War, violence and the mental health crisis in Kashmir


Warning: This article contains content that readers may find distressing.

As tensions continue to rise in Kashmir after the Pulwama terror attack of February 2019 where over forty military personnel lost their lives, fear has, once again, gripped the Valley of Kashmir. Over four hundred separatists are claimed to have been arrested and local political organisations have been  banned by the Indian central government.

The general population of Kashmir are stuck in a cyclical pattern of mass local protests, state sanctioned military crackdowns, gun battles (between police and the few remaining rebels), local calls for statewide shutdowns and Indian government imposed curfews. Decades of violence and conflict have taken a huge toll on the mental health of those living in the Kashmir Valley. Mental health experts note a rise in symptoms of psychological distress such as anxiety and suicide.

The mental health burdens of this militarisation is reflected in interviews conducted by Medecins Sans Frontieres (MSF) in two conflict affected rural districts of Kashmir between 1989-2005. During this period, one in ten people reported having lost one or more members of their immediate family to the violence. A third had lost extended family members. Just under half of those interviewed reported that they were unhappy to the extent that they had suicidal thoughts (33.9%). On average, an adult living in the Kashmir Valley has witnessed or experienced 7.7 traumatic events during his/her lifetime and approximately 70% adults had witnessed the sudden or violent death of someone they knew. (1,2)

The highest estimates of depression, anxiety and PTSD were significantly higher in women than men. Nearly 30% of Kashmiri adults use tobacco – one person in half of all Kashmiri households- as a coping strategy. People were seen dealing with stress by isolating themselves or becoming aggressive which are considered typical coping mechanisms when exposed to violence. Whilst the people interviewed believed talking confidentially to someone they trust was helpful when confronted with tension (89.4%), over two-thirds (68%) did not know what counselling is.(3) The great levels of suicidal ideation in such strong Muslim communities was flagged by the MSF researchers as “a worrying indicator of the level of despair and hopelessness” (1). The chronic violence from the conflict has resulted in a 33% increase in mental health problems (3).

While mental health is a now well-recognised condition in Jammu and Kashmir, services remain thin. In areas where MSF operates, community based mental health services have been implemented. In all other Kashmiri districts community-based mental health services are almost non-existent, despite the intentions set out in the Indian Mental Health Policy to implement such services(1).  

Picturesque Kashmir:  world’s most militarised zone  (photo credit: @kashmirthroughmylens)

History of the conflict

The people of Kashmir are survivors of a long, enduring and internationally under-reported conflict. In 1989, the conflict took a turn towards armed insurgency, in the aftermath of an allegedly rigged local election, which the Kashmiri people believed robbed them of their voice in the Indian democratic process.  As a result, more than half the population of Jammu and Kashmir has been subjected to or witnessed violent government crackdowns, public explosions and cross firing between military personnel and armed rebels in the decade that followed the insurgency(4). The extent and  violence of the conflict has been overwhelming, with reports estimating enforced disappearances of 8,000-10,000 Kashmiri people (with over 7,000 unmarked mass graves discovered), over a 100,000 extra-judicial killings and more than 10,700  gang-rapes and cases of sexual abuse(4)

The past two decades, which saw the squashing of the Kashmiri armed insurgency by Indian security forces, has not resulted in the cessation of hostilities. The number of armed militants, which are estimated to be around the one hundred mark, are met with by a military might which is 770,000 strong; making Kashmir the most militarised zone in the world. The decade that followed the armed insurgency gave birth to a youth who chose to engage in peaceful protests against what they believed to be the military occupation of Kashmir, but were met with the same kind of brutality by the Indian military as was witnessed by the rebels before them.

The history of the conflict is rooted in the partition of the Indian subcontinent in 1947; and example of one of the bloodiest and largest mass migrations of people in modern history. Jammu and Kashmir, a Muslim majority state, ruled by oppressive Dogra maharajas since the Treaty of Amritsar in 1847, became a bone of contention between the newly formed nations of India and Pakistan. The state’s strategic and economic importance led to persuasive, bids by both India and Pakistan, for the annexation of Kashmir into their respective territories.

The two countries have fought three successive wars over Kashmir in 1948, 1965 and 1999,but the political status of Kashmir remains unresolved.(5)The fragile “line of control” between Pakistan and India’s northern borders runs through the middle of Kashmir, giving Pakistan control of 30% of the original state consisting of Gilgit and Baltistan and Azad Jammu & Kashmir whereas India has control of 40% of the state including Kashmir Valley, Jammu and Ladakh. The longevity of this conflict is rooted in the accession of the state of Jammu and Kashmir by its Hindu leader to India, a move contested by Pakistan in light of the state’s Muslim majority. The Kashmiri people, on the other hand have suffered long standing resentment towards India due to never receiving the plebiscite to decide their own fate, as promised by the first Prime Minister of India, Jawaharlal Nehru and as envisioned in a UN resolution in 1948. Successive governments of Pakistan point towards the great injustice afforded the Kashmiri people by disallowing them the promised plebiscite, the outcome of which Pakistan is confident would result its favour whilst the Indian state argues that Pakistan supports terrorism in Kashmir meant to damage India and worsen the relations between the government of India and the Kashmiri people. The Kashmiri people themselves remain divided between wishing to join Pakistan and forming an independent secular state of their own.(5,6,7)

