Islamic separatist insurgency erupted in 1989.
Advertisement"There's an alarming mental health crisis," leading psychologist Arshid Hussain told AFP as he ushered into his office at the state-run Kashmir Psychiatry Hospital a woman whose husband was recently shot dead by gunmen.
"The violence has dropped but the flow of people seeking psychiatric help gets higher each day," he said. "I'm getting an increasing number complaining of insomnia, nightmares, anxiety and unexplained pains."
The insurgency in the flashpoint South Asian region was long ranked as one of the world's most deadly, but now has been eclipsed by other trouble spots.
The number of daily revolt-related deaths involving soldiers, civilians and rebels now stands at two, still high but down from 10 a day in 2001.
Part of that decline has been attributed to a slow-moving peace process that began four years ago between India and Pakistan. The Himalayan region is held in part by each but claimed in full by both.
Still, while 43,000 people have died by official count, thousands more have suffered mentally after narrowly escaping death in blasts, being wounded or discovering that loved ones have been tortured or killed in the conflict.
"Thousands of people have suffered trauma because they've seen killings, explosions and other forms of violence," said Pervez Masoodi, a doctor at a small government-run hospital in Chadoora, a 45-minute drive from Srinagar.
"Villagers come in droves to seek help for their traumas, but we can't do much as we're under-staffed," says Masoodi. "The psychiatric care crisis needs to be urgently addressed. We need counselling centres across the state."
Casual conversations with Kashmiris quickly turn to stories of relatives killed, of near-misses in bomb attacks and anonymous threatening telephone calls.
The scale of the psychiatric problem is evident in the numbers.
At the state's lone state-run psychiatric hospital in Srinagar, doctors registered more than 60,000 patients last year compared with just 1,500 patients in 1989, the year the insurgency began.
But the figure only represents the tip of the iceberg. Many do not visit mental health experts because of the huge stigma attached to mental illness.
Mushtaq Margoob, another leading psychiatrist, estimated one million people -- ten percent of Kashmir's population of 10 million -- has suffered from some form of depression, with a number displaying suicidal tendencies.
Doctors say the biggest problem in offering treatment is a lack of facilities as the one state-run psychiatric hospital cannot cope with the numbers. There are some private clinics but too few and only available to those with sufficient means.
"Mental health services are dangerously inadequate," Hussain said at the hospital, turning to ask another woman who lost her husband and son in a 1996 bomb blast how she was faring.
"I've been visiting a private clinic for psychological help," said Mehbooba Akhter, whose husband died in a blast several years ago. "I've often thought of ending my life but I keep going for the sake of my daughter who's just 11.
Experts say they are particularly concerned about children, as many parents are reluctant to bring them in for counselling in case neighbours find out.
Mirwaiz Umar Farooq, the region's main Muslim cleric and leader of a moderate separatist alliance, also said he has noted people, especially the young, seem more tense.
"It's difficult preaching to an angry audience, to bring them some kind of solace," said Farooq, whose father was shot dead in 1990 by unidentified gunmen.
"We need to find a political solution to the Kashmir dispute to end all these traumas."