Conflict in the Indian Kashmir Valley II: psychosocial impact.

Hdl Handle:
http://hdl.handle.net/10144/40198
Title:
Conflict in the Indian Kashmir Valley II: psychosocial impact.
Authors:
de Jong, K; van der Kam, S; Ford, N; Lokuge, K; Fromm, S; van Galen, R; Reilley, B; Kleber, R
Journal:
Conflict and Health
Abstract:
ABSTRACT: BACKGROUND: India and Pakistan have disputed ownership of the Kashmir Valley region for many years, resulting in high level of exposure to violence among the civilian population of Kashmir (India). A survey was done as part of routine programme evaluation to assess confrontation with violence and its consequences on mental health, health service usage, and socio-economic functioning. METHODS: We undertook a two-stage cluster household survey in two districts of Kashmir (India) using questionnaires adapted from other conflict areas. Analysis was stratified for gender. RESULTS: Over one-third of respondents (n=510) were found to have symptoms of psychological distress (33.3%, CI: 28.3-38.4); women scored significantly higher (OR 2.5; CI: 1.7-3.6). A third of respondents had contemplated suicide (33.3%, CI: 28.3-38.4). Feelings of insecurity were associated with higher levels of psychological distress for both genders (males: OR 2.4, CI: 1.3-4.4; females: OR 1.9, CI: 1.1-3.3). Among males, violation of modesty, (OR 3.3, CI: 1.6-6.8), forced displacement, (OR 3.5, CI: 1.7-7.1), and physical disability resulting from violence (OR 2.7, CI: 1.2-5.9) were associated with greater levels of psychological distress; for women, risk factors for psychological distress included dependency on others for daily living (OR 2.4, CI: 1.3-4.8), the witnessing of killing (OR 1.9, CI: 1.1-3.4), and torture (OR 2.1, CI: 1.2-3.7). Self-rated poor health (male: OR 4.4, CI: 2.4-8.1; female: OR 3.4, CI: 2.0-5.8) and being unable to work (male: OR 6.7, CI: 3.5-13.0; female: OR 2.6, CI: 1.5-4.4) were associated with mental distress. CONCLUSIONS: The ongoing conflict exacts a huge toll on the communities' mental well-being. We found high levels of psychological distress that impacts on daily life and places a burden on the health system. Ongoing feelings of personal vulnerability (not feeling safe) were associated with high levels of psychological distress. Community mental health programmes should be considered as a way reduce the pressure on the health system and improve socio-economic functioning of those suffering from mental health problems.
Issue Date:
14-Oct-2008
URI:
http://hdl.handle.net/10144/40198
DOI:
10.1186/1752-1505-2-11
PubMed ID:
18854027
Type:
Article
Language:
en
ISSN:
1752-1505
Appears in Collections:
Mental Health

Full metadata record

DC FieldValue Language
dc.contributor.authorde Jong, K-
dc.contributor.authorvan der Kam, S-
dc.contributor.authorFord, N-
dc.contributor.authorLokuge, K-
dc.contributor.authorFromm, S-
dc.contributor.authorvan Galen, R-
dc.contributor.authorReilley, B-
dc.contributor.authorKleber, R-
dc.date.accessioned2008-11-04T09:58:42Z-
dc.date.available2008-11-04T09:58:42Z-
dc.date.issued2008-10-14-
dc.identifier.citationConflict in the Indian Kashmir Valley II: psychosocial impact. 2008, 2 (1):11notConfl Healthen
dc.identifier.issn1752-1505-
dc.identifier.pmid18854027-
dc.identifier.doi10.1186/1752-1505-2-11-
dc.identifier.urihttp://hdl.handle.net/10144/40198-
dc.description.abstractABSTRACT: BACKGROUND: India and Pakistan have disputed ownership of the Kashmir Valley region for many years, resulting in high level of exposure to violence among the civilian population of Kashmir (India). A survey was done as part of routine programme evaluation to assess confrontation with violence and its consequences on mental health, health service usage, and socio-economic functioning. METHODS: We undertook a two-stage cluster household survey in two districts of Kashmir (India) using questionnaires adapted from other conflict areas. Analysis was stratified for gender. RESULTS: Over one-third of respondents (n=510) were found to have symptoms of psychological distress (33.3%, CI: 28.3-38.4); women scored significantly higher (OR 2.5; CI: 1.7-3.6). A third of respondents had contemplated suicide (33.3%, CI: 28.3-38.4). Feelings of insecurity were associated with higher levels of psychological distress for both genders (males: OR 2.4, CI: 1.3-4.4; females: OR 1.9, CI: 1.1-3.3). Among males, violation of modesty, (OR 3.3, CI: 1.6-6.8), forced displacement, (OR 3.5, CI: 1.7-7.1), and physical disability resulting from violence (OR 2.7, CI: 1.2-5.9) were associated with greater levels of psychological distress; for women, risk factors for psychological distress included dependency on others for daily living (OR 2.4, CI: 1.3-4.8), the witnessing of killing (OR 1.9, CI: 1.1-3.4), and torture (OR 2.1, CI: 1.2-3.7). Self-rated poor health (male: OR 4.4, CI: 2.4-8.1; female: OR 3.4, CI: 2.0-5.8) and being unable to work (male: OR 6.7, CI: 3.5-13.0; female: OR 2.6, CI: 1.5-4.4) were associated with mental distress. CONCLUSIONS: The ongoing conflict exacts a huge toll on the communities' mental well-being. We found high levels of psychological distress that impacts on daily life and places a burden on the health system. Ongoing feelings of personal vulnerability (not feeling safe) were associated with high levels of psychological distress. Community mental health programmes should be considered as a way reduce the pressure on the health system and improve socio-economic functioning of those suffering from mental health problems.en
dc.languageENG-
dc.language.isoenen
dc.rightsArchived via Open Access with thanks to Conflict and Healthen
dc.subjectmental healthen
dc.subjectconflicten
dc.titleConflict in the Indian Kashmir Valley II: psychosocial impact.en
dc.typeArticleen
dc.identifier.journalConflict and Healthen

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