The most recent uprising occurred in 2016 – after the murder of a charismatic 22-year-old insurgent called Burhan Wani, which led to another round of human right atrocities by the Indian army. The Human Rights Report for Indian-Controlled Kashmir, published in 2016 reports:

“Apart from the basic history of 1947, incidents of the past like massacres of Bomai-Sopore, Gowakadal, Kulgram, Zakoora, Tengpora, Bijbera etc.., torture and sexual violence, gang rapes (like in Kunan poshpora hamlet, Tabinda rape and murder case, Asiya-Nilofar rape andmurder), draconian laws (like AFSPA and PSA), fake encounters, extra judicial killings, disappearances, so on and so forth have been pushing people from time to time to voice for Azadi (freedom), and that voice grows louder each passing day” (4)

The Armed Forces Special Powers Act (AFSPA) and Public Safety Act (PSA) enable the Indian military to carry out any search operation without a warrant, arrest or shoot to kill any person with or without reason, whilst also allowing security forces to detain and torture citizens without following normal legal procedures. Both said laws protect any military personnel from being prosecuted for their actions despite international pressure from Human Rights Watch and Amnesty International – AFSPA and PSA have not been revoked in Kashmir.(8) Due to the undemocratic nature of these laws, there have been around 10,000 enforced disappearances in the region since 1980; countless arbitrary arrests and illegal detentions; injuries due to excessive force against peaceful protests; assaults on health services/aid workers; sexual violence; media gags/ attacks on media professionals; restriction on religious activities and blockades on communication services.(4)

Towards a just solution

To meet the growing mental health needs of the Kashmiri population, a comprehensive mental health plan involving all relevant community institutions would be a good place to start. The long-term solution necessitates a holistic response, which tackles the factors in the political environment that contribute to mental ill health. The Kashmiri people, whose lives are lived on a knife’s edge, see little hope for a resolution of a conflict that has engulfed their collective memory; the hope for peace and security ever elusive.

Kashmiri Professor of International Law Sheikh Shaukat Hussain laments

“we have been telling and re-telling our accounts to anyone who will listen, knowing full well that nothing will emanate from these conversations. There is a sort of hopelessness we feel when we search for any remedy within your system” (10) .

As the media focus on the tensions between India and Pakistan and the potential of a nuclear war, it is ironic that the plight of those at the heart of the conflict is ignored. It is our responsibility as the international community to listen to Kashmiris, amplify their voices, show solidarity and ensure that their needs are centred in all conversations about a resolution to this decades-old conflict.

This article is part of a blog series drawing attention to overlooked conflict zones. The series examines man-made disasters, which despite causing years of human suffering and environmental degradation rarely receive any media or policy attention. Send us your suggestions or get in touch if you would like to write about conflict areas you believe are overlooked by the world.


  1. Fromm S, Galen R Van, Kemmere T, Ford N. Kashmir : Violence and Health. 2006 [cited 2017 Oct 25];(November). Available from: https://ru.msf.org/sites/russia/files/migrated/KASHMIR_FINAL_VERSION,_221106.pdf
  2. MSF. Research summary [Internet]. Kashmir Mental Health Survey 2015. 2015 [cited 2017 Oct 30]. Available from:https://www.msfindia.in/sites/india/files/research_summary.pdf
  3. De Jong K, Kam S, Ford N, Lokuge K, Fromm S, Van Galen R. Conflict in the Indian Kashmir Valley II: psychosocial impact. Confl Health [Internet]. BioMed Central; 2008 Oct 14 [cited 2017 Oct 30];2(1):11. Available from: http://conflictandhealth.biomedcentral.com/articles/10.1186/1752-1505-2-11
  4. Wani M, Asim A. Human Rights Report 2016 – Indian Occupied Kashmir [Internet]. 2016 [cited 2019 Feb 6]. Available from: https://drive.google.com/file/d/0B2TtY2QDnK2idlZITjVqd3RLdmc/view
  5. Behera NC. Demystifying Kashmir. Identity. 2006. 187-205 p.
  6. Schofield V. Why Kashmir is still important. Asian Aff (Lond) [Routledge; 2015 Jan 2 [cited 2017 Nov 21];46(1):18–31. Available from: http://www.tandfonline.com/doi/abs/10.1080/03068374.2014.994961
  7. Ghate P. Kashmir: The Dirty War. Econ Polit Wkly [Internet]. 2002;37(4):313–22. Available from: http://www.jstor.org/stable/4411657
  8. Haji M. Killing One Colonial Law at a Time – After Section 377, It’s Time to Repeal AFSPA [Internet]. The Wire; 2018 [cited 2019 Feb 22]. p. 1. Available from: https://thewire.in/law/repealing-afspa-colonial-law-northeast-jammu-kashmir
  9. Price G. Is India Getting Serious About Dialogue in Kashmir? | Chatham House [Internet]. Chatham House: The Royal Institute of International Affairs. 2017 [cited 2018 Jan 20]. p. 1. Available from: https://www.chathamhouse.org/expert/comment/india-getting-serious-about-dialogue-kashmir
  10. Mohan D, Mander H, Singh N, Philipose P, Bose T. Unending trauma: The heavy toll of ongoing violence on mental health in Kashmir. In: Blood, Censored: When Kashmiris Become the ‘Enemy’ [Internet]. Yoda Press; 2018 [cited 2019 Mar 6]. Available from: https://scroll.in/article/888123/unending-trauma-the-heavy-toll-of-ongoing-violence-on-mental-health-in-kashmir